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Education ?

Medical School Score
Texas Tech University (2003)

Affiliations ?

Dr. Shirley is affiliated with 3 hospitals.

Hospital Affiliations



  • Longview Regional Medical Center
    2901 N 4th St, Longview, TX 75605
    Top 50%
  • Good Shepherd Medical Center
    700 E Marshall Ave, Longview, TX 75601
  • Good Shepard Health Systems
  • Publications & Research

    Dr. Shirley has contributed to 4 publications.
    Title Cryptococcal Lung Disease.
    Date June 2009
    Journal Current Opinion in Pulmonary Medicine

    Cryptococcosis is an important opportunistic fungal infection, especially in the immunocompromised patient. Meningitis is the most common manifestation of cryptococcosis; however, cryptococcal lung disease is probably underdiagnosed, and knowledge of epidemiology, diagnosis, and treatment is necessary.

    Title Successful Closure of a Benign Postsurgical Esophagocutaneous Fistula by Temporary Placement of a Self-expanding Plastic Stent.
    Date January 2008
    Journal Gastrointestinal Endoscopy
    Title Statewide Experience with Clostridium Difficile Colitis in Academic and Nonacademic Medical Centers (*).
    Journal Surgical Infections

    Abstract Background: Clostridium difficile colitis is a nosocomial infection that can present as minor, readily treated symptoms or as fulminant colitis leading to death. Risk factors for C. difficile colitis have been defined, and certain populations of hospitalized patients appear to be particularly susceptible. However, most information on C. difficile colitis is from large tertiary-care medical centers. Whether the community hospital experience is similar to that of large referral centers is unknown. Methods: We abstracted all cases of C. difficile colitis (ICD-9-CM 008.45) for 2003-2005 from a state database and divided the hospitals into academic and nonacademic centers. Cases were stratified according to whether the colitis was listed as the primary presenting diagnosis or a secondary diagnosis. Demographic information, associated diagnoses, length of stay, and deaths were analyzed. Results: The incidence of C. difficile colitis increased from 2003 to 2005, and the majority of cases occurred at nonacademic centers. Patients in nonacademic centers more frequently had C. difficile colitis as the primary diagnosis, had a shorter length of stay, were older, and were more frequently women. The mortality rate was higher for secondary (8.5%) than for primary (2.6%; p < 0.05) C. difficile colitis, but there was no difference between academic and nonacademic centers. Conclusions: The incidence of C. difficile colitis is increasing in this statewide database. Compared with academic medical centers, nonacademic centers deal with a higher rate of primary C. difficile colitis that is associated with a lower mortality rate and shorter stay than secondary colitis.

    Title Observational Study of the Epidemiology and Outcomes of Vancomycin-resistant Enterococcus Bacteraemia Treated with Newer Antimicrobial Agents.
    Journal Epidemiology and Infection

    SUMMARYVancomycin-resistant Enterococcus bloodstream infections (VRE-BSI) are a growing problem with few clinical trials to guide therapy. We conducted a retrospective study of management and predictors of mortality for VRE-BSI at a tertiary-care centre from January 2005 to August 2008. Univariate and multivariable analyses examined the relationship of patient characteristics and antibiotic therapy with 30-day all-cause mortality. Rates of VRE-BSI increased from 0·06 to 0·17 infections/1000 patient-days (P=0·03). For 235 patients, 30-day mortality was 34·9%. Patients were primarily treated with linezolid (44·2%) or daptomycin (36·5%). Factors associated with mortality were haemodialysis [odds ratio (OR) 3·2, 95% confidence interval (CI) 1·6-6·3, P=0·007], mechanical ventilation (OR 3·7, 95% CI 1·3-10·4, P=0·01), and malnutrition (OR 2·0, 95% CI 1·0-4·0, P=0·046). Use of linezolid, but not daptomycin (P=0·052) showed a trend towards an association with survival. In conclusion, VRE-BSI is a growing problem, associated with significant 30-day mortality. Multiple factors were associated with poor outcomes at our hospital.

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