Publications by authors named "Kevin Squires"
Article Synopsis
- - The study investigates the role of heteroresistance in cefiderocol treatment failure among patients with carbapenem-resistant Acinetobacter baumannii (CRAb) infections, finding a significant portion (59%) of the isolates had heteroresistance, particularly higher in Italy compared to the USA.
- - Patients with cefiderocol-heteroresistant strains had worse clinical outcomes, with 81% experiencing treatment failure, compared to 55% for those with susceptible strains, and higher minimum inhibitory concentrations (MICs) were linked to increased failure rates.
- - Whole-genome sequencing revealed a genetic mutation in some heteroresistant isolates, supporting the idea that both higher MICs and the presence of resistant subpopulations contribute to
Among consecutive patients with multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia we found those treated with ceftazidime-avibactam were more likely to develop resistance (defined as ≥4-fold increased MIC) than those treated with ceftolozane-tazobactam (40% vs. 10%; P=0.002).
View Article and Find Full Text PDFObjectives: To investigate the genomic diversity and β-lactam susceptibilities of Enterococcus faecalis collected from patients with infective endocarditis (IE).
Methods: We collected 60 contemporary E. faecalis isolates from definite or probable IE cases identified between 2018 and 2021 at the University of Pittsburgh Medical Center.
Objectives: Ceftazidime/avibactam and meropenem/vaborbactam are preferred agents for carbapenemase (KPC)-producing (KPC-) infections and are often used in combination with other agents. We aimed to characterize the synergy of combinations against KPC- with varying genotypes.
Methods: KPC- that harboured WT, IS or glycine-aspartic acid duplication (GD) genotypes were selected.
Background: Cefiderocol demonstrates excellent activity against MDR ; however, the activity against isolates from patients previously treated with β-lactam agents is unknown. We aimed to determine the activity of cefiderocol against collected before and after treatment with traditional β-lactams and new β-lactam/β-lactamase inhibitors.
Methods: Cefiderocol MICs were determined in triplicate in iron-depleted cation-adjusted Mueller-Hinton broth and compared with β-lactam MICs tested by standard methods.
Article Synopsis
- New β-lactam/β-lactamase inhibitors, such as ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/relebactam, are showing promise in treating KPC-producing infections, but their effectiveness varies based on the specific genetic make-up of the bacteria.
- The study analyzed 104 KPC- isolates to understand how differences in their genetic profiles affected antibiotic efficacy, and found that mutations significantly influenced resistance levels.
- Time-kill tests revealed that ceftazidime/avibactam was effective across different isolates, while imipenem/relebactam struggled with certain mutations, indicating the need for targeted treatment strategies based on genetic
Objectives: We evaluated the clinical characteristics and outcomes of patients with COVID-19 who received three-drug combination regimens for treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) infections during a single-centre outbreak. Our objective was to describe the clinical outcomes and molecular characteristics and in vitro synergy of antibiotics against CRAB isolates.
Materials And Methods: Patients with severe COVID-19 admitted between April and July 2020 with CRAB infections were retrospectively evaluated.
Article Synopsis
- Bacterial bloodstream infections (BSIs) may involve a mix of different organisms rather than just single pathogens, specifically investigating the behavior of carbapenem-resistant Klebsiella pneumoniae (CRKP).
- Researchers analyzed 10 strains of CRKP from 6 patients, revealing genetic and phenotypic diversity among strains within individual patients, indicating significant variations in antibiotic resistance and virulence factors.
- The findings challenge traditional beliefs about BSIs being caused by a single organism, suggesting that understanding within-host microbial diversity could change infection management and treatment strategies.
Performance of T2Candida for detecting intra-abdominal candidiasis (IAC) was assessed in 48 high-risk patients. T2Candida sensitivity/specificity and positive/negative predictive values were 33%/93% and 71%/74%, respectively. IAC was present in 100% of cases with concordant positive T2Candida/1,3-beta-d-glucan and absent in 90% of concordant negative results.
View Article and Find Full Text PDFCeftazidime-avibactam resistance among carbapenem-resistant Klebsiella pneumoniae at our hospital has emerged in sequence type (ST)-258, clade II isolates. We investigated hypermutability of ST258, clade II (n = 6) and clade I K. pneumoniae (n = 8) using a standard rifampin assay.
View Article and Find Full Text PDF