A5077815692- Neutropenia and Cancer Infections
- Gut microbiota and health
- Hematopoietic Stem Cell Transplantation
- Respiratory viral infections research
- COVID-19 Clinical Research Studies
- Cytomegalovirus and herpesvirus research
- SARS-CoV-2 and COVID-19 Research
- Pediatric health and respiratory diseases
- Mycobacterium research and diagnosis
- Antibiotic Resistance in Bacteria
- Clostridium difficile and Clostridium perfringens research
- COVID-19 Impact on Reproduction
- Bacterial Identification and Susceptibility Testing
- Infant Nutrition and Health
- Hematological disorders and diagnostics
- Syphilis Diagnosis and Treatment
- Influenza Virus Research Studies
- Pneumonia and Respiratory Infections
- Antibiotics Pharmacokinetics and Efficacy
- Neonatal and Maternal Infections
- Immune Response and Inflammation
- Immune Cell Function and Interaction
- Herpesvirus Infections and Treatments
- Reproductive tract infections research
- Long-Term Effects of COVID-19
Duke University
2020-2025
Office of Infectious Diseases
2023
Duke Medical Center
2019-2023
Le Bonheur Children's Hospital
2018
University of Tennessee Health Science Center
2018
St. Jude Children's Research Hospital
2011
Host inflammatory responses contribute to the significant immunopathology that occurs during treatment of secondary bacterial pneumonia following influenza. We undertook present study determine mechanisms underlying disparate outcomes in a mouse model with β-lactam and macrolide antibiotics. Lysis superinfecting bacteria by ampicillin caused an extensive influx neutrophils into lungs resulting consolidative pneumonia, necrotic lung damage, mortality. This was mediated through Toll-like...
Child with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum SARS-CoV-2-related illnesses viruses causes children.We conducted prospective cohort study children and adolescents (aged <21 years) SARS-CoV-2-infected close contact. We collected nasopharyngeal or nasal swabs at enrollment tested for SARS-CoV-2 using real-time polymerase chain reaction...
Children are less susceptible to SARS-CoV-2 infection and typically have milder illness courses than adults, but the factors underlying these age-associated differences not well understood. The upper respiratory microbiome undergoes substantial shifts during childhood is increasingly recognized influence host defense against pathogens. Thus, we sought identify features associated with susceptibility severity.We collected clinical data nasopharyngeal swabs from 285 children, adolescents,...
ABSTRACT BACKGROUND Children with SARS-CoV-2 infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum illnesses virus causes children. METHODS We conducted prospective cohort study children and adolescents (<21 years age) SARS-CoV-2-infected close contact. collected nasopharyngeal or nasal swabs at enrollment tested for using real-time PCR assay. RESULTS Of 382 children, 289 (76%) were SARS-CoV-2-infected. more likely...
Highlights•Gut colonization precedes most mucosal barrier injury BSIs in HSCT recipients.•Antibiotics are associated with rising abundances of resistant strains the gut.•Detection vanA and ESBL genes predicts phenotypic resistance BSI strains.ABSTRACTThe gastrointestinal tract is predicted reservoir for bloodstream infections (BSIs) after hematopoietic stem cell transplantation (HSCT). Whole-genome sequencing comparative genomics have potential to improve our understanding dynamics gut that...
Certain anaerobic bacteria are important for maintenance of gut barrier integrity and immune tolerance may influence the risk graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). We conducted a single-center retrospective cohort study HSCT recipients to evaluate associations between receipt antibiotics with an spectrum activity GVHD outcomes. identified 1214 children adults who developed febrile neutropenia 7 days before 28 compared mortality...
Abstract Background Pediatric solid organ transplant (SOT) recipients are at increased risk for vaccine preventable illnesses (VPI). They frequently receive vaccines after transplantation when immunosuppressive medications and cytopenias may impact their immune response to routine childhood vaccines. Current guidelines recommend monitoring vaccine-specific serologies ensure optimal responses guide the need repeat doses. Methods In this single-center retrospective cohort study, a multivariate...
Antibiotic resistance is a global threat driven primarily by antibiotic use. We evaluated the effects of exposures on gut microbiomes and resistomes children at high risk colonization antibiotic-resistant bacteria. performed shotgun metagenomic sequencing 691 serially collected fecal samples from 80 (<18 years) undergoing hematopoietic cell transplantation. aerobic (cefepime, vancomycin, fluoroquinolones, aminoglycosides, macrolides, trimethoprim-sulfamethoxazole) anaerobic...
Abstract Background Gut dysbiosis contributes to the high risk of bloodstream infection (BSI) among premature infants. Most prior studies infant gut microbiota were conducted in Western countries and development current tools for strain-resolved analysis. Methods We performed metagenomic sequencing weekly fecal samples from 75 infants at a single hospital Singapore. evaluated associations between clinical factors composition using PERMANOVA mixed effects linear regression. used inStrain...
Cytomegalovirus (CMV) causes substantial morbidity and mortality after hematopoietic stem cell transplantation (HSCT). There are limited data on risk factors for CMV viremia the safety of antiviral medications used to treat in children.We conducted a single-center retrospective study children who underwent HSCT between 2000 2016. We log-logistic regression evaluate associations clinical characteristics CMV-free survival at 100 days HSCT. compared incidences laboratory-defined adverse events...
Children undergoing hematopoietic stem cell transplantation (HSCT) are at high risk for hospital-associated bloodstream infections (HA-BSIs). This study aimed to describe the incidence, microbiology, and factors HA-BSI in pediatric HSCT recipients.We performed a single-center retrospective cohort of children adolescents (<18 years age) who underwent over 20-year period (1997-2016). We determined incidence case fatality rate by causative organism. used multivariable Poisson regression...
Bloodstream infections (BSIs) occur frequently after hematopoietic stem cell transplantation (HSCT). We examined the microbiology of BSI in pediatric HSCT recipients over a 2-decade period at our institution to inform empirical antimicrobial prescribing and infection prevention strategies.We conducted retrospective cohort study children (<18 years) who underwent Duke University between 1997 2015. used recurrent-event gap-time Cox proportional hazards models determine all-cause cause-specific...
Children are less susceptible to SARS-CoV-2 and typically have milder illness courses than adults. We studied the nasopharyngeal microbiomes of 274 children, adolescents, young adults with exposure using 16S rRNA gene sequencing. find that higher abundances Corynebacterium species associated infection SARS-CoV-2-associated respiratory symptoms, while Dolosigranulum pigrum present in SARS-CoV-2-infected individuals without symptoms. also demonstrate these bacteria strongly, independently,...
Abstract Background Bacteremia in hematopoietic stem cell transplant (HSCT) recipients most frequently arises from gut bacterial translocation and is associated with a higher mortality if the organism antibiotic-resistant. We sought to determine impact of prior antibiotic exposure on resistance genes (ARGs) metagenomes HSCT inform future infection prevention strategies. Methods performed shotgun metagenomic sequencing fecal samples collected during hospitalization children (&lt; 18 years...
Abstract Background Children undergoing hematopoietic stem cell transplantation (HCT) are at high risk of acquiring antibiotic-resistant bacteria. Few prior studies examined antibiotic resistance genes (ARGs) within the gut metagenomes children HCT. Methods We conducted a longitudinal study (age <18 years) HCT single institution. performed shotgun metagenomic sequencing fecal samples collected between days -30 and +100 relative to evaluated effects aerobic (cefepime, vancomycin,...
Abstract Background Due to their gestational age, low birth weight, and immature gut barriers, premature neonates are at high risk of bloodstream infections (BSI) caused by bacteria that reside in the gastrointestinal tract. Relatively little is known about effect alterations microbiota on BSI neonates. Methods This prospective cohort study was conducted neonatal intensive care unit KK Women’s Children’s Hospital Singapore between June 1, 2019 May 31, 2021. Clinical data twice weekly fecal...
Abstract Background Cytomegalovirus (CMV) causes substantial morbidity and mortality after hematopoietic stem cell transplantation (HCT), antibiotic exposure HCT is increasingly recognized as a risk for negative clinical outcomes. Recent studies identified an association between receipt of antibiotics with anaerobic spectrum activity infection cytomegalovirus in adults. We sought to evaluate the CMV viremia well-characterized cohort pediatric recipients. Method conducted single-center...