Angela M Caliendo

Alpert Medical School - Brown University, Providence, Rhode Island, United States

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Publications (170)649.52 Total impact

  • Journal of Clinical Microbiology 02/2015; · 4.23 Impact Factor
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    ABSTRACT: The recent development of the 1st WHO International Standard for human cytomegalovirus (CMV) and introduction of commercially produced secondary standards has raised hopes of improved agreement among laboratories performing quantitative CMV PCR. However, data are lacking to evaluate the trueness and uniformity of secondary standards and the consistency of results achieved when these materials are run on various assays. Three concentrations of each of three commercially prepared secondary CMV standards were tested in quadruplicate by three real-time and two digital PCR methods. Mean results were compared in a pairwise fashion with nominal values provided by each manufacturer. Agreement of results among all methods was also assessed for each sample and for like concentrations of each standard. The relationship between nominal values of standards and measured values varied depending upon assay used and manufacturer of standards, with the degree of bias ranging from +0.6 to -1.0 log10(IU/ml). The mean digital PCR result differed significantly among the secondary standards, as did the results of real-time PCR, particularly when plotted against nominal log10IU values. Commercially available quantitative secondary CMV standards produce variable results when tested by different real-time and digital PCR assays, with varying magnitudes of bias compared to nominal values. These findings suggest that the use of such materials may not achieve the intended uniformity among laboratories measuring CMV viral load, as envisioned by adaptation of the WHO standard.
    Journal of Clinical Microbiology 02/2015; · 4.23 Impact Factor
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    ABSTRACT: For developing countries, sexually transmitted infections (STIs) and their complications are ranked in the top 5 disease categories for which adults seek medical treatment. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) are the three most common STIs worldwide, with TV accounting for over half of the cases. In developing countries, traditional methods for diagnosing STIs are laborious, often not very sensitive, and have a long turnaround time with most recent commercially available diagnostic tests targeting one or, at most, two of these STIs at a time. Here, we describe the development of a highly sensitive, rapid and affordable sample-to-answer multiplex PCR-based assay for the simultaneous detection of Trichomonas vaginalis, Neisseria gonorrhoeae, and Chlamydia trachomatis.
    Experimental and Molecular Pathology 01/2015; 98(2). DOI:10.1016/j.yexmp.2015.01.011 · 2.88 Impact Factor
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    ABSTRACT: Objective:To evaluate the efficacy of a brief, phone counseling Prevention Maintenance Intervention (PMI) to sustain STI/HIV-preventive behaviors and reduce incident STIs over a 36-month follow-up. Design:A two-arm randomized controlled supplemental treatment trial Setting:Three clinics in Atlanta, Georgia. Participants:African-American adolescent females, 14-20 years, (N=701). Intervention:Participants in the experimental condition received an adapted CDC-defined evidence-based STI/HIV intervention (HORIZONS) and a PMI consisting of brief, tailored phone counseling every 8 weeks over 36-months. Comparison condition participants received HORIZONS and a time- and dose-consistent PMI focused on general health. Main Outcome Measure(s):Primary outcomes were proportion of participants with a laboratory-confirmed chlamydial or gonococcal infection. Behavioral outcomes include: (1) proportion of condom-protected sex acts (2) number of sexual episodes in which participants engaged in sexual intercourse while high on drugs/alcohol, and (3) number of vaginal sex partners. Results: Over 36-months follow-up, fewer participants in the experimental condition had incident chlamydial (94 versus 104; RR = 0.47; 95%CI 0.25 to 0.89; p=.02) and gonococcal infections (48 versus 54; RR = 0.39; 95%CI 0.14 to 1.04; p=.060). A dose effect was observed; participants completing more phone contacts had a lower risk of chlamydial infection (RR= 0.94, 95%CI 0.89, 0.99; p=0.049). Participants in the experimental condition reported a higher proportion of condom-protected sex acts (mean difference6 months=.08; 95%CI 0.06, 0.10; p=0.036), and fewer episodes of sex while high on alcohol/drugs (mean difference=-0.61; 95%CI -0.98,-0.24; p=0.0001). Conclusions and Relevance: Sustaining the long-term impact of HIV interventions is achievable with brief, tailored phone counseling.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
  • Journal of Clinical Microbiology 11/2014; 52(11):4119. DOI:10.1128/JCM.02433-14 · 4.23 Impact Factor
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    ABSTRACT: Little is known about why some adolescents with internalizing symptoms engage in sexual behaviors that increase their risk for HIV. This study tested a mediation model of internalizing symptoms and safe sex intentions among adolescents receiving mental health treatment. Self-efficacy for HIV prevention, HIV knowledge, and worry about HIV were hypothesized to mediate associations between internalizing symptoms and safe sex intentions among sexually active and non-active adolescents receiving mental health treatment (N = 893, M age = 14.9). Significant indirect effects from internalizing symptoms to safe sex intentions varied according to sexual experience: for sexually non-active adolescents, HIV worry and knowledge mediated this link, whereas for sexually active adolescents, HIV self-efficacy was the significant mediator. Increasing both HIV knowledge and self-efficacy for HIV prevention are important targets for HIV prevention with adolescents with internalizing symptoms, and careful attention should be paid towards targeting these interventions to sexually experienced and inexperienced youth.
    Children and Youth Services Review 11/2014; 46:177–185. DOI:10.1016/j.childyouth.2014.07.023 · 1.27 Impact Factor
  • IDWeek 2014 Meeting of the Infectious Diseases Society of America; 10/2014
  • Conference Paper: Interactive Panelist
    IDWeek 2014 Meeting of the Infectious Diseases Society of America; 10/2014
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    ABSTRACT: Importance: Postnatal cytomegalovirus (CMV) infection can cause serious morbidity and mortality in very low-birth-weight (VLBW) infants. The primary sources of postnatal CMV infection in this population are breast milk and blood transfusion. The current risks attributable to these vectors, as well as the efficacy of approaches to prevent CMV transmission, are poorly characterized. Objective: To estimate the risk of postnatal CMV transmission from 2 sources: (1) transfusion of CMV-seronegative and leukoreduced blood and (2) maternal breast milk. Design, Setting, and Participants: A prospective, multicenter birth-cohort study was conducted from January 2010 to June 2013 at 3 neonatal intensive care units (2 academically affiliated and 1 private) in Atlanta, Georgia. Cytomegalovirus serologic testing of enrolled mothers was performed to determine their status. Cytomegalovirus nucleic acid testing (NAT) of transfused blood components and breast milk was performed to identify sources of CMV transmission. A total of 539 VLBW infants (birth weight, ≤1500 g) who had not received a blood transfusion were enrolled, with their mothers (n = 462), within 5 days of birth. The infants underwent serum and urine CMV NAT at birth to evaluate congenital infection and surveillance CMV NAT at 5 additional intervals between birth and 90 days, discharge, or death. Exposures: Blood transfusion and breast milk feeding. Main Outcomes and Measures: Cumulative incidence of postnatal CMV infection, detected by serum or urine NAT. Results: The seroprevalence of CMV among the 462 enrolled mothers was 76.2% (n = 352). Among the 539 VLBW infants, the cumulative incidence of postnatal CMV infection at 12 weeks was 6.9% (95% CI, 4.2%-9.2%); 5 of 29 infants (17.2%) with postnatal CMV infection developed symptomatic disease or died. A total of 2061 transfusions were administered among 57.5% (n = 310) of the infants; none of the CMV infections was linked to transfusion, resulting in a CMV infection incidence of 0.0% (95% CI, 0.0%-0.3%) per unit of CMV-seronegative and leukoreduced blood. Twenty-seven of 28 postnatal infections occurred among infants fed CMV-positive breast milk (12-week incidence, 15.3%; 95% CI, 9.3%-20.2%). Conclusions and Relevance: Transfusion of CMV-seronegative and leukoreduced blood products effectively prevents transmission of CMV to VLBW infants. Among infants whose care is managed with this transfusion approach, maternal breast milk is the primary source of postnatal CMV infection. Trial Registration: clinicaltrials.gov Identifier: NCT00907686.
    JAMA Pediatrics 09/2014; 168(11). DOI:10.1001/jamapediatrics.2014.1360 · 4.25 Impact Factor
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    ABSTRACT: Behavioral change interventions have demonstrated short-term efficacy in reducing sexually transmitted infection (STI)/human immunodeficiency virus (HIV) risk behaviors; however, few have demonstrated long-term efficacy.
    JAMA Pediatrics 08/2014; 168(10). DOI:10.1001/jamapediatrics.2014.1436 · 4.25 Impact Factor
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    ABSTRACT: Invasive aspergillosis is a difficult-to-diagnose infection with a high mortality rate that affects high-risk groups such as patients with neutropenia and hematologic malignancies. We performed a bivariate meta-analysis of diagnostic data for an Aspergillus sp. PCR assay with blood specimens from high-risk hematology patients. We included all studies involving human subjects that assessed the performance of any PCR assay for invasive aspergillosis in whole blood or serum and that used the European Organization for the treatment of Cancer/Mycoses Study Group criteria as a reference standard. Three investigators independently searched the literature for eligible studies and extracted the data. Out of a total of 37 studies, 25 met strict quality criteria and were included in our evidence synthesis. Twenty-five studies with 2,595 patients were analyzed. The pooled diagnostic performance of whole-blood and serum PCR assays was moderate, with a sensitivity and specificity of 84% (95% confidence interval [CI], 75 to 91%) and 76% (95% CI, 65 to 84%), respectively, suggesting that a positive or negative result is unable, on its own, to confirm or exclude a suspected infection. The performance of a PCR assay of serum was not significantly different from that of whole blood. Notably, at least two positive PCR test results were found to have a specificity of 95% and a sensitivity of 64% for invasive infection, achieving a high positive likelihood ratio of 12.8. Importantly, the European Aspergillus PCR Initiative (EAPCRI) recommendations improved the performance of the PCR even further when at least two positive specimens were used to define PCR positivity. In conclusion, two positive PCR results should be considered highly indicative of an active Aspergillus sp. infection. Use of the EAPCRI recommendations by clinical laboratories can further enhance PCR performance.
    Journal of Clinical Microbiology 08/2014; 52(10). DOI:10.1128/JCM.01365-14 · 4.23 Impact Factor
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    ABSTRACT: Objectives: To determine whether rhinovirus (RV) species is associated with more severe clinical illness in adults. Methods: Seventy-two RV-positive viral respiratory samples from adult patients were sequenced and analyzed phylogenetically after reverse transcriptase polymerase chain reaction of the region spanning the VP4 gene and 5' terminus of the VP2 gene. The clinical features and severity of illness associated with the different RV species were compared. Results: Phylogenetic analysis identified three distinct clusters as RV-A (54%), B (11%), or C (35%) species. In an unadjusted model, patients with RV-B infection were significantly more likely to have the composite outcome variable of death or intensive care unit admission (P = .03), but this effect diminished when controlling for patient sex. A logistic model of the relationship between RV species and adverse outcomes produced nonsignificant odds ratios when controlling for patient sex. Conclusions: Infection with RV-A or RV-B was associated with greater severity of illness in our adult population; however, the association disappeared after controlling for confounders.
    American Journal of Clinical Pathology 08/2014; 142(2):165-72. DOI:10.1309/AJCPHIKRJC67AAZJ · 3.01 Impact Factor
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    ABSTRACT: Invasive fungal infections constitute a serious threat to an ever-growing population of immunocompromised individuals and other individuals at risk. Traditional diagnostic methods, such as histopathology and culture, which are still considered the gold standards, have low sensitivity, which underscores the need for the development of new means of detecting fungal infectious agents. Indeed, novel serologic and molecular techniques have been developed and are currently under clinical evaluation. Tests like the galactomannan antigen test for aspergillosis and the β-glucan test for invasive Candida spp. and molds, as well as other antigen and antibody tests, for Cryptococcus spp., Pneumocystis spp., and dimorphic fungi, have already been established as important diagnostic approaches and are implemented in routine clinical practice. On the other hand, PCR and other molecular approaches, such as matrix-assisted laser desorption ionization (MALDI) and fluorescence in situ hybridization (FISH), have proved promising in clinical trials but still need to undergo standardization before their clinical use can become widespread. The purpose of this review is to highlight the different diagnostic approaches that are currently utilized or under development for invasive fungal infections and to identify their performance characteristics and the challenges associated with their use.
    Clinical Microbiology Reviews 07/2014; 27(3):490-526. DOI:10.1128/CMR.00091-13 · 16.00 Impact Factor
  • Hayden RT, Gu Z, S S Sam, Tang L, Pounds S, Caliendo AM
    [Show abstract] [Hide abstract]
    ABSTRACT: The recent development of the 1st WHO International Standard for human cytomegalovirus (CMV) and introduction of commercially produced secondary standards has raised hopes of improved agreement among laboratories performing quantitative CMV PCR. However, data are lacking to evaluate the trueness and uniformity of secondary standards and the consistency of results achieved when these materials are run on various assays. Three concentrations of each of three commercially prepared secondary CMV standards were tested in quadruplicate by three real-time and two digital PCR methods. Mean results were compared in a pairwise fashion with nominal values provided by each manufacturer. Agreement of results among all methods was also assessed for each sample and for like concentrations of each standard. The relationship between nominal values of standards and measured values varied depending upon assay used and manufacturer of standards, with the degree of bias ranging from +0.6 to -1.0 log10(IU/ml). The mean digital PCR result differed significantly among the secondary standards, as did the results of real-time PCR, particularly when plotted against nominal log10IU values. Commercially available quantitative secondary CMV standards produce variable results when tested by different real-time and digital PCR assays, with varying magnitudes of bias compared to nominal values. These findings suggest that the use of such materials may not achieve the intended uniformity among laboratories measuring CMV viral load, as envisioned by adaptation of the WHO standard. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    30th Annual Clinical Virology Symposium; 04/2014
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    ABSTRACT: Research to develop and validate novel methods for diagnosis of aspergillosis based on detection of galactomannan requires use of clinical specimens that have been stored frozen. Data that galactomannan remains stable when frozen are scant. The objective of this study was to determine the stability of galactomannan in clinical specimens stored at -20°C that were resulted positive in the Platelia™ Aspergillus enzyme immunoassay when initially tested. Prospective real-time testing of serum and bronchoalveolar lavage (BAL) fluid pools from positive and negative patient specimens showed no decline in galactomannan index (GMI) over 11 months at -20° C, and no development of positive reactions in the negative control pool. Retrospective testing of positive specimens that had been stored at -20° C for 5 years showed that 28 of 30 serum (N=15) or BAL (N=15) specimens remained positive. These findings support the use of frozen serum or BAL specimens stored for at least five years in evaluation of diagnostic tests based on detection of galactomannan.
    Journal of clinical microbiology 04/2014; 52(6). DOI:10.1128/JCM.03500-13 · 4.23 Impact Factor
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    ABSTRACT: Piperacillin-tazobactam (PTZ) is known to cause false-positive results in the Platelia™ Aspergillus EIA, due to contamination with galactomannan (GM). We tested 32 lots of PTZ and 27 serum specimens from patients receiving PTZ. GM was not detected in lots; one serum (3.7%) was positive. PTZ formulations commonly used in the United States today appear to be a rare cause for false-positive GM results.
    Journal of clinical microbiology 04/2014; 52(6). DOI:10.1128/JCM.00285-14 · 4.23 Impact Factor
  • Jeannette Guarner, Charles E Hill, Angela M Caliendo
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    ABSTRACT: Objectives: To increase awareness in pathology residents of different career choices and familiarize them with the job market. Methods: For 3 years, community pathologists and faculty members participated in half-day panels that residents attended voluntarily. Panelists presented their professional life experiences and shared advice. We showcase the implementation and resident evaluation of these panels. Results: Panelists were rated as outstanding or excellent for relevance. Residents chose the following themes as most useful: visualizing the array of practices (community, part-time, public health, and others), careers that follow unexpected courses and people taking advantage of opportunities as they happen, knowing that not having a definitive direction is frequent, and finding out what different practices look for when they are hiring. Conclusions: Career planning is a neglected aspect of pathology residency training, and panels in which pathologists present their experiences are helpful to prepare residents for what lies ahead.
    American Journal of Clinical Pathology 04/2014; 141(4):478-81. DOI:10.1309/AJCPEANOYD9Y7GEC · 3.01 Impact Factor
  • Audrey F Jackson, Angela M Caliendo
    Clinical Infectious Diseases 02/2014; DOI:10.1093/cid/ciu082 · 9.42 Impact Factor
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    ABSTRACT: In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians.
    Clinical Infectious Diseases 12/2013; 57 Suppl 3:S139-70. DOI:10.1093/cid/cit578 · 9.42 Impact Factor
  • Angela Caliendo, Trichomonas vaginalis
    IDWeek 2013 Meeting of the Infectious Diseases Society of America; 10/2013

Publication Stats

3k Citations
649.52 Total Impact Points

Institutions

  • 2013–2015
    • Alpert Medical School - Brown University
      • Department of Medicine
      Providence, Rhode Island, United States
    • Vanderbilt University
      Нашвилл, Michigan, United States
  • 2001–2014
    • Emory University
      • • Department of Ophthalmology
      • • Department of Pathology and Laboratory Medicine
      • • Division of Infectious Diseases
      Atlanta, Georgia, United States
    • University Medical Center Utrecht
      Utrecht, Utrecht, Netherlands
  • 1997–2014
    • Brown University
      • Department of Obstetrics and Gynecology
      Providence, Rhode Island, United States
  • 2011
    • Johns Hopkins Medicine
      • Department of Pathology
      Baltimore, Maryland, United States
  • 2010
    • University of Connecticut
      • Department of Psychology
      Storrs, CT, United States
  • 2007
    • Indiana University Bloomington
      • Rural Center for AIDS/STD Prevention
      Bloomington, Indiana, United States
  • 2000–2006
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2005
    • University of Kentucky
      • College of Public Health
      Lexington, KY, United States
  • 2002
    • University of Massachusetts Boston
      Boston, Massachusetts, United States
  • 1999–2002
    • University of Toronto
      • Department of Medicine
      Toronto, Ontario, Canada
  • 1998–2000
    • Massachusetts General Hospital
      • Microbiology Laboratory
      Boston, MA, United States
  • 1993–1994
    • Harvard Medical School
      Boston, Massachusetts, United States