Publications by authors named "Mohanad Al-Obaidi"

10 Publications

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A Comparative Analysis of Mucormycosis in Immunosuppressed Hosts Including Patients with Uncontrolled Diabetes in the Southwest United States.

Am J Med 2021 May 8. Epub 2021 May 8.

Division of Infectious Diseases.

Background: Mucormycosis (zygomycosis) is an invasive fungal infection that carries a high risk of morbidity and mortality. Uncontrolled diabetes mellitus and other immunocompromising conditions are risk factors for mucormycosis development. We here describe the differences in characteristics and outcomes of mucormycosis among solid organ transplant, hematological malignancy, and diabetes mellitus groups at our institution.

Methods: We conducted a retrospective chart review over the period of 2009-2020, with identifying patients using the International Classification of Diseases, Ninth and Tenth Revisions. Clinical, laboratory, and outcome data were collected.

Results: There were 28 patients identified: 7 solid organ transplant, 3 hematological malignancy, and 18 diabetes mellitus patients were included in the study. Three solid organ transplant patients experienced an episode of rejection, and another 3 had cytomegalovirus infection prior to presenting with mucormycosis. Four of seven solid organ transplant patients had a history of diabetes mellitus, but the median hemoglobin A1C was lower than in the diabetes mellitus group (6.3 vs 11.5; P = .006). The mortality rate difference between solid organ transplant and diabetes mellitus was not statistically significant: 2/7 (28.57%) vs 5/18 (27.78%); P = .66. Patients with bilateral disease (pulmonary or sinus) had significantly higher mortality (80% vs 13%, P = .008). There was no difference in mortality outcomes among the different types of antifungal therapies administered.

Conclusion: A multispecialty approach is imperative in mucormycosis therapy. While the underlying risk factors were different, the outcomes were comparable for the solid organ transplant and diabetes mellitus groups. Future larger and longitudinal studies are recommended.
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http://dx.doi.org/10.1016/j.amjmed.2021.04.008DOI Listing
May 2021

Pulmonary infection secondary to Blastobotrys raffinosifermentans in a cystic fibrosis patient: Review of the literature.

Mycoses 2021 Jun 20;64(6):616-623. Epub 2021 Feb 20.

Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

Background: The genus Blastobotrys consists of at least 20 species. Disease in humans has been reported with B adeninivorans, B raffinosifermentans, B proliferans and B serpentis, mostly in immunocompromised patients and those with cystic fibrosis.

Objective: We report a lung infection secondary to B raffinosifermentans in a cystic fibrosis patient successfully treated with isavuconazole and review the literature of invasive infections caused this genus. We also evaluated clinical isolates in our laboratory for species identification and antifungal susceptibility.

Methods: Phylogenetic analysis was performed on a collection of 22 Blastobotrys isolates in our reference laboratory, and antifungal susceptibility patterns were determined for nine clinically available antifungals against 19 of these isolates.

Results: By phylogenetic analysis, 21 of the 22 isolates in our collection were identified as B raffinosifermentans and only 1 as B adeninivorans. Most were cultured from the respiratory tract, although others were recovered from other sources, including CSF and blood. Isavuconazole, caspofungin and micafungin demonstrated the most potent in vitro activity, followed by amphotericin B. In contrast, fluconazole demonstrated poor activity. The patient in this case responded to isavuconazole treatment for breakthrough infection due to B raffinosifermentans that was cultured from pleural fluid while on posaconazole prophylaxis post-bilateral lung transplantation for cystic fibrosis.

Conclusions: Blastobotrys species are rare causes of infections in humans and primarily occur in immunocompromised hosts. In our collection, the majority of isolates were identified as B raffinosifermentans. To our knowledge, this is the first report of successful treatment of such an infection with isavuconazole.
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http://dx.doi.org/10.1111/myc.13252DOI Listing
June 2021

Evolution of Cefiderocol Non-Susceptibility in Pseudomonas aeruginosa in a Patient Without Previous Exposure to the Antibiotic.

Clin Infect Dis 2021 Jan 7. Epub 2021 Jan 7.

Center for Antimicrobial Resistance and Microbial Genomics.

We report the emergence of non-susceptibility to cefiderocol from a subpopulation of Pseudomonas aeruginosa recovered from a patient without history of cefiderocol exposure. Whole genome sequencing identified mutations in major iron transport pathways previously associated with cefiderocol uptake. Susceptibility testing should be performed before therapy with siderophore cephalosporins.
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http://dx.doi.org/10.1093/cid/ciaa1909DOI Listing
January 2021

Fixed Dosing of Amphotericin B in Morbidly Obese Individuals.

Clin Infect Dis 2021 05;72(9):e431

Department of Medicine, Section of Infectious Diseases, University of Arizona, Tucson, Arizona, USA.

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http://dx.doi.org/10.1093/cid/ciaa1076DOI Listing
May 2021

Perinephric abscess in a renal transplant recipient due to Mycoplasma hominis: Case report and review of the literature.

Transpl Infect Dis 2020 Oct 7;22(5):e13308. Epub 2020 Jul 7.

Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA.

A 42-year-old man presented with nausea, malaise, and pain at his renal graft site 4 months following deceased donor renal transplant. His transplantation had been complicated by urinary leak with delayed wound closure requiring ureteral revision with biologic mesh placement. The initial evaluation in the hospital revealed urinalysis with significant pyuria as well as abdominal CT imaging concerning for abscess formation anterior to the grafted kidney. Interventional radiology (IR) guided drainage of this abscess yielded growth of Enterococcus faecalis treated with intravenous ampicillin/sulbactam. He continued to have pain at his graft site and repeat imaging revealed a persistent abscess despite prolonged antimicrobial therapy. Urine cultures isolated Mycoplasma species. A repeat aspirate of abscess fluid collected and Mycoplasma hominis was identified by molecular test. Patient's symptoms abated and his abscess completely resolved on repeat imaging after completing a course of oral moxifloxacin and doxycycline. His immunosuppression did not require adjustment and the renal graft continued to function well following this therapy. Mycoplasma and Ureaplasma should be considered as a potential etiology for perinephric abscess in renal transplant recipients.
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http://dx.doi.org/10.1111/tid.13308DOI Listing
October 2020

Pulmonary Mucormycosis in a Heart Transplant Patient.

Am J Med 2020 09 19;133(9):e524-e525. Epub 2020 Mar 19.

University of Arizona, College of Medicine, Division of Infectious Diseases, Tucson.

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http://dx.doi.org/10.1016/j.amjmed.2020.02.020DOI Listing
September 2020

Seroprevalence of Strongyloides stercoralis and Evaluation of Universal Screening in Kidney Transplant Candidates: A Single-Center Experience in Houston (2012-2017).

Open Forum Infect Dis 2019 Jul;6(7)

Division of Infectious Diseases, McGovern Medical School, University of Texas Health Science Center at Houston.

Background: Disseminated strongyloidiasis in solid organ transplant recipients is a rare but devastating infection. In our center, we implemented a universal screening of all candidates for kidney transplantation. We assessed the seroprevalence and utility of universal screening for strongyloidiasis in our center.

Methods: Patients were identified from our transplant referral list (from July 2012 to June 2017). Demographics, pretransplant laboratory, and serological screenings were retrospectively collected. For Strongyloides-seropositive (SSp) patients, data on travel history, symptoms, treatment, and stool ova and parasite examinations were extracted. Logistic regression and multiple imputation for missing data were performed.

Results: A total of 1689 patients underwent serological screening, of whom 168 (9.9%) were SSp. Univariate analysis revealed that SSp patients had higher rates of eosinophilia, diabetes mellitus, latent tuberculosis and were likely to be either Hispanic or Asian (P < .05). In multivariate analysis, eosinophilia (P = .01), diabetes mellitus (P = .02), and Asian race (P = .03) were associated with being SSp, but 45 (27%) of the SSp patients did not have any of these 3 factors, and 18 SSp patients (11%) had no epidemiological risk factors. All patients received ivermectin, and none developed disseminated strongyloidiasis. Of patients who underwent serological screening on multiple occasions, 6.8% seroconverted while waiting for kidney transplantation.

Conclusions: We found a high rate of Strongyloides seropositivity among our kidney transplantation candidates. No epidemiological risk factors effectively predicted SSp status in our population, and universal screening identified a large number of patients without such factors. Serial screening should be considered when a long wait time is expected before transplantation.
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http://dx.doi.org/10.1093/ofid/ofz172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656655PMC
July 2019

Post-exposure prophylaxis with isavuconazole after occupational exposure to .

Oxf Med Case Reports 2018 Oct 18;2018(10):omy062. Epub 2018 Sep 18.

Division of Infectious Diseases, McGovern Medical School, Houston, TX, USA.

Invasive mucormycosis is typically seen in patients with hematological malignancies, diabetes and other conditions that affect the immune system. However, locally invasive disease can also be seen in both immunocompromised and immunocompetent hosts after trauma and direct inoculation. Since historically post-exposure prophylaxis with lipid-based amphotericin B compounds has not been feasible because of a high toxicity profile, there is no experience regarding the role of post-exposure prophylaxis after injuries contaminated with agents of mucormycosis. We describe the first case of a patient with occupational exposure to that received post-exposure prophylaxis with oral isavuconazole.
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http://dx.doi.org/10.1093/omcr/omy062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142719PMC
October 2018

Invasive Fungal Infections in the Intensive Care Unit.

Infect Dis Clin North Am 2017 09 5;31(3):475-487. Epub 2017 Jul 5.

Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, 6431 Fannin MSB 2.112, Houston, TX 77030, USA. Electronic address:

Patients in the intensive care unit are exposed to multiple stressors that predispose them to invasive fungal infections (IFIs), which carry high morbidity and mortality. Getting acquainted with the diagnostic methods and therapies is imperative for patient safety and for providing high-quality health care. This article focuses on the most frequent IFIs: invasive candidiasis and invasive aspergillosis.
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http://dx.doi.org/10.1016/j.idc.2017.05.005DOI Listing
September 2017

Progressive headache in a 48-year-old man.

BMJ Case Rep 2015 Jan 9;2015. Epub 2015 Jan 9.

Texas Tech University Health Sciences Center, Amarillo, Texas, USA.

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http://dx.doi.org/10.1136/bcr-2014-208736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289794PMC
January 2015