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Joshua Thomas Thaden

Associate Professor of Medicine
Medicine, Infectious Diseases
DUMC Box 102359, Durham, NC 27710
Rm 201 Alexander H. Sands Buil, 303 Research Drive, Durham, NC 27710

Selected Publications


Combination Therapy Is Not Associated with Decreased Mortality in Infectious Endocarditis: A Systematic Review and Meta-Analysis.

Journal Article Microorganisms · November 2, 2024 Untreated infective endocarditis (IE) is uniformly fatal. The practice of combination antibiotic therapy for IE is recommended by treatment guidelines but largely unsupported by high-quality evidence. This study aimed to assess the efficacy of combination ... Full text Link to item Cite

A microbiological and genomic perspective of globally collected Escherichia coli from adults hospitalized with invasive E. coli disease.

Journal Article J Antimicrob Chemother · September 3, 2024 OBJECTIVES: Escherichia coli can cause infections in the urinary tract and in normally sterile body sites leading to invasive E. coli disease (IED), including bacteraemia and sepsis, with older populations at increased risk. We aimed to estimate the theore ... Full text Link to item Cite

Persistent Gram-negative Bloodstream Infection Increases the Risk of Recurrent Bloodstream Infection With the Same Species.

Journal Article Clin Infect Dis · June 14, 2024 The association between persistent gram-negative bloodstream infection (GN-BSI), or ongoing positive cultures, and recurrent GN-BSI has not been investigated. Among 992 adults, persistent GN-BSI was associated with increased recurrent GN-BSI with the same ... Full text Link to item Cite

Clinical presentation and antimicrobial resistance of invasive Escherichia coli disease in hospitalized older adults: a prospective multinational observational study.

Journal Article Infection · June 2024 BACKGROUND: Clinical data characterizing invasive Escherichia coli disease (IED) are limited. We assessed the clinical presentation of IED and antimicrobial resistance (AMR) patterns of causative E. coli isolates in older adults. METHODS: EXPECT-2 (NCT0411 ... Full text Link to item Cite

Use of Transcriptional Signatures to Differentiate Pathogen-Specific and Treatment-Specific Host Responses in Patients With Bacterial Bloodstream Infections.

Journal Article J Infect Dis · May 15, 2024 BACKGROUND: Clinical outcomes in bacterial bloodstream infections (BSIs) are influenced by bacterial species, host immunity, and antibiotic therapy. The mechanisms by which such factors influence outcomes are poorly understood. We aimed to identify bacteri ... Full text Link to item Cite

Female Sex and Mortality in Patients with Staphylococcus aureus Bacteremia: A Systematic Review and Meta-analysis.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: Staphylococcus aureus is the leading cause of death due to bacterial bloodstream infection. Female sex has been identified as a risk factor for mortality in S aureus bacteremia (SAB) in some studies, but not in others. OBJECTIVE: To determine w ... Full text Link to item Cite

In-patient evolution of a high-persister Escherichia coli strain with reduced in vivo antibiotic susceptibility.

Journal Article Proc Natl Acad Sci U S A · January 16, 2024 Gram-negative bacterial bloodstream infections (GNB-BSI) are common and frequently lethal. Despite appropriate antibiotic treatment, relapse of GNB-BSI with the same bacterial strain is common and associated with poor clinical outcomes and high healthcare ... Full text Link to item Cite

Serum susceptibility of Escherichia coli and its association with patient clinical outcomes.

Journal Article PLoS One · 2024 The innate immune system eliminates bloodstream pathogens such as Escherichia coli in part through complement protein deposition and subsequent bacterial death (i.e., "serum killing"). Some E. coli strains have developed mechanisms to resist serum killing, ... Full text Link to item Cite

Preclinical safety and efficacy characterization of an LpxC inhibitor against Gram-negative pathogens.

Journal Article Sci Transl Med · August 9, 2023 The UDP-3-O-(R-3-hydroxyacyl)-N-acetylglucosamine deacetylase LpxC is an essential enzyme in the biosynthesis of lipid A, the outer membrane anchor of lipopolysaccharide and lipooligosaccharide in Gram-negative bacteria. The development of LpxC-targeting a ... Full text Link to item Cite

Escherichia coli ST131 Associated with Increased Mortality in Bloodstream Infections from Urinary Tract Source.

Journal Article J Clin Microbiol · July 20, 2023 Escherichia coli sequence type 131 (ST131) is a globally dominant multidrug-resistant clone, although its clinical impact on patients with bloodstream infection (BSI) is incompletely understood. This study aims to further define the risk factors, clinical ... Full text Link to item Cite

Clinical and Molecular Analyses of Recurrent Gram-Negative Bloodstream Infections.

Journal Article Clin Infect Dis · February 8, 2023 BACKGROUND: The causes and clinical characteristics of recurrent gram-negative bacterial bloodstream infections (GNB-BSI) are poorly understood. METHODS: We used a cohort of patients with GNB-BSI to identify clinical characteristics, microbiology, and risk ... Full text Link to item Cite

Gram-negative bacteremia in solid organ transplant recipients: Clinical characteristics and outcomes as compared to immunocompetent non-transplant recipients.

Journal Article Transpl Infect Dis · December 2022 BACKGROUND: Outcomes from Gram-negative bacteremia (GNB) in solid organ transplant (SOT) recipients are poorly understood. METHODS: This is a single center prospective cohort study comparing the clinical characteristics and outcomes of SOT recipients with ... Full text Link to item Cite

Association of Follow-up Blood Cultures With Mortality in Patients With Gram-Negative Bloodstream Infections: A Systematic Review and Meta-analysis.

Journal Article JAMA Netw Open · September 1, 2022 IMPORTANCE: Obtaining follow-up blood cultures (FUBCs) in patients with Staphylococcus aureus bloodstream infection (BSI) is standard practice, although its utility in patients with gram-negative bacterial BSI (GN-BSI) is unclear. OBJECTIVE: To examine whe ... Full text Link to item Cite

Staphylococcus aureus Bacteremia Among Patients Receiving Maintenance Hemodialysis: Trends in Clinical Characteristics and Outcomes.

Journal Article Am J Kidney Dis · March 2022 RATIONALE & OBJECTIVE: Staphylococcus aureus (Saureus) bacteremia (SAB) is associated with morbidity and mortality in patients receiving maintenance hemodialysis (HD). We evaluated changes in clinical and bacterial characteristics, and their associations w ... Full text Open Access Link to item Cite

Survey of infectious diseases providers reveals variability in duration of antibiotic therapy for the treatment of Gram-negative bloodstream infections.

Journal Article JAC Antimicrob Resist · March 2022 BACKGROUND: Trials supporting shorter durations of antibiotic therapy for Gram-negative bloodstream infections (GN-BSI) have recently been published. However, adoption of these findings into practice is unclear given limited eligibility criteria and relati ... Full text Link to item Cite

Distribution of serotypes and antibiotic resistance of invasive Pseudomonas aeruginosa in a multi-country collection.

Journal Article BMC Microbiol · January 6, 2022 BACKGROUND: Pseudomonas aeruginosa is an opportunistic pathogen that causes a wide range of acute and chronic infections and is frequently associated with healthcare-associated infections. Because of its ability to rapidly acquire resistance to antibiotics ... Full text Link to item Cite

Variability in oral antibiotic step-down therapy in the management of Gram-negative bloodstream infections.

Journal Article Int J Antimicrob Agents · December 2021 There are important gaps in the literature regarding the role and timing of oral therapy for Gram-negative bloodstream infections (GN-BSIs). To better understand contemporary management practices involving oral step-down in GN-BSI, we conducted an internat ... Full text Link to item Cite

Bacteremia in solid organ transplant recipients as compared to immunocompetent patients: Acute phase cytokines and outcomes in a prospective, matched cohort study.

Journal Article Am J Transplant · June 2021 We undertook a prospective, matched cohort study of patients with Staphylococcus aureus bacteremia (SAB) and gram-negative bacteremia (GNB) to compare the characteristics, outcomes, and chemokine and cytokine response in transplant recipients to immunocomp ... Full text Open Access Link to item Cite

Human DNA methylation signatures differentiate persistent from resolving MRSA bacteremia.

Journal Article Proc Natl Acad Sci U S A · March 9, 2021 Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is life threatening and occurs in up to 30% of MRSA bacteremia cases despite appropriate antimicrobial therapy. Isolates of MRSA that cause antibiotic-persistent methicillin-resistant ... Full text Link to item Cite