Publications by authors named "Silvia Caceres"

Background: Routine screening for nontuberculous mycobacterial (NTM) lung disease is dependent on sputum cultures. This is particularly challenging in the cystic fibrosis (CF) population due to reduced sputum production and low culture sensitivity. Biomarkers of infection that do not rely on sputum may lead to earlier diagnosis, but validation trials require a unique prospective design.

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Arterial hypertension is a growing burden worldwide, leading to over 10.8 million deaths each year. Before the outbreak of the COVID-19 pandemic, cardiovascular diseases were the main cause of death in Ecuador.

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  • This study investigated a suspected outbreak of nontuberculous mycobacteria (NTM) among cystic fibrosis (CF) patients at the University of Texas Southwestern (UTSW) using genomic sequencing and epidemiological methods.
  • Whole-genome sequencing of 50 respiratory isolates revealed seven clusters of genetically similar NTM, with some evidence of potential healthcare-associated transmission within three clusters.
  • The findings suggest that while person-to-person transmission within the healthcare setting is rare, patients may be acquiring infections from multiple sources outside of the hospital environment.
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  • - The study aims to investigate how nontuberculous mycobacteria (NTM) are transmitted among people with cystic fibrosis (pwCF) in a healthcare setting, focusing on potential outbreaks linked to shared environments or patient interactions.
  • - Participants, who have identifiable NTM infections and have received care at the same CF Care Center, will be monitored over three years to identify common sources of infection and related environmental factors.
  • - Researchers expect to find that related NTM strains among patients may result from healthcare environments, suggesting a need for improved infection control measures in CF care facilities.
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Background: Nontuberculous mycobacteria (NTM) are an important cause of airway infections in people with cystic fibrosis (pwCF). Isolation of NTM from respiratory specimens of pwCF do not mandate treatment in the absence of clinical and radiologic features of NTM pulmonary disease (NTM-PD), as some pwCF clear the infection without treatment and others do not appear to progress to NTM-PD despite persistent infection. An evidence-based protocol to standardize diagnosis of NTM-PD is needed to systematically identify pwCF who may benefit from treatment.

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is a nontuberculous mycobacterium emerging as a significant pathogen for individuals with chronic lung disease, including cystic fibrosis and chronic obstructive pulmonary disease. Current therapeutics have poor efficacy. New strategies of bacterial control based on host defenses are appealing, but anti-mycobacterial immune mechanisms are poorly understood and are complicated by the appearance of smooth and rough morphotypes with distinct host responses.

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Outbreaks of nontuberculous mycobacteria (NTM) among people with cystic fibrosis (pwCF) have been reported at CF centers with conflicting conclusions. The occurrence of NTM at the UVMC (University of Vermont Medical Center) adult CF program was investigated. Use the HALT NTM (Healthcare-associated Links in Transmission of NTM) toolkit to investigate the healthcare-associated transmission and/or acquisition of NTM among pwCF having genetically similar NTM isolates.

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Nontuberculous mycobacteria (NTM), including Mycobacterium avium, are clinically important pathogens in cystic fibrosis (CF). The innate immune response to M. avium remains incompletely understood.

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Nontuberculous mycobacteria (NTM) are opportunistic pathogens that affect a relatively small but significant portion of the people with cystic fibrosis (CF), and may cause increased morbidity and mortality in this population. Cultures from the airway are the only test currently in clinical use for detecting NTM. Culture techniques used in clinical laboratories are insensitive and poorly suited for population screening or to follow progression of disease or treatment response.

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Nontuberculous mycobacteria (NTM) infections are increasingly prevalent in chronic lung diseases, including cystic fibrosis (CF). Mycobacterium abscessus is of particular concern due to relatively greater virulence and intrinsic antimicrobial resistance. Airway culture identification, the standard method for detecting pulmonary infection, is hindered by low sensitivity, long culture times, and reliance on sputum production or lavage.

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Two mycobacteriophages were administered intravenously to a male with treatment-refractory Mycobacterium abscessus pulmonary infection and severe cystic fibrosis lung disease. The phages were engineered to enhance their capacity to lyse M. abscessus and were selected specifically as the most effective against the subject's bacterial isolate.

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Article Synopsis
  • A 10-gene panel from blood leukocytes was previously linked to predicting responses to intravenous antibiotics, and this study aimed to see if it could also predict responses to inhaled antibiotics.
  • Results showed a slight improvement in lung function and reduced bacterial counts in sputum, with one specific gene, HCA112, linked to better lung function improvement, suggesting that analyzing inflammatory gene expression could help personalize CF treatment strategies.
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  • Pulmonary infections from mycobacteria significantly impact human health, leading to high rates of illness and death, with diagnosis often taking a long time.
  • Prior research indicated that analyzing volatile molecules in exhaled breath might help detect these infections more quickly.
  • This study identified 17 specific volatile molecules in the breath of cystic fibrosis patients that can differentiate between those with active mycobacterial disease, those with indolent infections, and those who have never been infected, highlighting the need for further research on these biomarkers as a non-invasive diagnostic tool.
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Healthcare-associated transmission of nontuberculous mycobacteria (NTM) among people with cystic fibrosis (pwCF) has been investigated at CF centers worldwide, with conflicting conclusions. We investigated transmission at the Colorado Adult CF Program. To systematically investigate healthcare-associated transmission and/or acquisition of NTM to determine similarity among respiratory and environmental isolates, and to compare home residence watershed mapping among pwCF having genetically similar NTM isolates.

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Background: Healthcare-associated transmission of nontuberculous mycobacteria (NTM) among people with cystic fibrosis (pwCF) has been reported and is of increasing concern. No standardized epidemiologic investigation tool has been published for healthcare-associated NTM outbreak investigations. This report describes the design of an ongoing observational study to standardize the approach to NTM outbreak investigation among pwCF.

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Arterial hypertension is a growing burden worldwide, leading to over 10.8 million deaths each year. In Ecuador, it is the main risk factor for the major cause of death, coronary, and cerebrovascular disease [GBD 2017 Risk Factor Collaborators.

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Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative by the International Society of Hypertension (ISH) aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018.

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Background: Individuals with Cystic fibrosis (CF) are the most vulnerable population for pulmonary infection with nontuberculous mycobacteria (NTM). Screening, diagnosis, and assessment of treatment response currently depend on traditional culture techniques, but sputum analysis for NTM in CF is challenging, and associated with a low sensitivity. The cell wall lipoarabinomannan (LAM), a lipoglycan found in all mycobacterial species, and has been validated as a biomarker in urine for active Mycobacterium tuberculosis infection.

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, a rapidly growing nontuberculous mycobacterium, is increasingly prevalent in chronic lung disease, including cystic fibrosis, and infections are characterized by neutrophil-dominated environments. However, mechanisms of immune control are poorly understood. Azithromycin, a macrolide antibiotic with immunomodulatory effects, is used to treat infections.

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Article Synopsis
  • Mycobacterium abscessus is a rapidly growing bacterium found in soft tissue infections and chronic lung diseases, primarily affecting neutrophil-rich environments, with two distinct morphotypes: smooth and rough.
  • The smooth morphotype starts infections with limited neutrophil activation, while the rough morphotype is more virulent and immune-stimulating, though the neutrophil response to it remains under-studied.
  • Both morphotypes are similarly killed by neutrophils, but mechanisms differ; killing the smooth type relies more on phagocytosis and heat-tolerant factors, whereas the rough type is attacked by extracellular traps and heat-labile factors, highlighting the complexity of host responses to infections.
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Rationale: Cystic fibrosis pulmonary exacerbations accelerate pulmonary decline and increase mortality. Previously, we identified a 10-gene leukocyte panel measured directly from whole blood, which indicates response to exacerbation treatment. We hypothesized that molecular characteristics of exacerbations could also predict future disease severity.

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is a rapidly growing nontuberculous mycobacterium (NTM) increasingly reported in soft tissue infections and chronic lung diseases, including cystic fibrosis. The environmental source of has not been definitively identified, but NTM have been detected in soil and water. To determine the potential of soil-derived as an infectious source, we explored the association, growth, and survival of with defined mineral particulates, including kaolin, halloysite, and silicone dioxide, and house dust as possible fomites.

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Background: Concomitant use of oral azithromycin and inhaled tobramycin occurs in approximately half of US cystic fibrosis (CF) patients. Recent data suggest that this combination may be antagonistic.

Methods: Test the hypothesis that azithromycin reduces the clinical benefits of tobramycin by analyses of clinical trial data, in vitro modeling of P.

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Acute Respiratory Distress Syndrome (ARDS) severity may be influenced by heterogeneity of neutrophil activation. Interferon-stimulated genes (ISG) are a broad gene family induced by Type I interferons, often as a response to viral infections, which evokes extensive immunomodulation. We tested the hypothesis that over- or under-expression of immunomodulatory ISG by neutrophils is associated with worse clinical outcomes in patients with ARDS.

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Pulmonary infections with Mycobacterium abscessus (M. abscessus) are increasingly prevalent in patients with lung diseases such as cystic fibrosis. M.

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