Jeannette Guarner

Emory University, Atlanta, Georgia, United States

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Publications (161)1112.16 Total impact

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    Jeannette Guarner · Hannah K Dolan · Lisa Cole

    Preview · Article · Sep 2015 · American Journal of Clinical Pathology
  • Carlos Del Rio · Jeannette Guarner
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    ABSTRACT: The 2014 Ebola virus disease outbreak in West Africa has been the largest in recorded history. During this Ebola epidemic, the media has focused much attention to the magnitude of the problem in West Africa but has also overplayed the potential for an Ebola virus pandemic as patients have been transported for treatment to the United States and Europe causing panic and paranoia in the population. Knowledge of the epidemiology, pathogenesis, clinical presentation, treatment, and prevention of this infection will allow a better understanding of the disease and decrease irrational fear of spread.
    No preview · Article · Sep 2015 · Transactions of the American Clinical and Climatological Association
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    ABSTRACT: We evaluated the use of treponemal serum tests in cerebrospinal fluid (CSF) to diagnose neurosyphilis since CSF-Venereal Disease Research Laboratory (VDRL) is specific but lacks sensitivity. We tested CSF specimens using the following treponemal serum tests: INNO-LIA, Treponema pallidum particle agglutination (TP-PA), Trep-Sure, and Maxi-Syph. The reference standard to calculate sensitivity and specificity was having two or more reactive/positive tests on CSF. The reference standard group included 11 cases that fulfilled the definition of neurosyphilis (reactive CSF-VDRL plus symptoms) and three cases that did not fulfill the definition: two cases had neurologic symptoms but a nonreactive CSF-VDRL, and one had several positive CSF syphilis tests (reactive VDRL and positive treponemal and syphilis polymerase chain reaction) but no history (referred sample). Controls included 18 patients in whom a CSF-VDRL was performed the same week as patients in the reference group. The sensitivity was 85.7% (12/14) for CSF-VDRL, 92.9% (13/14) for Trep-Sure, 100% (10/10) for Maxi-Syph, 92.3% (12/13) for INNO-LIA, and 83.3% (10/12) for TP-PA. Specificity was 100% for all tests. Treponemal serum tests performed on CSF were useful in identifying two patients with nonreactive CSF-VDRL. Copyright© by the American Society for Clinical Pathology.
    Full-text · Article · Apr 2015 · American Journal of Clinical Pathology
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    Jeannette Guarner · Drucilla Roberts · Ann Nelson · Michael L. Wilson

    Full-text · Article · Apr 2015
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    ABSTRACT: A better understanding of second-line drug (SLD) pharmacokinetics including cavitary penetration may help optimize SLD dosing. Patients with pulmonary MDR-TB undergoing adjunctive surgery were enrolled in Tbilisi, Georgia. Serum was obtained at 0, 1, 4, and 8 hours and at time of cavitary removal to measure levofloxacin concentrations. After surgery, microdialysis was performed using the ex vivo cavity and levofloxacin concentrations were measured in collected dialysate fluid. Noncompartmental analysis was performed and a cavitary to serum levofloxacin concentration ratio was calculated. Twelve patients received levofloxacin for a median of 373 days before surgery; median dose 11.8 mg/kg. The median serum levofloxacin Cmax was 6.5 μg/ml and was < 2μg/ml in 3 (25%) patients. Among 11 patients with complete data, the median cavitary concentration of levofloxacin was 4.36 μg/ml (range 0.46-8.82). The median cavitary-serum levofloxacin ratio was 1.33 (range 0.63-2.36) and 7 patients (64%) had a ratio > 1. There was a significant correlation between serum and cavitary concentrations (R=0.71, p=0.01) CONCLUSIONS: Levofloxacin had excellent penetration into chronic cavitary TB lesions and there was good correlation between serum and cavitary concentrations. Optimizing serum concentrations will help ensure optimal cavitary concentrations of levofloxacin, which may enhance treatment outcomes. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Full-text · Article · Mar 2015 · Antimicrobial Agents and Chemotherapy
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    ABSTRACT: To describe a 4-day laboratory medicine course for clinicians given at Addis Ababa University, Ethiopia, designed to improve the use of laboratory-based diagnoses. Each day was dedicated to one of the following topics: hematology, blood bank/transfusion medicine and coagulation, chemistry, and microbiology. The course included lectures, case-based learning, laboratory tours, and interactive computer case-based homework. The same 12-question knowledge quiz was given before and after the course. Twenty-eight participants took the quiz before and 21 after completing the course. The average score was 5.28 (range, 2-10) for the initial quiz and 8.09 (range, 4-11) for the second quiz (P = .0001). Two of 12 and 8 of 12 questions were answered correctly by more than 60% of trainees on the initial and second quiz, respectively. Knowledge and awareness of the role of the laboratory increased after participation in the course. Understanding of laboratory medicine principles by clinicians will likely improve use of laboratory services and build capacity in Africa. Copyright© by the American Society for Clinical Pathology.
    Full-text · Article · Mar 2015 · American Journal of Clinical Pathology
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    ABSTRACT: Mycobacterium kansasii is a photochromogenic, slow-growing mycobacterium species that can cause pulmonary infection in patients with predisposing lung diseases, as well as extrapulmonary or disseminated disease in immunosuppressed patients. We describe a patient with a myelodysplastic syndrome, disseminated M kansasii infection, and ruptured aortic aneurysm. He had a recent diagnosis of mycobacterium cavitary lung lesions and was transferred to our facility for possible surgical intervention of an aortic aneurysm. Few hours after admission, the patient suddenly collapsed and died despite resuscitation efforts. A complete autopsy was performed and showed ruptured ascending aortic pseudoaneurysm with hemopericardium, disseminated necrotizing and nonnecrotizing granulomas with acid-fast bacilli in the aortic wall, lungs, heart, liver, spleen, and kidneys. Further genetic studies were consistent with monocytopenia and mycobacterial infection syndrome. Copyright © 2014 Elsevier Inc. All rights reserved.
    No preview · Article · Nov 2014 · Human pathology
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    ABSTRACT: Microbiology rounds are an integral part of infectious disease consultation service. During microbiology rounds, we highlight microbiology principles using vignettes. We created case-based, interactive, microbiology online modules similar to the vignettes presented during microbiology rounds. Since internal medicine residents rotating on our infectious disease elective have limited time to participate in rounds and learn microbiology, our objective was to evaluate the use of the microbiology online modules by internal medicine residents. We asked residents to complete 10 of 25 online modules during their infectious disease elective. We evaluated which modules they chose and the change in their knowledge level. Forty-six internal medicine residents completed assessments given before and after accessing the modules with an average of 11/20 (range, 6 to 19) and 16/20 (range, 9 to 20) correct questions, respectively (average improvement, 5 questions; P = 0.0001). The modules accessed by more than 30 residents included those related to Clostridium difficile, anaerobes, Candida spp., Streptococcus pneumoniae, influenza, Mycobacterium tuberculosis, and Neisseria meningitidis. We demonstrated improved microbiology knowledge after completion of the online modules. This improvement may not be solely attributed to completing the online modules, as fellows and faculty may have provided additional microbiology education during the rotation.
    Full-text · Article · Nov 2014 · Journal of Clinical Microbiology
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    Jeannette Guarner · Kenneth Fleming

    Full-text · Article · Oct 2014 · American Journal of Clinical Pathology
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    Jeannette Guarner

    Preview · Article · Oct 2014 · American Journal of Clinical Pathology
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    Full-text · Article · Aug 2014 · Annals of internal medicine
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    Jeannette Guarner
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    ABSTRACT: The role pathology plays in establishing or excluding infectious diseases has been established. However, as the practice of pathology has become subspecialized, there is not enough infectious disease specimen volume to have a pathologist dedicated full time to this crosscutting subspecialty. So, what are the myths and realities of a practicing infectious disease pathologist in the hospital setting? Infectious disease clinicians tend to consult pathologists when there are questions regarding terminology used in pathology reports; when there is the need to perform additional studies on formalin-fixed, paraffin-embedded tissues; and when there is an interest in seeing biopsies or resections obtained from patients and in obtaining photographs for presentations. Pathologists consult infectious disease pathologists when there is a need to review diverse inflammatory reactions; for identification of fungi, parasites, or unknown structures; to define the need to use special stains and other techniques in order to identify organisms in tissues that have been formalin fixed; and to help with terminology to be used in reports. This review explores in more detail why and how these consultations occur.
    Preview · Article · Jun 2014 · Clinical Infectious Diseases
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    Jeannette Guarner · Carlos del Rio

    Preview · Article · May 2014 · American Journal of Clinical Pathology
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    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.
    Preview · Article · Apr 2014 · American Journal of Clinical Pathology
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    ABSTRACT: Objectives: To describe the implementation and evaluation of a case-based microbiology curriculum during daily microbiology rounds. Methods: Vignettes consist of short cases with images and questions that facilitate discussion among microbiologists, pathologists, infectious disease physicians, and trainees (residents and fellows). We performed a survey to assess the value of these vignettes to trainees. Results: Motivation to come to rounds on time increased from 60% to 100%. Trainees attending rounds after implementation of the vignettes perceived the value of microbiology rounds to be significantly higher compared with those who attended rounds before implementation (P = .04). Pathology residents found that vignettes were helpful for retaining knowledge (8.3 of 10 points). Conclusions: The vignettes have enhanced the value of microbiology rounds by serving as a formalized curriculum exposing trainees from multiple specialties to various microbiology topics. Emphasis on interdisciplinary interactions between clinical and laboratory personnel was highlighted with this case-based curriculum.
    No preview · Article · Mar 2014 · American Journal of Clinical Pathology

  • No preview · Conference Paper · Sep 2013

  • No preview · Conference Paper · Sep 2013
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    Preview · Article · Jul 2013 · Journal of clinical microbiology

  • No preview · Article · Jul 2013 · Journal of clinical microbiology
  • Kathleen T Montone · Jeannette Guarner
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    ABSTRACT: Fungal infections are a frequent occurrence in medical practice due to increasing numbers of immunosuppressed patients. New antifungal medications have been developed and it has become evident that different fungi require different treatments as some are intrinsically resistant to these drugs. Thus, it is imperative that pathologists recognize the limitations of histopathologic diagnosis regarding speciation of fungal infections and advocate for the use of different techniques that can help define the genus and species of the fungus present in the specimen they are studying. In this review we present the use of in situ hybridization as an important adjunct for the diagnosis of fungal diseases, the different techniques that have been used for fungal identification, and the limitations that these techniques have.
    No preview · Article · May 2013 · Advances in anatomic pathology

Publication Stats

8k Citations
1,112.16 Total Impact Points

Institutions

  • 1989-2015
    • Emory University
      • • Department of Pathology and Laboratory Medicine
      • • Department of Pediatrics
      • • School of Medicine
      Atlanta, Georgia, United States
  • 2001-2010
    • Centers for Disease Control and Prevention
      • • Division of Vector-Borne Diseases
      • • National Center for Emerging and Zoonotic Infectious Diseases
      • • Division of Parasitic Diseases and Malaria
      • • Division Of Cancer Prevention and Control
      Атланта, Michigan, United States
  • 2009
    • University of Maryland, Baltimore
      • Department of Pediatrics
      Baltimore, Maryland, United States
  • 1998-2007
    • National Institute of Allergy and Infectious Diseases
      베서스다, Maryland, United States
  • 2000-2006
    • Stanford University
      • • Department of Statistics
      • • Department of Medicine
      • • Division of Infectious Diseases
      Palo Alto, California, United States
  • 2005
    • United States Army Medical Research Institute for Infectious Diseases
      Фредерик, Maryland, United States
  • 2004
    • University of New Mexico Hospitals
      Albuquerque, New Mexico, United States
  • 2003
    • University of Malaya
      Kuala Lumpor, Kuala Lumpur, Malaysia
    • Case Western Reserve University
      Cleveland, Ohio, United States
  • 1997-2003
    • Instituto Nacional de Cancerología - Mexico
      Ciudad de México, Mexico City, Mexico