Preeti Pancholi

• The Ohio State University

Background: Whole genome sequencing (WGS) is a relatively new method for analyzing outbreaks and modes of transmission, particularly for multidrug resistant bacteria. This study sought to investigate clusters of patients with genetically related Vancomycin-Resistant Enterococcus spp. (VRE) bacteremia for shared hospital environmental exposures. Met...

Virion‐mediated outbreaks are imminent and despite rapid responses, continue to cause adverse symptoms and death. Therefore, tunable, sensitive, high‐throughput assays are needed to help diagnose future virion‐mediated outbreaks. Herein, it is developed a tunable in situ assay to selectively enrich virions and extracellular vesicles (EVs) and simul...

A healthcare-associated group A Streptococcus outbreak involving six patients, four healthcare workers, and one household contact occurred in the labor and delivery unit of an academic medical center. Isolates were highly related by whole genome sequencing. Infection prevention measures, healthcare worker screening, and chemoprophylaxis of those co...

The rapid pace of name changes of medically important fungi is creating challenges for clinical laboratories and clinicians involved in patient care. We describe two sources of name change which have different drivers, at the species versus the genus level. Some suggestions are made here to reduce the number of name changes. We urge taxonomists to...

Background: Multidrug-resistant organisms (MDROs) are increasingly implicated in nosocomial outbreaks worldwide. We evaluated whole-genome sequencing (WGS) as an adjunctive epidemiological tool to identify infection clusters and MDRO transmission in the healthcare setting. Methods: Clinical isolates of carbapenem-resistant Enterobacterales (CRE) fr...

Virion-mediated outbreaks are imminent and despite rapid responses, they continue to cause adverse symptoms and death. Therefore, tunable, sensitive, high-throughput assays are needed to control future virion-mediated outbreaks. Herein, we developed a tunable in situ assay to selectively sort virions and infected host-derived extracellular vesicles...

Companion animals have been shown to carry Clostridioides difficile strains that are similar or identical to strains found in people, and a small number of studies have shown that pets carry genetically identical C. difficile isolates as their owners, suggesting inter-species transmission. However, the directionality of transmission is ultimately u...

Background Staphylococcus infection-associated glomerulonephritis (SAGN), an autoimmune sequela of infection affecting a subset of infected patients without specific predictive factors, frequently presenting with acute nephritic syndrome and propensity for chronic kidney disease. We performed a comparative genotypic and phenotypic analysis of S. au...

Clinical Microbiology Open (CMO), a meeting supported by the American Society for Microbiology’s Clinical and Public Health Microbiology Committee (CPHMC) and Corporate Council, provides a unique interactive platform for leaders from diagnostic microbiology laboratories, industry, and federal agencies to discuss the current and future state of the...

Varicella-zoster virus (VZV) is the etiologic agent of varicella (chickenpox) and herpes zoster (shingles) infections commonly involving skin, mucous membranes, and less frequently the central nervous system. Traditional methods for the laboratory diagnosis of these infections are time-consuming, labor-intensive, and often insensitive. As such, the...

Developments in genomics are profoundly influencing medical practice. With broader use of genetic and genomic testing across every aspect of the health care continuum, patients and their families are increasingly turning to primary care physicians (PCPs) for discussion and advice regarding tests, implications and results. Yet, with the rapid growth...

While gillosis the (CAPA) incidence in COVID-19 of coronavirus patients disease admitted (COVID)-associated to the intensive pulmonary care unit (ICU) asper- in Europe is widely published (incidence up to 30%) (1), data on CAPA from the United States is lacking or has not been well described (2, 3). During the first surge of COVID-19 (March to Augu...

Fungal infections are a rising threat to our immunocompromised patient population as well as other non-immunocompromised patients with various medical conditions. However, little progress has been made in the past decade to improve fungal diagnostics. To jointly address this diagnostic challenge, the Fungal Diagnostics Laboratory Consortium (FDLC)...

Following the worldwide emergence of the p.Asp614Gly shift in the Spike (S) gene of SARS-CoV-2, there have been few recurring pathogenic shifts occurring during 2020, as assessed by genomic sequencing. This situation has evolved in the last several months with the emergence of several distinct variants (first identified in the United Kingdom and So...

Background GAS can cause severe postpartum infections and may be transmitted from colonized healthcare workers (HCWs). Methods Two cases of GAS bacteremia following vaginal delivery were identified on the L&D unit June-July 2019 (Cluster 1), prompting a carrier-disseminator investigation. Two additional cases were identified September-October 2019...

Background The high clinical burden of Clostridioides difficile infections merits rapid and sensitive identification of affected individuals. However, effective diagnosis remains challenging. Current best practice guidelines recommend molecular and/or direct toxin detection-based screening for symptomatic individuals, but previous work has called i...

Objectives: Empiric antibiotic prescribing can be supported by guidelines and/or local antibiograms, but these have limitations. We sought to use data from a comprehensive electronic health record to use statistical learning to develop predictive models for individual antibiotics that incorporate patient-, and hospital-specific factors. This paper...

Background:Clostridioides difficile infection (CDI) is one of the most common health-care associated infections that can cause significant morbidity and mortality. CDI diagnosis involves laboratory testing in conjunction with clinical assessment. The objective of this study was to assess the performance of various C. difficile tests and to compare...

Purpose of Review Major technologic advances in two main areas of molecular infectious disease diagnostics have resulted in accelerated adoption or ordering, outpacing implementation, and clinical utility studies. Physicians must understand the limitations to and appropriate utilization of these technologies in order to provide cost-effective and w...

Background Predictive models for empiric antibiotic prescribing often estimate the probability of infection with multidrug-resistant organisms. In this work, we developed models to predict coverage of specific treatment regimens to better target antibiotics to high- and low-risk patients. Methods We established a retrospective cohort of adults adm...

Background Providers use institutional recommendations, national guidelines, and antibiograms to decide on empiric antibiotics. As local antibiograms are most effective after organisms are known, we sought to use local microbiology and clinical data to develop predictive models for antibiotic coverage prior to identifying the organism. We focused o...

Background Monitoring antimicrobial use and resistance are key components of initiatives to promote antimicrobial stewardship and prevent antimicrobial-resistant infections. In this surveillance study, we evaluated trends in resistance among healthcare-associated P. aeruginosa isolates and potential associations with antimicrobial consumption. Met...

We evaluated the performance of the Luminex ARIES® C. difficile Assay on 984 stool specimens prospectively collected from patients being tested for CDI at 4 clinical laboratories in the United States. Results were compared to direct and enriched toxigenic culture. Positive percent agreement (PPA) of the ARIES® C. difficile Assay was 98.1% versus di...

Objectives Rapid and accurate mold identification is critical for guiding therapy for mold infections. MALDI-TOF MS has been widely adopted for bacterial and yeast identification; however, few clinical laboratories have applied this technology for routine mold identification due to limited database availability and lack of standardized processes. H...

Companion animals are likely relevant in the transmission of antimicrobial resistant bacteria in the community. Enterobacter xiangfangensis ST171, a clone that has been implicated in clusters of infections in humans, was isolated from two dogs with clinical disease in Ohio, U.S. The canine isolates contained IncHI2 plasmids encoding blaKPC-4 . Whol...

Background Antibiograms are often stratified by location (e.g., ICU) to better assess resistance risk of patients in those locations (1). A weighted-incidence syndromic antibiogram (WISCA) may be more useful for empiric prescribing in that it stratifies on syndrome (e.g., urinary tract infection (UTI)) and calculates coverage over all organisms (i....

Rule-based techniques are common in domains that require explainability and interpretability, such as the health-sciences. In certain cases, rules from multiple systems or humans have to be consolidated for consensus. When there is no objective function to measure rule validity and the rule generation process can contain errors, human involvement i...

Increasing evidence suggests that asymptomatic carriers are an important source of healthcare-associated Clostridium difficile infection. However, it is not known which test for the detection of C. difficile colonization is most sensitive in patients with haematological malignancies. We performed a prospective cohort study of 101 patients with haem...

We describe results from a multicenter study evaluating the Accelerate Pheno™ system, a first of its kind diagnostic system that rapidly identifies common bloodstream pathogens from positive blood cultures within 90 minutes and determines bacterial phenotypic antimicrobial susceptibility testing (AST) results within ∼seven h. A combination of fresh...

Polymyxins are one of the last-line antibiotics for multidrug-resistant Acinetobacter baumannii. Reports have demonstrated the emergence of colistin heteroresistance in A. baumannii, which can complicate assessment of minimum inhibitory concentrations and promote resistance to colistin. We aimed to determine the presence of colistin heteroresistanc...

Introduction Wohlfahrtiimonas chitiniclastica has been associated with open wound infections, cellulitis, osteomyelitis, and bacteremia. Case presentation We report the case of a 41 year old woman with history of congenital myelomeningocele, paraplegia and extensive decubitus ulcers that developed W. chitiniclastica bacteremia secondary to an infe...

Background When prescribing empiric antibiotics, providers try to choose the narrowest spectrum antibiotic that will cover a patient’s infection. To do this they must assess the likelihood of coverage of different regimens. We developed a model for cefazolin (or cephalexin) coverage for patients admitted to the hospital with urinary tract infection...

Objective To study LpxA/C/D and pmrA/B gene systems role in colistin resistant clinical strains of Acinetobacter baumannii. Methods Transmission Electron Microscopy (TEM) was employed to observe changes in the cell wall, inner and outer membranes. GC-Chromatography was applied to quantify the fatty acid content as a result of changes in the LPS in...

Objectives: Studies are conflicting regarding the association of the North American pulsed-field gel electrophoresis type 1 (NAP1) strain in Clostridium difficile infection (CDI) and outcomes. We evaluated the association of NAP1 with healthcare-associated CDI disease severity, mortality, and recurrence at our academic medical center. Methods: H...

Epstein Barr virus (EBV)-encoded RNAs (EBER) in tumor tissue and cell-free plasma EBV-DNA (pEBVd) are detected in EBV-associated lymphomas. Studies have suggested that EBER+ peripheral T-cell lymphomas (PTCL) have worse prognosis but the role of EBV in these neoplasms remains unclear. pEBVd is quantitative and more easily amenable to standardizatio...

Common causes of chronic diarrhea among travelers worldwide include protozoan parasites. The majority of parasitic infections are caused by Giardia duodenalis , Entamoeba histolytica, Cryptosporidium parvum and C. hominis . Similarly, these species cause the majority of parasitic diarrhea acquired in the United States. Detection of parasites by gol...

We tested 76 extensively-drug resistant (XDR) Acinetobacter baumannii ( AB ) by the checkerboard method using only serum achievable concentration (SAC) wells. Checkerboard results were correlated by time-kill and clinical outcomes. Minocycline-colistin was the best combination in-vitro as it inhibited ≥ 1 SAC well in all isolates. Patients receivin...

The dissemination of Enterobacteriaceae expressing resistance to extended-spectrum cephalosporins, which are therapeutically used in both human and veterinary medicine, is of critical concern. The normal commensal flora of food animals may serve as an important reservoir for the zoonotic food-borne transmission of Enterobacteriaceae harbouring β-la...

Introduction: Outcomes in advanced stage (AS) cutaneous T-cell lymphomas (CTCL) are poor but with great variability. Epstein-Barr virus (EBV) is associated with a subset of non-Hodgkin lymphomas. Frequency of plasma EBV-DNA (pEBVd) detection, concordance with EBV RNA (EBER) in tumor tissue, codetection of plasma cytomegalovirus DNA (pCMVd), and pr...

Limited data exist evaluating outcomes in patients with serious S. anginosus group infections, particularly bacteremia. A retrospective, single-center cohort study was conducted to characterize potential risk factors along with clinical and microbiological outcomes in patients with S. anginosus group bacteremia (SAGB). Adult inpatients with SAGB id...

The enteric microbiota of hospitalized patients serves as one reservoir for carbapenem resistant Enterobacteriaceae (CRE) infections (1), although it has not been well characterized.…. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Bloodstream infection is a serious condition associated with significant morbidity and mortality. The outcome of these infections can be positively affected by early implementation of effective antibiotic therapy based on the identification of the infecting organism and genetic markers associated with antibiotic resistance. We evaluate the microarr...

We evaluated the clinical performance (sensitivity and specificity) of the AmpliVue group A Streptococcus (GAS) isothermal helicase-dependent amplification assay using 1,192 pharyngeal swab specimens. AmpliVue GAS assay results were compared to the results of routine throat cultures on selective streptococcal blood agar plates. The sensitivity and...

Group A Streptococcus (GAS) is a human pathogen that causes high morbidity and mortality. GAS lacks a gene encoding tyrosine kinase but contains one encoding tyrosine phosphatase (SP-PTP). Thus, GAS is thought to lack tyrosine phosphorylation and the physiological significance of SP-PTP is, therefore, questionable. Here, we demonstrate that SP-PTP...

Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are classified epidemiologically as healthcare-associated hospital-onset (HAHO), healthcare-associated community-onset (HACO), or community-associated (CA)-MRSA. Clinical and molecular differences between HAHO- and HACO-MRSA BSI are not well known. Thus, we evaluated c...

The identification of compounds with anti-mycobacterial activity within classes of molecules that have been developed for other purposes is a fruitful approach for the development of anti-tuberculosis (TB) agents. In this study we used the scaffold of celecoxib which exhibits several activities against different pathogens, for the design and focuse...

Bloodstream infection with Staphylococcus aureus, including methicillin resistant S. aureus (MRSA), is a serious condition that carries a high mortality rate and is also associated with significant hospital costs. Rapid and accurate identification and differentiation of methicillin susceptible (MSSA) and resistant S. aureus directly from positive b...

A 63-year-old Caucasian female with a history of Crohn's disease and recurrent gastrointestinal strictures requiring multiple surgeries, including end ileostomy, presented to our medical center in June 2012 with a 1-week history of fevers up to 104°F and rigors. She had also experienced acute worsening of her chronic high-volume stool output, for w...

Mycobacterial skin and soft tissue infection (SSTI) includes nontuberculous mycobacterial (NTM) infections, tuberculosis (TB), and leprosy. Diagnosis of mycobacterial SSTI can be challenging due to diverse clinical presentation, low yield from cultured specimens, and nonspecific histopathology on tissue biopsy. In addition, immunosuppressed patient...

Clostridium difficile is a gram-positive bacterium commonly found in health-care and long-term care facilities and is the most common cause of antibiotic-associated diarrhea. Rapid detection of this bacterium can assist physicians in implementing contact precautions and appropriate antibiotic therapy within a timely manner. The purpose of this stud...

Repetitive element polymerase chain reaction (rep-PCR) typing has been used for methicillin-resistant Staphylococcus aureus (MRSA) strain characterization. The goal of this study was to determine if a rapid commercial rep-PCR system, DiversiLab™ (DL, bioMérieux, Durham, NC), could be used for MRSA surveillance at a large medical center and communit...

Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to...

The Verigene Clostridium difficile Nucleic Acid Test (Verigene CDF Test) (Nanosphere, Northbrook, IL) is a multiplex qualitative PCR assay that utilizes a nanoparticle-based array hybridization method to detect C. difficile tcdA and tcdB in fecal specimens. In addition, the assay detects binary toxin gene sequences and the single base pair deletion...

Candidemia is associated with significant morbidity, mortality, and hospital cost. We conducted a quasi-experimental study to evaluate the impact of an Antimicrobial Stewardship Program (ASP) pharmacist's interventions on time to effective antifungal therapy, in-hospital mortality, infection-related length of stay (LOS), and costs in patients with...

Background: Methicillin-Resistant Staphylococcus aureus (MRSA) causes considerable morbidity and mortality throughout the United States. From March 2009 through February 2010, all MRSA isolates were prospectively collected from 7 community hospitals across Ohio (located 30 – 120 miles from an academic medical center) allowing comparison of rep-PC...

Mycobacteria cause significant morbidity in humans. Rapid and accurate mycobacterial identification is important for improvement of patient outcomes. However, identification may be challenging due to the slow and fastidious growth of mycobacteria. Several diagnostic methods, such as biochemical, sequencing, and probe methods, are used for mycobacte...

Flowchart for reference testing of isolates obtained from positive blood cultures. (TIF)

STARD checklist for reporting of studies of diagnostic accuracy. (DOC)

Full study protocol including inclusion and exclusion criteria, BC-GP test method, and routine culture method used in this study. (DOCX)

Sequence results for vanA in prospectively tested blood cultures containing Enterococcus spp . (DOCX)

A multicenter study was conducted to evaluate the diagnostic accuracy (sensitivity and specificity) of the Verigene Gram-Positive Blood Culture Test (BC-GP) test to identify 12 Gram-positive bacterial gene targets and three genetic resistance determinants directly from positive blood culture broths containing Gram-positive bacteria. 1,252 blood cul...

Introduction: We set a goal to reduce the incidence rate of catheter-related bloodstream infections to rate of <1 per 1,000 central line days in a two-year period. Methods: This is an observational cohort study with historical controls in a 25-bed intensive care unit at a tertiary academic hospital. All patients admitted to the unit from January...

Background: Molecular genotyping of MRSA can identify clusters in a hospital or community settings. Our goal was to develop a community-wide pathogen-based, genotyping, geocoding, and clinical data collection surveillance collaborative for 4 healthcare systems in Franklin County, Ohio. We hypothesize that this collaborative will provide a framework...

Background: Central line associated blood stream infections (CLA-BSI) in intensive care units account for most of the excess morbidity, mortality and increased cost associated with nosocomial infections. Our objective was to investigate and eliminate the role of the environment in CLA-BSI. Methods: The CDC/NHSN definition was used to measure...

Methicillin-resistant Staphylococcus aureus (MRSA) is a human pathogen that has diverse molecular heterogeneity. Most MRSA strains in the United States are pulsed-field gel electrophoresis USA100 sequence type (ST) 5 and USA300 ST8. Infections with MRSA ST239-III are common and found during health care-associated outbreaks. However, this strain has...

Neisseria bacilliformis has most often been associated with infections of the oral cavity and the respiratory tract. We report a case of N. bacilliformis mitral valve endocarditis in a previously healthy adult which required valve replacement, thus confirming the opportunistic nature and pathogenic potential of this novel organism.

BACKGROUND: Antimicrobial Stewardship Programs should consider old antimicrobials for emerging multidrug-resistant (MDR) organisms such as Acinetobacter baumannii. Our purpose is to evaluate susceptibilities of minocycline to MDR-A. baumannii and assess the outcomes of patients treated with minocycline. METHODS: Consecutive isolates from 67 patient...

We evaluated the Abbott RealTime (ART) and Roche Cobas TaqMan Hepatitis C virus (HCV) viral load assays for quantification of HCV genotypes in patient specimens. The ART HCV assay was a more sensitive and precise tool for accurate HCV viral load quantification across the HCV genotypes tested, especially genotype 1b.

Clostridium difficile is the most important cause of nosocomial diarrhea. Several laboratory techniques are available to detect C. difficile toxins or the genes that encode them in fecal samples. We evaluated the Xpert C. difficile and Xpert C. difficile/Epi (Cepheid, CA) that detect the toxin B gene (tcdB) and tcdB, cdt, and a deletion in tcdC ass...

Streptococcus pneumoniae exploits a battery of virulence factors to colonize the host. Although the eukaryote-like Ser/Thr kinase of S. pneumoniae (StkP) has been implicated in physiology and virulence, the role of its cotranscribing phosphatase (PhpP) has remained elusive. The construction of nonpolar markerless phpP knockout mutants (ΔphpP) in tw...

A multiplex-PCR Luminex xMAP bead probe fluid array using xTAG analyte-specific reagents (multiplex xTAG fungal ASR assay) was employed for detection of clinically significant Candida species, Cryptococcus neoformans, Histoplasma capsulatum, and Blastomyces dermatitidis from blood cultures. We tested 132 blood cultures negative (n = 10) or positive...

This investigation illustrates an important property of eukaryote-type serine/threonine phosphatase (SP-STP) of group A Streptococcus (GAS) in causing programmed cell death of human pharyngeal cells. The secretory nature of SP-STP, its elevated expression in the intracellular GAS, and the ability of wild-type GAS but not the GAS mutant devoid of SP...

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of healthcare- and community-acquired infections. The emergence and spread of MRSA strains resistant to commonly prescribed antibiotics has made successful treatment conditional on having detailed knowledge of the antimicrobial susceptibility profile. Medical factors such as...

Background: Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are associated with longer hospital stays, higher mortality, and increased costs. MRSA BSI can be classified epidemiologically as Healthcare-associated (HA), culture obtained >48 hours after admission; Healthcare-associated Community Onset (HACO), culture o...

Background: MRSA is an increasing cause of healthcare-associated (HA) and community -associated (CA) infections. Historically, HA-MRSA and CA-MRSA differed in specific MRSA strains types, patient populations, and clinical presentations. To determine if transmission of CA- and HA-MRSA is occurring between a tertiary medical center (MC) and 7 referri...

Reversible phosphorylation is the key mechanism regulating several cellular events in prokaryotes and eukaryotes. In prokaryotes, signal transduction is perceived to occur primarily via the two-component signaling system involving histidine kinases and cognate response regulators. Although an alternative regulatory pathway controlled by the eukaryo...

The superior sensitivity and specificity associated with the use of molecular assays has greatly improved the field of infectious disease diagnostics by providing clinicians with results that are both accurate and rapidly obtained. Herein, we review molecularly based infectious disease diagnostic tests that are Food and Drug Administration approved...

Clostridium difficile bacteremia is rare. Here, we report two cases of C. difficile bacteremia in patients with significant underlying gastrointestinal pathology. In one case, the bacteremia was caused by the North American pulsed-field gel electrophoresis (PFGE) type 1 (NAP-1) strain, which is responsible for recent outbreaks of C. difficile infec...

The aim of this study was to elucidate the role of two novel membrane fusion proteins (MFPs) in the susceptibility of Acinetobacter baumannii to antimicrobial agents. The genome sequence of A. baumannii ATCC 17978 contains two open reading frames (ORFs) annotated as AdeT in the NCBI genome database. Both the putative efflux genes display >30% simil...