Infectious Diseases 2020 Projects

Project Title: Evaluation of Epidemiological and Clinical Outcomes Among Patients with Nocardiosis in Florida

Faculty Mentor: Norman Beatty 
Email: norman.beatty@medicine.ufl.edu

Student: Laura Velez Turizo 
Email: laurav14@ufl.edu 

Research Project Description:

Nocardia is a gram-positive branching filamentous bacterium found ubiquitously in soil and the environment. It causes a life-threatening opportunistic infection in immunocompromised patients, with a high likelihood of recurrence(1). Increased incidence has been found among organ transplant patients, patients on corticosteroid therapy and calcineurin inhibitors, as well as HIV/AIDS patients(2,3). The aerosolized organisms have a respiratory mechanism of entry into the body, causing patients to most commonly present with severe pulmonary infections. Nocardiosis is also known to cause subsequent dissemination to the central nervous system causing debilitating brain abscesses. Additionally, cutaneous presentation of Nocardiosis after trauma injury has also been characterized in immunocompetent individuals. The climate and soil conditions in Florida are considered suitable for this pathogen, as analyzed by Stapleton et al(4) and Kachuei et al(5) during their evaluation of environmental risk factors for Nocardiosis.

This will be the first epidemiological and clinical outcomes review of Nocardiosis infection in Florida. This study will provide knowledge on the impact of this pathogen in the Southeastern U.S. by identifying its incidence, risk factors, clinical, microbiological, and radiological characteristics in patients that presented to UF Health Shands Hospital with Nocardiosis infection from 2016 to 2020.

We hypothesize that there is a high incidence of Nocardiosis infection in Florida among populations at risk from 2016 to 2020 that has not been well-characterized in the literature.
The environmental and soil conditions in the state align with Nocardia’s predilection for temperate climate. There is a significant population at risk of infection, disseminating disease, and mortality due to the common risk factors of immunosuppression, HIV/AIDS, steroid therapy, chemotherapy, COPD, malignancy, and autoimmune disease. Therefore, this study will provide significant data and evaluation of the impact of Nocardia infection in the Southeastern U.S.

Project Title: Analysis of outcomes of nursing home patients admitted to hospital for COVID-19 in Shands health system

Faculty Mentor: Mike Lauzardo 
Email: mike.lauzardo@medicine.ufl.edu 

Student: Elizabeth Acevedo 
Email: ufellieacevedo@ufl.edu 

Research Project Description:

In December 2019, a series of unexplained pneumonia was found to be caused by SARS-CoV-2 , and declared COVID 10 disease by the World Health Organization5 . By February 11th,2020 there were a total of 72,314 cases of COVID-19 in China. Of those cases, the majority were adults greater than 30 years, but the highest case-fatality rates were patients aged 70-79 years at 8.0% and even higher for patiets greater than 80 years old with a case fatality rate of 14.8%4 . While a large majority of the population are susceptible to contracting the virus, the elderly and those with underlying co-morbidities are more susceptible. Studies show that the elderly population are more likely to develop ARDS, have a higher Pneumonia Severity Index, and more often patients in the ICU compared to younger individuals1,3. There are several comorbidities linked to the progression of COVID-19 including hypertension and cardiovascular disease. Therefore, an understanding of the risk factors and outcomes in the elderly nursing home population is critical in order to decrease the high mortality rates and better manage future outcomes.

  1. .K. Liu , Y. Chen and R. Lin et all., Clinical feature of COVID-19 in elderly patients: A comparison with young and middle-aged patients, Journal of Infection htttps://doi.org/10.1016/j.jinf.2020.03.005
  2. Liu W, Tao ZW, Wang L, Yuan ML, Liu K, Zhou L, Wei S, Deng Y, Liu J, Liu HG, Yang M, Hu Y. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J 2020;133:00–00. doi: 10.1097/ CM9.0000000000000775
  3. Wang, Dawei, et al. “Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.” JAMA, American Medical Association, 7 Feb. 2020, www.ncbi.nlm.nih.gov/pubmed/32031570.
  4. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–1242. doi:10.1001/jama.2020.2648
  5. Yang, Jing, et al. “Prevalence of Comorbidities and Its Effects in Patients Infected with SARS-CoV-2: a Systematic Review and Meta-Analysis.” International Journal of Infectious Diseases, Elsevier, 12 Mar. 2020, www.sciencedirect.com/science/article/pii/S1201971220301363.
  6. Zheng, Ying-Ying, et al. “COVID-19 and the Cardiovascular System.” Nature News, Nature Publishing Group, 5 Mar. 2020, www.nature.com/articles/s41569-020-0360-5.

Project Title: use and type of antibiotics in fever clinics within Karnataka, India

Faculty Mentor: Gautam Kalyatanda
Email: gautam.kalyatanda@medicine.ufl.edu 

Student: Helen Ernyey
Email: helenernyey@ufl.edu 

Research Project Description:

Antibiotic resistance is a growing problem within India that is leading to a development of antimicrobial resistance. India is a growing country of over 1.3 billion individuals where antibiotics are being more readily dispersed with a high burden of infectious disease. Every time an individual uses an antibiotic as treatment, he or she is at a greater risk for developing antibiotic resistance and will be resistant to future treatment. Severe conditions which need antibiotics may not work and treatment will become more challenging. Due to varying guidelines and empirical treatment, we will examine the conditions and symptoms that led to the prescription of antibiotics and whether or not these clinical symptoms required antibiotics or not. Furthermore, due to the current pandemic of COVID-19 with numerous primary care clinics and facilities being closed in India, these fever clinics are being utilized for chronic rather than acute symptoms. Thus, this descriptive study will also examine whether or not these fever clinics are being used appropriately to treat acutely ill patients.

Disclaimer: The images on this page were taken prior to the national guidelines of face coverings and social distancing.