Allen Griffin - Academia.edu (original) (raw)
Papers by Allen Griffin
Clinics in Laboratory Medicine, Jun 1, 2014
The American Journal of the Medical Sciences, Dec 1, 2012
The Journal of the Kentucky Medical Association
BMJ: British medical journal
Clinics in Laboratory Medicine, 2014
The American Journal of the Medical Sciences, 2012
Coxiella burnetii, the agent of Q fever, is an obligate intracellular pathogen typically associat... more Coxiella burnetii, the agent of Q fever, is an obligate intracellular pathogen typically associated with exposure to livestock. This organism may present with acute or chronic manifestations, the most typical chronic manifestation being endocarditis. We report a highly unusual case of Q fever endocarditis acquired in the United States marked by atypical cardiac manifestations.
Microbiology spectrum, 2016
Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnos... more Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnosis and aggressive treatment are essential for good clinical outcomes in immunocompromised patients. The host immune response plays an essential role in determining the course of exposure to potential fungal pathogens. Depending on the effectiveness of immune response and the burden of organism exposure, fungi can either be cleared or infection can occur and progress to a potentially fatal invasive disease. Nonspecific cellular immunity (i.e., neutrophils, natural killer [NK] cells, and macrophages) combined with T-cell responses are the main immunologic mechanisms of protection. The most common potential mold pathogens include certain hyaline hyphomycetes, endemic fungi, the Mucorales, and some dematiaceous fungi. Laboratory diagnostics aimed at detecting and differentiating these organisms are crucial to helping clinicians make informed decisions about treatment. The purpose of this cha...
The Journal of the Kentucky Medical Association
The Journal of the Kentucky Medical Association
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2010
Data supporting a quinolone or a macrolide as preferred therapy for community-acquired pneumonia ... more Data supporting a quinolone or a macrolide as preferred therapy for community-acquired pneumonia (CAP) due to Legionella pneumophila are not firmly established. Some literature suggests a benefit of quinolones over macrolides. To compare time to clinical stability (TCS) and length of hospital stay (LOS) in patients with Legionella pneumonia who were treated with levofloxacin (LVX) compared to those treated with newer macrolides. An analysis of patients with Legionnaires' disease from the Community-Acquired Pneumonia Organization database was performed. Patients were diagnosed with CAP using radiographic and clinical criteria, while Legionella was detected by urinary antigen or sputum culture. All patients received a macrolide (azithromycin or clarithromycin) or LVX. TCS was defined as the time from hospital admission to candidacy for switch to oral therapy. A total of 39 patients were included for analysis. The mean TCS for the macrolide group was 5.1 days vs. 4.3 days for the L...
Infectious Diseases in Clinical Practice, 2013
Current Infectious Disease Reports, 2014
ABSTRACT Invasive fungal disease (IFD) is becoming more prevalent in transplant and oncology pati... more ABSTRACT Invasive fungal disease (IFD) is becoming more prevalent in transplant and oncology patients as a result of the potent immunosuppressive therapies used to prevent allograft rejection and/or high-dose chemotherapeutic regimens for cancer. Attributable mortality in IFD remains high despite better antifungal treatments. There is a continued need for advancements in diagnostics to help improve clinical outcomes further. In recent years, traditional histopathological and culture-based detection and identification strategies have been supplemented with advanced molecular diagnostics, surrogate biomarker testing and direct antigen detection. Refinements in these assays are improving diagnosis, with the greatest strides made within the molecular and proteomic realms. The following is a review of the latest diagnostic improvements in the field of mycology with the predominant focus on Candida and Cryptococcus yeasts; common invasive molds; and the endemic fungi Histoplasma capsulatum, Blastomyces dermititidis, and Coccidioides immitis/posadosii.
Infectious Diseases in Clinical Practice, 2011
ABSTRACT Clostridium difficile is more common, more virulent, and more difficult to treat than in... more ABSTRACT Clostridium difficile is more common, more virulent, and more difficult to treat than in past decades. Oral vancomycin and metronidazole have been the subject of the most rigorous study in this disease. Although these antibiotics have largely been viewed as equivalent, studies support vancomycin for severe disease, whereas metronidazole is noninferior in milder disease. Both antibiotics are superior to the toxin-binding agent tolevamer. No evidence supports probiotics for initial disease, but there may be utility in relapsing disease. There is an exiguous evidence base regarding antibiotic treatment of relapsing disease, but tapered and pulsed regimens of vancomycin remain possible options. Preliminary evidence supports the use of monoclonal antibodies against C. difficile toxins A and B for relapsing episodes. The studies concerning refractory disease are limited to a case series design, whereas it remains unclear how effective probiotics are in the prevention of C. difficile infection.
Infectious Diseases in Clinical Practice, 2012
Abstract Propionibacterium acnes typically colonizes the oropharynx and skin but may cause postop... more Abstract Propionibacterium acnes typically colonizes the oropharynx and skin but may cause postoperative infections and opportunistic infections, especially when a foreign device is present. We report a case of pericarditis due to P. acnes complicated by ...
Postgraduate Medical Journal, 2013
Purpose The Streptococcus anginosus group comprises three species of bacteria classified within t... more Purpose The Streptococcus anginosus group comprises three species of bacteria classified within the viridans streptococci. This group is known for abscess formation and endocarditis. While a variety of sites in the body claim anginosus streptococci as an agent of infection, osteomyelitis is unusual. The objective of this study was to describe a series of patients with osteomyelitis due to S anginosus group pathogens in terms of demographics, comorbidities, presentation and outcomes. Study design We reviewed our database for cases of osteomyelitis caused by S anginosus organisms. Data described included demographics, comorbidities, site of infection, route of infection (haematogenous versus contiguous), laboratory data and course. Results 11 patients with S anginosus group osteomyelitis were identified. All cases arose from a contiguous anatomical site, with the exception of one haematogenous case. Five instances were related to foot osteomyelitis while three, two and one case, respe...
International Journal of Infectious Diseases, 2013
This study was a secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) datab... more This study was a secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) database on CAP, a multicenter, retrospective, international cohort study of inpatients from 80 centers in 13 countries. Patients with a confirmed diagnosis of CAP were entered into the database from June 1, 2011 to November 12, 2012. Data procured for CAPO were collected on a case report form, entered into a computer database, and then reviewed for quality assurance before final acceptance into the database. Institutional review board evaluation was performed at each of the sites from which patients were sampled. Informed consent was waived due to the retrospective nature of this investigation. Inclusion criteria were age !16 years and confirmed CAP. CAP was verified if a new infiltrate on chest X-ray was present with any
Infection, 2012
The Infectious Diseases Society of America has recommended empiric therapy active against methici... more The Infectious Diseases Society of America has recommended empiric therapy active against methicillin-resistant Staphylococcus aureus (MRSA) for all community-acquired pneumonia (CAP) patients admitted to the intensive care unit (ICU). However, there is sparse data to support this recommendation. The objective of our study was to ascertain if such a practice improves outcomes. This study was a secondary, retrospective analysis of the Community-Acquired Pneumonia Organization (CAPO) international database on CAP. Outcomes in patients admitted to the ICU were compared according to empiric initiation of anti-MRSA therapy (vancomycin or linezolid) with standard ICU CAP therapy (MRSA therapy group) or standard therapy alone for ICU CAP (standard therapy group). A total of 621 patients were identified with ICU pneumonia, of whom 57 patients had been initiated empirically on vancomycin or linezolid (MRSA therapy group). Patients of the MRSA therapy group had more comorbidities and were more severely ill than those of the standard therapy group. However, there were no statistical differences between the MRSA therapy group and standard therapy group for the primary outcomes of in-hospital and 28-day mortality, length of stay and time to clinical stability. These findings suggest that empiric MRSA therapy in all ICU CAP patients may not improve outcomes and argue for clinician review of local epidemiologic trends on MRSA prevalence to ascertain the need for empiric MRSA coverage.
Diagnostic Microbiology and Infectious Disease, 2014
Fusobacteria are obligate anaerobic bacilli residing in the oral cavity, female genital tract, an... more Fusobacteria are obligate anaerobic bacilli residing in the oral cavity, female genital tract, and intestine. These pathogens are typical components of head, neck, and abdominal abscesses due to contiguous spread from adjacent mucosal surfaces. They are unusual etiologies, however, of bone and joint infections, particularly outside the cranial region. We report an unusual case of hematogenous lumbar spondylodiscitis caused by Fusobacterium nucleatum of suspected odontogenic origin.
Clinics in Laboratory Medicine, Jun 1, 2014
The American Journal of the Medical Sciences, Dec 1, 2012
The Journal of the Kentucky Medical Association
BMJ: British medical journal
Clinics in Laboratory Medicine, 2014
The American Journal of the Medical Sciences, 2012
Coxiella burnetii, the agent of Q fever, is an obligate intracellular pathogen typically associat... more Coxiella burnetii, the agent of Q fever, is an obligate intracellular pathogen typically associated with exposure to livestock. This organism may present with acute or chronic manifestations, the most typical chronic manifestation being endocarditis. We report a highly unusual case of Q fever endocarditis acquired in the United States marked by atypical cardiac manifestations.
Microbiology spectrum, 2016
Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnos... more Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnosis and aggressive treatment are essential for good clinical outcomes in immunocompromised patients. The host immune response plays an essential role in determining the course of exposure to potential fungal pathogens. Depending on the effectiveness of immune response and the burden of organism exposure, fungi can either be cleared or infection can occur and progress to a potentially fatal invasive disease. Nonspecific cellular immunity (i.e., neutrophils, natural killer [NK] cells, and macrophages) combined with T-cell responses are the main immunologic mechanisms of protection. The most common potential mold pathogens include certain hyaline hyphomycetes, endemic fungi, the Mucorales, and some dematiaceous fungi. Laboratory diagnostics aimed at detecting and differentiating these organisms are crucial to helping clinicians make informed decisions about treatment. The purpose of this cha...
The Journal of the Kentucky Medical Association
The Journal of the Kentucky Medical Association
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2010
Data supporting a quinolone or a macrolide as preferred therapy for community-acquired pneumonia ... more Data supporting a quinolone or a macrolide as preferred therapy for community-acquired pneumonia (CAP) due to Legionella pneumophila are not firmly established. Some literature suggests a benefit of quinolones over macrolides. To compare time to clinical stability (TCS) and length of hospital stay (LOS) in patients with Legionella pneumonia who were treated with levofloxacin (LVX) compared to those treated with newer macrolides. An analysis of patients with Legionnaires' disease from the Community-Acquired Pneumonia Organization database was performed. Patients were diagnosed with CAP using radiographic and clinical criteria, while Legionella was detected by urinary antigen or sputum culture. All patients received a macrolide (azithromycin or clarithromycin) or LVX. TCS was defined as the time from hospital admission to candidacy for switch to oral therapy. A total of 39 patients were included for analysis. The mean TCS for the macrolide group was 5.1 days vs. 4.3 days for the L...
Infectious Diseases in Clinical Practice, 2013
Current Infectious Disease Reports, 2014
ABSTRACT Invasive fungal disease (IFD) is becoming more prevalent in transplant and oncology pati... more ABSTRACT Invasive fungal disease (IFD) is becoming more prevalent in transplant and oncology patients as a result of the potent immunosuppressive therapies used to prevent allograft rejection and/or high-dose chemotherapeutic regimens for cancer. Attributable mortality in IFD remains high despite better antifungal treatments. There is a continued need for advancements in diagnostics to help improve clinical outcomes further. In recent years, traditional histopathological and culture-based detection and identification strategies have been supplemented with advanced molecular diagnostics, surrogate biomarker testing and direct antigen detection. Refinements in these assays are improving diagnosis, with the greatest strides made within the molecular and proteomic realms. The following is a review of the latest diagnostic improvements in the field of mycology with the predominant focus on Candida and Cryptococcus yeasts; common invasive molds; and the endemic fungi Histoplasma capsulatum, Blastomyces dermititidis, and Coccidioides immitis/posadosii.
Infectious Diseases in Clinical Practice, 2011
ABSTRACT Clostridium difficile is more common, more virulent, and more difficult to treat than in... more ABSTRACT Clostridium difficile is more common, more virulent, and more difficult to treat than in past decades. Oral vancomycin and metronidazole have been the subject of the most rigorous study in this disease. Although these antibiotics have largely been viewed as equivalent, studies support vancomycin for severe disease, whereas metronidazole is noninferior in milder disease. Both antibiotics are superior to the toxin-binding agent tolevamer. No evidence supports probiotics for initial disease, but there may be utility in relapsing disease. There is an exiguous evidence base regarding antibiotic treatment of relapsing disease, but tapered and pulsed regimens of vancomycin remain possible options. Preliminary evidence supports the use of monoclonal antibodies against C. difficile toxins A and B for relapsing episodes. The studies concerning refractory disease are limited to a case series design, whereas it remains unclear how effective probiotics are in the prevention of C. difficile infection.
Infectious Diseases in Clinical Practice, 2012
Abstract Propionibacterium acnes typically colonizes the oropharynx and skin but may cause postop... more Abstract Propionibacterium acnes typically colonizes the oropharynx and skin but may cause postoperative infections and opportunistic infections, especially when a foreign device is present. We report a case of pericarditis due to P. acnes complicated by ...
Postgraduate Medical Journal, 2013
Purpose The Streptococcus anginosus group comprises three species of bacteria classified within t... more Purpose The Streptococcus anginosus group comprises three species of bacteria classified within the viridans streptococci. This group is known for abscess formation and endocarditis. While a variety of sites in the body claim anginosus streptococci as an agent of infection, osteomyelitis is unusual. The objective of this study was to describe a series of patients with osteomyelitis due to S anginosus group pathogens in terms of demographics, comorbidities, presentation and outcomes. Study design We reviewed our database for cases of osteomyelitis caused by S anginosus organisms. Data described included demographics, comorbidities, site of infection, route of infection (haematogenous versus contiguous), laboratory data and course. Results 11 patients with S anginosus group osteomyelitis were identified. All cases arose from a contiguous anatomical site, with the exception of one haematogenous case. Five instances were related to foot osteomyelitis while three, two and one case, respe...
International Journal of Infectious Diseases, 2013
This study was a secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) datab... more This study was a secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) database on CAP, a multicenter, retrospective, international cohort study of inpatients from 80 centers in 13 countries. Patients with a confirmed diagnosis of CAP were entered into the database from June 1, 2011 to November 12, 2012. Data procured for CAPO were collected on a case report form, entered into a computer database, and then reviewed for quality assurance before final acceptance into the database. Institutional review board evaluation was performed at each of the sites from which patients were sampled. Informed consent was waived due to the retrospective nature of this investigation. Inclusion criteria were age !16 years and confirmed CAP. CAP was verified if a new infiltrate on chest X-ray was present with any
Infection, 2012
The Infectious Diseases Society of America has recommended empiric therapy active against methici... more The Infectious Diseases Society of America has recommended empiric therapy active against methicillin-resistant Staphylococcus aureus (MRSA) for all community-acquired pneumonia (CAP) patients admitted to the intensive care unit (ICU). However, there is sparse data to support this recommendation. The objective of our study was to ascertain if such a practice improves outcomes. This study was a secondary, retrospective analysis of the Community-Acquired Pneumonia Organization (CAPO) international database on CAP. Outcomes in patients admitted to the ICU were compared according to empiric initiation of anti-MRSA therapy (vancomycin or linezolid) with standard ICU CAP therapy (MRSA therapy group) or standard therapy alone for ICU CAP (standard therapy group). A total of 621 patients were identified with ICU pneumonia, of whom 57 patients had been initiated empirically on vancomycin or linezolid (MRSA therapy group). Patients of the MRSA therapy group had more comorbidities and were more severely ill than those of the standard therapy group. However, there were no statistical differences between the MRSA therapy group and standard therapy group for the primary outcomes of in-hospital and 28-day mortality, length of stay and time to clinical stability. These findings suggest that empiric MRSA therapy in all ICU CAP patients may not improve outcomes and argue for clinician review of local epidemiologic trends on MRSA prevalence to ascertain the need for empiric MRSA coverage.
Diagnostic Microbiology and Infectious Disease, 2014
Fusobacteria are obligate anaerobic bacilli residing in the oral cavity, female genital tract, an... more Fusobacteria are obligate anaerobic bacilli residing in the oral cavity, female genital tract, and intestine. These pathogens are typical components of head, neck, and abdominal abscesses due to contiguous spread from adjacent mucosal surfaces. They are unusual etiologies, however, of bone and joint infections, particularly outside the cranial region. We report an unusual case of hematogenous lumbar spondylodiscitis caused by Fusobacterium nucleatum of suspected odontogenic origin.