Person:
LaSalvia, Mary

Profile Picture

Email Address

AA Acceptance Date

Birth Date

Research Projects

Organizational Units

Job Title

Last Name

LaSalvia

First Name

Mary

Name

LaSalvia, Mary
Author's Publications: search.filters.isAuthorOfPublication.c76fce58-7cc5-4cfd-b2ed-2675398cb9a6

Search Results

Now showing 1 - 2 of 2
  • Thumbnail Image
    Publication
    Does Adjunctive Tigecycline Improve Outcomes in Severe-Complicated, Nonoperative Clostridium difficile Infection?
    (Oxford University Press (OUP), 2017) LaSalvia, Mary; Branch-Elliman, Westyn; Snyder, Graham Michael; Mahoney, Monica V.; Alonso, Carolyn; Gold, Howard; Wright, Sharon
    Severe Clostridium difficile infection is associated with a high rate of mortality; however, the optimal treatment for severe- complicated infection remains uncertain for patients who are not candidates for surgical intervention. Thus, we sought to evaluate the benefit of adjunctive tigecycline in this patient population using a retrospective cohort adjusted for propensity to receive tigecycline. We found that patients who received tigecycline had similar outcomes to those who did not, although the small sample size limited power to adjust for comorbidities and severity of illness.
  • No Thumbnail Available
    Publication
    Investigation of a Candida guilliermondii Pseudo-Outbreak Reveals a Novel Source of Laboratory Contamination
    (American Society for Microbiology, 2017-04) Kirby, James; Branch-Elliman, Westyn; LaSalvia, Mary; Longhi, Lorinda; MacKechnie, Matthew; Urman, Grigoriy; Baldini, Linda M.; Muriel, Fatima R.; Sullivan, Bernadette; Yassa, David; Gold, Howard; Wagner, Trevor K.; Diekema, Daniel J.; Wright, Sharon
    Candida guilliermondii was isolated from sterile specimens with increasing frequency over a several-month period despite a paucity of clinical evidence suggesting true Candida infections. However, a health care-associated outbreak was strongly considered due to growth patterns in the microbiology laboratory that were more consistent with true infection than environmental contamination. Therefore, an extensive investigation was performed to identify its cause. With the exception of one case, patient clinical courses were not consistent with true invasive fungal infections. Furthermore, no epidemiologic link between patients was identified. Rather, extensive environmental sampling revealed C. guilliermondii in an anaerobic holding jar in the clinical microbiology laboratory, where anaerobic plates were prereduced and held before inoculating specimens. C. guilliermondii grows poorly under anaerobic conditions. Thus, we postulate that anaerobic plates became intermittently contaminated. Passaging from intermittently contaminated anaerobic plates to primary quadrants of aerobic media during specimen planting yielded a colonial growth pattern typical for true specimen infection, thus obscuring laboratory contamination. A molecular evaluation of the C. guilliermondii isolates confirmed a common source for pseudo-outbreak cases but not for the one true infection. In line with Reason's model of organizational accidents, active and latent errors coincided to contribute to the pseudo-outbreak. These included organism factors (lack of growth in anaerobic conditions obscuring plate contamination), human factors (lack of strict adherence to plating order, leading to only intermittent observation of aerobic plate positivity), and laboratory factors (novel equipment). All of these variables should be considered when evaluating possible laboratory-based pseudo-outbreaks.