Jennifer A Shuford

Mayo Clinic - Rochester, Рочестер, Minnesota, United States

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Publications (8)27.17 Total impact

  • Jennifer A Shuford · Kerryl E Piper · James M Steckelberg · Robin Patel
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    ABSTRACT: Thirty clinical isolates of Candida albicans were collected from blood or other sterile site infections. Biofilm dry weight and metabolic activity were measured for each isolate. Planktonic and sessile antifungal susceptibilities of each isolate were determined for amphotericin B deoxycholate, caspofungin, and voriconazole. Sessile susceptibilities were determined for the combination of caspofungin/voriconazole. No significant differences in biofilm dry weight or metabolic activity were found between bloodstream and other invasive isolates. Planktonic MIC90 values and sessile MIC90 (SMIC90) values were 0.25 and 2, 0.06 and >256, and 0.5 and 2 microg/mL for amphotericin, voriconazole, and caspofungin, respectively. The SMIC90 of the combination of caspofungin/voriconazole against sessile isolates was 0.5/2 microg/mL. Therefore, the source of invasive C. albicans clinical isolates did not affect in vitro biofilm formation. Susceptibility to antifungal agents decreased when C. albicans was associated with biofilm, and the combination of caspofungin/voriconazole did not appear to provide enhanced activity compared with caspofungin alone.
    No preview · Article · Mar 2007 · Diagnostic Microbiology and Infectious Disease
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    ABSTRACT: Candida albicans biofilms complicate the treatment of infected implanted intravascular devices because of decreased antifungal susceptibility. In our investigation, 48 rabbits with experimental central venous catheter C. albicans infection were equally allocated to a control arm or to receive amphotericin B deoxycholate or caspofungin treatment while undergoing systemic and intraluminal lock therapy for 7 days. C. albicans was cultured from catheters from all control rabbits, from 3 that received amphotericin B, and from 0 that received caspofungin. Differences in colony counts were detected between the control and amphotericin (P<.001) and control and caspofungin (P<.001) arms. Caspofungin may be useful in the treatment of C. albicans biofilm–associated intravascular catheter infections, which warrants further study
    Preview · Article · Sep 2006 · The Journal of Infectious Diseases
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    ABSTRACT: Association of cefazolin treatment failure with type A beta-lactamase-producing Staphylococcus aureus has been suggested. The prevalence of beta-lactamase gene types among 23 methicillin-susceptible S. aureus (MSSA) isolates associated with prosthetic joint infection (PJI) treated with cefazolin was determined using polymerase chain reaction (PCR), and clinical and microbiologic outcomes were assessed. PCR revealed 4 isolates without blaZ, and 12 with type A, 2 with type B, and 5 with type C blaZ. Of 13 patients undergoing resection arthroplasty with subsequent reimplantation, all received antimicrobial spacer placement at resection with or without antimicrobial-impregnated polymethylmethacrylate at reimplantation. All 13 cases had tissue cultures at time of reimplantation that were negative for S. aureus and 11 had histopathology specimens showing no acute inflammation. Of 8 type A cases undergoing reimplantation, all prostheses remained in place at follow-up (median, 798 days; range, 32-927 days). We conclude that type A blaZ is common in MSSA PJI and that cefazolin therapy for blaZ MSSA PJI can be successful when combined with 2-stage reimplantation and local antimicrobial therapy.
    No preview · Article · Apr 2006 · Diagnostic Microbiology and Infectious Disease
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    Jennifer A Shuford · James M Steckelberg · Robin Patel

    Preview · Article · Feb 2005 · Antimicrobial Agents and Chemotherapy
  • Jennifer A Shuford · Robin Patel
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    ABSTRACT: The use of antimicrobial growth promotants began in the 1940s and continues in much of the world today. In the USA, the majority of antimicrobial use is dedicated to growth promotion in feed animals. Use of glycopeptides, tetracyclines, streptothricins, macrolides, and streptogramins for livestock growth promotion has been associated with selection of drug resistant bacteria. The selection of antimicrobial resistance in livestock has been associated with antimicrobial resistance in bacteria causing human disease. This threat to human health has led to recommendations from many experts to limit the use of antimicrobial agents for the purposes of growth promotion in animals. Such recommendations have effected large-scale livestock health policy changes in some parts of the world, although the USA has enacted few policy changes regarding the use of antimicrobial growth promotants.
    No preview · Article · Dec 2004 · Reviews in Medical Microbiology
  • James Steckelberg · Jennifer Shuford · Mark Rouse · Robin Patel · Steven Kavros
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    ABSTRACT: Background: UAW of advanced or slow-healing wounds has become a standard practice in many wound care centers in the United States. Clinical studies have demonstrated decreased healing times for recalcitrant wounds undergoing UAW when compared to traditional therapy. One proposed mechanism for the improved outcome is a direct antimicrobial effect of low-frequency sonication. As these complicated wounds often harbor organisms living within a layer of exudative material, a biofilm model was chosen for study. Methods: Silicone elastomer disks were immersed in 1x107 colony forming units (CFU) of C. albicans (GDH 2346) for 90 min. The disks were then rinsed with phosphate buffered saline and immersed in yeast nitrogen base for 48 hours at 37oC on an orbital shaker (to enable formation of a mature biofilm). Experiments were run in triplicate on three different days. Biofilm laden disks underwent treatment with the Sonoca-180 device (Söring GmbH Medizintechnik; Germany) for 1 minute per side on 0 or 100% power (25 kH, 120 W) with sterile saline at 20 ml/min. The disks and the effluent were evaluated for presence of viable organisms. Results: The mean log CFU/cm2 recovered was 6.58 (range 5.49-7.23) from the sonicated disks and 5.82 (range 4.76-7.45) from the placebo disks (p=0.06). The mean log CFU/cm2 recovered from the effluent was 6.96 (range 6.36-7.36) in the sonication arm and 7.19 (range 6.57-7.76) in the placebo arm (p=0.16). The mean total log CFU/cm2 recovered from each disk and its respective effluent combined was 7.23 (range 6.97-7.42) in the sonication arm and 7.33 (range 7.03-7.76) in the placebo arm (p=0.28). Conclusions: An UAW device showed no fungicidal activity against C. albicans in biofilms and did not dislodge C. albicans biofilms.
    No preview · Conference Paper · Oct 2004
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    ABSTRACT: The use of pacemakers and implantable cardioverter-defibrillators continues to increase for the management of cardiac dysrhythmias and, more recently, heart failure. Long-term complications associated with their use include infection, lead failure, and spurious shocks. Although the risk of infection with intracardiac devices is well known, the clinical presentation of this complication can be insidious, delayed in onset, and difficult to diagnose. We report a case of Aspergillus fumigatus infection of an implantable cardioverter-defibrillator with right-sided endocarditis in a 55-year-old man. The infection presented as persistent pulmonary infiltrates (due to recurrent septic pulmonary embolism) and anemia more than 2 years after implantation of the device. Clinicians should be aware of the variable manifestations resulting from infection of intracardiac devices.
    Full-text · Article · May 2004 · Mayo Clinic Proceedings
  • Jennifer A Shuford · James M Steckelberg
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    ABSTRACT: Medical therapy of chronic osteomyelitis is largely based on experimental models, historical observational or non-randomized studies, and expert opinions. A minimum of 4-6 weeks of intravenous antimicrobial therapy targeting the causative organism, given in conjunction with surgery, has become the standard for chronic long-bone osteomyelitis in adults. Given the expense, inconvenience, and potential complications inherent to such a treatment program, alternative strategies including effective oral antimicrobial regimens are desirable. Several oral antimicrobial agents have undergone evaluation for the treatment of acute and chronic osteomyelitis recently. These include fluoroquinolones, clindamycin, and linezolid. For the treatment of atypical causes of Gram-positive osteomyelitis, other oral therapies have been evaluated with reported success in small numbers of patients. The standard of care for chronic osteomyelitis in adults remains intravenous antimicrobial therapy, in combination with surgery, for at least 4-6 weeks. Acute osteomyelitis in the pediatric population as well as osteomyelitis caused by atypical Gram-positive organisms and some Gram-negative organisms may be treated successfully with oral antibiotics. Some antimicrobials have equivalent concentration in serum whether administered orally or parenterally. When therapy with these antimicrobials is indicated, the oral route is preferred in compliant patients. As research continues in this area and as new drug formulations are developed, oral therapy may become an accepted alternative in additional selected patients.
    No preview · Article · Jan 2004 · Current Opinion in Infectious Diseases