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Anne Rebecca Fabiny, M.D.

TitleAssistant Professor of Medicine
InstitutionCambridge Health Alliance
DepartmentMedicine
AddressCambridge Health Alliance
Department of Medicine, Geriatrics Division
1493 Cambridge St
Cambridge MA 02139
Phone617/665-1029
Fax617/665-1671
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 Mentoring 
 current student opportunities
Available: 09/19/11, Expires: 09/19/21

Objectives: 1. Identify the most common uropathogens causing symptomatic cystitis in patient > 65 years of age 2. Determine prevalence of antimicrobial resistance 3. Understand risk factors that predispose patients to infection with extended-spectrum beta-lactamase (ESBL) producing bacteria 4. Determine optimal antibiotic selection for this population Methods: A prospective surveillance study will be conducted in patients > 65 yr of age presenting to the Cambridge Health Alliance geriatrics ambulatory practices and Emergency Department who meet the definition of a symptomatic UTI defined as presenting with any of the following symptoms: dysuria, frequency, urgency, suprapubic pain, confusion, new or worsened incontinence or lethargy and a positive urine culture (>100,000 colony forming units/mL) with pyuria (>5 leukocytes/high power field on urinalysis). Urine samples will be collected by mid-stream clean catch or by catheterization for culture, sensitivity and microscopic analysis. Samples will be processed according to routine laboratory methodology. A case control study will be performed in order to identify risk factors for infection with an ESBL producing organism. Age, sex, ethnicity, residence, weight, (functional status ?), indwelling bladder catheter, hospitalization within the past year, antibiotic treatment within preceding 3 mos (drugs, dose, duration), comorbidities (DM, cancer, neurogenic bladder, BPH, immunosuppression, renal insufficiency (Clcr), nephrolithiasis, urologic abnormalities, etc.), catheterization within the past three months, bacterial pathogen accounting for current infection, and bacteria documented in urine cultures in the preceding 12 mo will be entered into a database. Univariate and multivariate logistic regression will be performed to identify risks for ESBL infection. The prevalence of fluoroquinolone, trimethoprim-sulfamethoxazole, oral beta-lactams and nitrofurantoin resistance will be determined. Conclusion: Results from this prospective study will inform practitioners about the susceptibility profile of uropathogens in this patient population and identify risk factors for infection with an ESBL-producing organism which may warrant consideration for parenteral therapy. An antibiogram will be developed for treating culture proven cystitis in outpatients older than 65. Student role: The student will be the project manager, overseeing collection of data, maintaining the database and work in partnership with a statistician (presumably available through HMS), as well as collaborate with the CHA Microbiology Laboratory to develop a susceptibility report for patients included in this study. The student will particpate in developing an Antibiogram for this patient population.


 Bibliographic 
 selected publications
Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
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  1. Fabiny A. Exercising outdoors in cold weather. Harv Womens Health Watch. 2014 Nov; 22(3):7.
    View in: PubMed
  2. Fabiny A. Ask the doctor. I am 61 and had been on atorvastatin for 10 years with no problems. Recently, I've had disabling muscle pain with both the generic atorvastatin and the brand-name version, Lipitor. My doctor says that I can no longer take statin drugs. Since strokes run in my family, I am concerned. Is there anything else I can do to decrease my risk of stroke? Harv Womens Health Watch. 2014 Nov; 22(3):2.
    View in: PubMed
  3. Fabiny A. Ask the doctor. Your advise women to eat 46 grams of protein daily, but I don't know what that translates to in ounces. Harv Womens Health Watch. 2014 Nov; 22(3):2.
    View in: PubMed
  4. Fabiny A. Ask the doctor. I have been taking a sleeping pill for about a year, and it has helped me get a good night's sleep. My doctor says he does not think it's a good idea for me to continue taking it. I'm worried that if I go off the drug, I won't sleep well. Should I stop? Harv Womens Health Watch. 2014 Sep; 21(13):2.
    View in: PubMed
  5. Fabiny A. Ask the doctor. I recently took antibiotics to treat an oral infection and as a result developed a vaginal yeast infection. Can I treat it myself, and what are the most effective options? Harv Womens Health Watch. 2014 Sep; 21(13):2.
    View in: PubMed
  6. Fabiny A. How to avoid overload and burnout. Harv Womens Health Watch. 2014 Aug; 21(12):7.
    View in: PubMed
  7. Fabiny A. Ask the doctor. My doctor recently added a couple of medications to my regimen. I am now taking enough pills every day that I need a system to keep them organized so I don't make mistakes. What do you recommend? Harv Womens Health Watch. 2014 Aug; 21(12):2.
    View in: PubMed
  8. Fabiny A. Ask the doctor. My doctor suggested I take a long-acting opioid like oxycodone to manage my pain. but I have heard so much frightening news about opioids recently that I am anxious about trying it. Are opioids a safe option for chronic pain? Harv Womens Health Watch. 2014 Aug; 21(12):2.
    View in: PubMed
  9. Fabiny A. Ask the doctor. All winter my mother complained about feeling cold, even though the heat was turned up and she was wearing plenty of warm clothing. Now that summer is here she is still complaining of feeling cold. Her doctor did lab work and everything was normal. Why is she always so cold? Harv Womens Health Watch. 2014 Jul; 21(11):2.
    View in: PubMed
  10. Fabiny A. Ask the doctor. I have been having frequent foot and calf cramps at night that are quite painful. They come on when I first get into bed. What causes them? Can I do anything to prevent them? Harv Womens Health Watch. 2014 Jul; 21(11):2.
    View in: PubMed
  11. Fabiny A. Ask the doctor. I am in my early 80s, and my doctor has not yet told me when I can stop getting mammograms, colonoscopes, and Pap tests. I'm due for my annual visit soon. Are there any guidelines for when women can stop getting these tests? Harv Womens Health Watch. 2014 Jun; 21(10):2.
    View in: PubMed
  12. Fabiny A. What's for dinner? Why it can be hard to cook at home, and a few suggestions for easier mealtimes. Harv Womens Health Watch. 2014 Jun; 21(10):7.
    View in: PubMed
  13. Fabiny A. Ask the doctor. Do you have any suggestions for a 79-year-old woman who has quite a bit of pain in her back? I have spinal stenosis and curvature of the spine. Harv Womens Health Watch. 2014 Jun; 21(10):2.
    View in: PubMed
  14. Fabiny A. Taking the first steps for planning end-of-life conversations. Harv Womens Health Watch. 2014 May; 21(9):5.
    View in: PubMed
  15. Fabiny A. Ask the doctor. Now that I am postmenopausal, I have been getting bladder infections more frequently. Why is that, and is there anything I can do to prevent them? Harv Womens Health Watch. 2014 May; 21(9):2.
    View in: PubMed
  16. Fabiny A. Ask the doctor. I have been feeling sad and without much interest in my social life for the past few weeks. My doctor diagnosed me with mild depression. She asked that I come back in a month for follow-up. Isn't there something else I should do to feel better? Harv Womens Health Watch. 2014 May; 21(9):2.
    View in: PubMed
  17. Fabiny A. Ask the doctor. I've had osteoporosis for several years, and I've been taking alendronate (Fosamax) once a week. I wasn't very good at remembering to take it regularly, so my doctor recently recommended that I start on once-a-year infusions of zoledronic acid (Reclast). Will it work as well to prevent me from breaking a bone? Harv Womens Health Watch. 2014 Apr; 21(8):2.
    View in: PubMed
  18. Fabiny A. Ask the doctor. I am a 68-year-old overweight woman with COPD who has recently started exercising regularly. I have been riding stationary bike for about 10 minutes, six days a week, and I just can't seem to go longer without getting short of breath. My doctor suggested that I stop using the bike and start weight training. How will that help me get in shape and lose weight? Harv Womens Health Watch. 2014 Apr; 21(8):2.
    View in: PubMed
  19. Fabiny A. Ask the doctor. I have just stopped taking a statin drug because it was causing muscle pain. To control my cholesterol I'm now taking ground flaxseed and a daily red yeast rice pill. Are these supplements effective for lowering cholesterol? Harv Womens Health Watch. 2014 Mar; 21(7):2.
    View in: PubMed
  20. Fabiny A. Ask the doctor. I am postmenopausal, and I've noticed that my belly isn't as flat as it once was, even though my weight hasn't changed much in the past 15 years and I am healthy. Is this change in shape something I am just going to have to get accustomed to, or can I do something about it? Harv Womens Health Watch. 2014 Mar; 21(7):2.
    View in: PubMed
  21. Fabiny A. Ask the doctor. My 83-year-old mother told me recently that she fell in her bedroom. She said she feels fine, and she's refusing to see her doctor about it. Should I insist that she go? Harv Womens Health Watch. 2014 Feb; 21(6):2.
    View in: PubMed
  22. Fabiny A. Ask the doctor. Every once in a while I get bloating and gas. It's uncomfortable and embarrassing. What can I do to get rid of it? Harv Womens Health Watch. 2014 Feb; 21(6):2.
    View in: PubMed
  23. Fabiny A. Ask the doctor. I've been feeling consistently down since my husband passed away last year. What are my treatment options? Harv Womens Health Watch. 2013 Oct; 21(2):2.
    View in: PubMed
  24. Fabiny A. Ask the doctor. Every time I get a urinary tract infection, my doctor prescribes antibiotics. Is there any other way to treat my infections? Harv Womens Health Watch. 2013 Oct; 21(2):2.
    View in: PubMed
  25. Williams BC, Warshaw G, Fabiny AR, Lundebjerg Mpa N, Medina-Walpole A, Sauvigne K, Schwartzberg JG, Leipzig RM. Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents. J Grad Med Educ. 2010 Sep; 2(3):373-83.
    View in: PubMed
  26. O'Sullivan P, Chao S, Russell M, Levine S, Fabiny A. Development and implementation of an objective structured clinical examination to provide formative feedback on communication and interpersonal skills in geriatric training. J Am Geriatr Soc. 2008 Sep; 56(9):1730-5.
    View in: PubMed
  27. Famakinwa A, Fabiny A. Assessing and managing caregiver stress: development of a teaching tool for medical residents. Gerontol Geriatr Educ. 2008; 29(1):52-65.
    View in: PubMed
  28. Simon SR, Fabiny AR, Kotch J. Geriatrics training in general internal medicine fellowship programs: current practice, barriers, and strategies for improvement. Ann Intern Med. 2003 Oct 7; 139(7):621-7.
    View in: PubMed
  29. Fabiny AR, Kiel DP. Assessing and treating weight loss in nursing home patients. Clin Geriatr Med. 1997 Nov; 13(4):737-51.
    View in: PubMed
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