Publications by authors named "Ruth Reitzel"

Objectives: Gram-negative bacilli (GNB) are currently the predominant bacterial pathogens in patients with cancer. Many GNB have become problematic due to the widespread emergence of resistance. Imipenem/relebactam (IMI/REL) is a combination of the carbapenem imipenem with relebactam, a non-β-lactam β-lactamase inhibitor.

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Chlorhexidine is an antimicrobial agent widely used for infection prevention in medical settings. Nevertheless, allergic reactions ranging from mild to severe have been reported following its use. In this review, we analyzed all case reports published between the introduction of chlorhexidine and the end of 2019 for allergic responses associated with the use of medical devices and or other medical products containing chlorhexidine (CHX) to ascertain the prevalence of severe CHX allergic reactions and what practices might best mitigate those risks.

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  • Microbial contamination in wounds, especially from bacterial biofilms, can delay healing, prompting the development of a new ointment combining pectinic acid (PG) and caprylic acid (CAP) that shows promise in eradicating pathogens with low toxicity.
  • In vitro tests demonstrated that the PG+CAP ointment effectively reduced microbial biofilms, leading to further evaluation in live porcine models with regular application over four weeks.
  • Results indicated that PG+CAP not only improved wound healing more than traditional ointment controls but also safely eradicated bacteria, suggesting its potential as a non-antibiotic treatment for infected wounds in further research.
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  • Antiseptic ointments are commonly used for treating contaminated wounds, and a new ointment combining polygalacturonic acid (PG) and caprylic acid (CAP) has shown promise in eliminating biofilms.
  • The study compared the effectiveness and toxicity of PG+CAP against popular commercial antiseptics, finding that PG+CAP completely eradicated resistant biofilms, while others did not perform as well within a 2-hour timeframe.
  • Cytotoxicity tests indicated that PG+CAP is safe for fibroblasts and erythrocytes, showing high cell viability similar to untreated cells, suggesting its potential as an effective and safe antimicrobial wound treatment worthy of further testing.
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Background: Catheter infections remain one of the most persistent adverse events causing significant morbidity, economic impact and mortality. Several strategies have been proposed to reduce these infections including the use of catheters embedded with antibiotics and/or antiseptics. One reoccurring challenge is the fear that antimicrobial medical devices will induce resistance.

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  • CAUTI (Catheter-Associated Urinary Tract Infection) poses significant risks for patients using catheters, leading to the development of a new double-balloon Foley catheter designed for effective irrigation of catheter surfaces.
  • The catheter features a retention cuff to hold it in place and a specialized irrigation cuff that delivers antimicrobial solutions to prevent infection by cleansing the area between the urethra and bladder.
  • Testing showed that this new catheter, when used with a specific antimicrobial solution (PG + CAP), significantly reduces biofilm formation by common uropathogens, suggesting potential effectiveness in preventing CAUTI, warranting further research.
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is an emerging pathogen that can cause virulent central-line-associated bloodstream infections. Catheter salvage through the eradication of biofilms is a desirable therapeutic option. We compared taurolidine and minocycline-EDTA-ethanol (MEE) catheter lock solutions for the eradication of biofilms of 10 strains.

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  • - Patients on parenteral nutrition (PN) face high risks of both infectious and noninfectious catheter complications, prompting a review to assess incidence rates and prevention strategies, particularly using antimicrobial lock therapy (ALT).
  • - A total of 53 studies on catheter complications and 12 on ALT were analyzed, revealing complications like catheter-related bloodstream infections (CRBSI) and central line-associated bloodstream infections (CLABSI) with specific rates per 1000 catheter days.
  • - The review highlighted the effectiveness of taurolidine or ethanol ALT in reducing infections but raised concerns about potential mechanical complications; further research is needed for better understanding and standardization of risk factors and prevention methods.
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poses emerging risks for causing severe central line-associated bloodstream infections. We tested the ability of antifungal lock solutions to rapidly eradicate biofilms. Liposomal amphotericin B, amphotericin B deoxycholate, fluconazole, voriconazole, micafungin, caspofungin, and anidulafungin failed to completely eradicate all 10 tested biofilms.

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To assess the potential for the induction of antimicrobial resistance following repeated subinhibitory exposures to the combination minocycline (MIN), rifampin (RIF), and chlorhexidine (CHX), a total of 29 clinical microbial pathogenic isolates were repeatedly exposed to subinhibitory concentrations of MIN, RIF, and CHX for 20 passages. MICs of the MIN, RIF, and CHX combination were assessed at each passage to evaluate the potential for resistance to have been induced. The combination of MIN, RIF, and CHX showed significant antimicrobial efficacy and synergy against organisms resistant to all 3 individual components (MIC of ≥16 μg/ml for MIN or MIC of ≥4 μg/ml for RIF or CHX).

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Background: Granulation tissue is a common complication of airway stenting, but no published methods can quantify the volume and type of tissue that develops.

Objective: To use design-based stereology to quantify changes in tissue volume and type associated with airway stenting.

Methods: We compared drug-eluting stents (DES) filled with gendine to standard silicone stents in pigs in an assessor-blinded randomized trial.

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A total of 248 Gram-positive isolates from cancer patients were tested for in-vitro susceptibility to tedizolid and 3 comparator agents using CLSI broth microdilution methodology. Tedizolid inhibited 97% of isolates at ≤0.5μg/ml.

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  • * The study compared the effectiveness of two FDA-approved catheter lock solutions (heparin and saline) with three experimental solutions (30% citrate, TCH, and NiCE) in eradicating fungal biofilms from catheters.
  • * The nitroglycerin-citrate-ethanol (NiCE) solution was the only one to completely eliminate fungal biofilms within 60 minutes, proving significantly more effective than TCH (p = 0.002).
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Implant-associated surgical-site infections can have significant clinical consequences. Previously we reported a method for prophylactically disinfecting implant surfaces in surgical pockets, where an antibiotic solution containing minocycline (M) and rifampin (R) was applied as a solid film in a crosslinked biopolymer matrix that partially liquefied in situ to provide extended prophylaxis. Here we studied the effect of adding sodium 2-mercaptoethane sulfonate (MeSNA) on durability of prophylaxis in an model of implant-associated surgical-site infection.

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There is a need for non-antibiotic, antimicrobial compositions with low toxicity capable of broad-spectrum eradication of pathogenic biofilms in food preparation and healthcare settings. In this study we demonstrated complete biofilm eradication within 60 min with synergistic combinations of caprylic and polygalacturonic (PG) acids in an biofilm eradication model against representative hospital and foodborne infectious pathogen biofilms (methicillin-resistant , multidrug-resistant , , , and ). Antimicrobial synergy against biofilms was demonstrated by quantifying viable organisms remaining in biofilms exposed to caprylic acid alone, PG acid alone, or combinations of the two.

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Background: The activity levels of telomerase and its mRNA have been found to be more diagnostically sensitive than cytological results in many cancerous tissues and correlate well with the clinical disease stage. Currently, there are several methods of detecting telomerase in tissues and in blood. The most commonly used method is a conventional quantitative real-time polymerase chain reaction (PCR) which is time and labor exhausting.

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For long-term central lines (CL), the lumen is the major source of central line-associated bloodstream infections (CLABSI). The current standard of care for maintaining catheter patency includes flushing the CL with saline or heparin. Neither agent has any antimicrobial activity.

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  • PCN catheters are essential for draining obstructed ureters due to cancer and preventing kidney function decline, but they're susceptible to infections like pyelonephritis and urosepsis.
  • Current PCN catheters lack antimicrobial coatings to prevent these infections, prompting a study on incorporating minocycline-rifampin (M/R) and a chlorhexidine combination (M/R plus CHD) to see if they can inhibit biofilm formation by common uropathogens.
  • The study found that M/R-plus-CHD catheters effectively prevented biofilm formation for up to 3 weeks against various multidrug-resistant bacteria, suggesting they could significantly reduce infection risks associated with PCN catheter use and warrant clinical evaluation.
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A total of 521 unique clinical isolates from cancer patients with primarily (>90%) bloodstream infections were tested for susceptibility to ceftazidime-avibactam and comparators using broth microdilution methods. Ceftazidime-avibactam inhibited 97.8% of all ( = 321) at the susceptibility breakpoint of ≤8/4 μg/ml (there were 7 nonsusceptible strains).

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  • A new antimicrobial solution called nitroglycerin-citrate-ethanol (NiCE) was developed to replace traditional catheter lock solutions and effectively eliminate biofilms caused by various drug-resistant bacteria and fungi.
  • The formulation was optimized by reducing nitroglycerin and citrate while increasing ethanol concentration, showing sustained effectiveness even with these adjustments.
  • NiCE not only eradicated biofilms rapidly but also exhibited anticoagulant properties similar to heparin, making it a promising nonantibiotic option for clinical use.
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Gram-positive bacterial infections are an important cause of morbidity and death among cancer patients, despite current therapy. In this case-control study, we evaluated the clinical outcomes and safety of telavancin in cancer patients with uncomplicated Gram-positive bloodstream infections (BSIs). Between March 2011 and May 2013, we enrolled cancer patients with uncomplicated Gram-positive BSIs to receive intravenous telavancin therapy for at least 14 days for Staphylococcus aureus and 7 days for other Gram-positive cocci.

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