A5075611963- Cytomegalovirus and herpesvirus research
- Pneumonia and Respiratory Infections
- Antifungal resistance and susceptibility
- Bacterial Identification and Susceptibility Testing
- Pneumocystis jirovecii pneumonia detection and treatment
- Neutropenia and Cancer Infections
- Mosquito-borne diseases and control
- Malaria Research and Control
- Antibiotic Resistance in Bacteria
- Complement system in diseases
- Transplantation: Methods and Outcomes
- Bacterial Infections and Vaccines
- Hematological disorders and diagnostics
- Respiratory viral infections research
- Clostridium difficile and Clostridium perfringens research
- COVID-19 Clinical Research Studies
- Sepsis Diagnosis and Treatment
- Fungal Infections and Studies
- Antibiotic Use and Resistance
- Vaccine Coverage and Hesitancy
- Gut microbiota and health
- Probiotics and Fermented Foods
- Parasitic Diseases Research and Treatment
- Pharmaceutical studies and practices
- Child and Adolescent Health
Children's National
2016-2025
Center for Cancer and Blood Disorders
2025
George Washington University
2016-2024
University of South Dakota
2024
National Hospital
2024
Office of Infectious Diseases
2021
University of Minnesota
2015
University of Minnesota Children's Hospital
2013-2014
German Center for Neurodegenerative Diseases
2013
Minnesota Department of Health
2013
Despite worldwide spread of severe acute respiratory syndrome coronavirus-2, few publications have reported the potential for disease in pediatric population. We report 177 infected children and young adults, including 44 hospitalized 9 critically ill patients, with a comparison patient characteristics between nonhospitalized cohorts, as well noncritically cohorts. Children <1 year adolescents adults >15 years age were over-represented among patients (P = .07). Adolescents cohort .02).
Here, we report a complex case that involved pediatric patient who experienced recalcitrant multidrug-resistant Pseudomonas aeruginosa infection complicated by bacteremia/sepsis; our antibacterial options were limited because of resistance, allergies, and suboptimal source control. A cocktail 2 bacteriophages targeting the infectious organism introduced on separate occasions sterilized bacteremia.
Expression of group A and the A-like subset B Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) is associated with severe malaria (SM). The diversity var sequences combined challenges distinct classification patient pathologies has made studying role PfEMP1 variants on disease severity challenging. application retinopathy in recent years provided a further method to clinically evaluate children cerebral (CM). question whether clinical CM but no represent completely different...
Antibiotic overuse contributes to antibiotic resistance, which is a threat public health. stewardship practice dedicated prescribing antibiotics only when necessary and, are considered necessary, promoting use of the appropriate agent(s), dose, duration, and route therapy optimize clinical outcomes while minimizing unintended consequences use. Because there differences in common infectious conditions, drug-specific considerations, evidence surrounding treatment recommendations (eg,...
Abstract Background Children and young adults were initially reported as largely spared from severe complications of SARS-CoV-2 infection, but the impact to this population has been significant. Methods This observational retrospective cohort study includes 420 symptomatic children with lab confirmed infection treated between March 15 June 16, 2020 at Children’s National Hospital in Washington DC. We identified compared cohorts non-hospitalized (N=324) hospitalized (N=96) patients, including...
Meningococcal disease is a sudden-onset, life-threatening illness caused by the bacterium Neisseria meningitidis. Prompt empiric antibiotic treatment can reduce morbidity and mortality among patients, prophylaxis prevent secondary in close contacts. Historically, N. meningitidis isolates United States have largely been susceptible to antibiotics recommended for prophylaxis, including penicillin ciprofloxacin. This report describes detection of penicillin-resistant ciprofloxacin-resistant...
Abstract Antibiotic overuse contributes to antibiotic resistance, which is a threat public health. stewardship practice dedicated prescribing antibiotics only when necessary and, are considered necessary, promoting the use of appropriate agent(s), dose, duration, and route therapy optimize clinical outcomes while minimizing unintended consequences use. Because there differences in common infectious conditions, drug-specific considerations, evidence surrounding treatment recommendations (eg,...
The last decade has seen an explosion of advanced assays for the diagnosis infectious diseases, yet evidence-based recommendations to inform their optimal use in care transplant recipients are lacking. A consensus conference sponsored by American Society Transplantation (AST) was convened on December 7, 2021, define utility novel disease diagnostics organ recipients. represented a collaborative effort experts diagnostic stewardship, and clinical microbiology from centers across North America...
Abstract Viral infections remain a major risk in immunocompromised pediatric patients, and virus-specific T cell (VST) therapy has been successful for treatment of refractory viral prior studies. We performed phase II multicenter study (NCT03475212) the patients with inborn errors immunity and/or post allogeneic hematopoietic stem transplant using partially-HLA matched VSTs targeting cytomegalovirus, Epstein-Barr virus, or adenovirus. Primary endpoints were feasibility, safety, clinical...
Abstract Hematopoietic cell transplantation (HCT) uses cytotoxic chemotherapy and/or radiation followed by intravenous infusion of stem cells to cure malignancies, bone marrow failure and inborn errors immunity, hemoglobin metabolism. Lung injury is a known complication the process, due in part disruption pulmonary microenvironment insults such as infection, alloreactive inflammation cellular toxicity. How microorganisms, immunity respiratory epithelium interact contribute lung uncertain,...
ABSTRACT Background Toxoplasma gondii can cause opportunistic infections leading to life‐threatening disseminated disease after organ transplantation. However, there is a paucity of pediatric‐specific data guide recommendations for the prevention toxoplasmosis solid Methods To assess current practices, international pediatric transplant providers were surveyed. Results Considerable variability in both screening and prophylaxis strategies was found across centers types, with heart programs...
ABSTRACT Background Hematopoietic stem cell transplant (HSCT) is a curative procedure for conditions requiring the replacement of bone marrow. Respiratory viral infections (RVI) in lower respiratory tract (LRT) cause substantial morbidity and transplant‐related mortality (TRM) pediatric recipients, but impact mild/asymptomatic RVI unclear. Some studies have identified certain as high risk posttransplant complications. To reduce morbidity, pretransplant screening program was started at...
Hematopoietic stem cell transplantation (HCT) is potentially curative for numerous malignant and non-malignant diseases but can lead to lung injury due chemoradiation toxicity, infection, immune dysregulation. Bronchoalveolar lavage (BAL) the most commonly used procedure diagnostic sampling of invasive, cannot be performed in medically fragile patients, challenging perform serially. We previously showed that BAL transcriptomes representing pulmonary inflammation cellular phenotype post-HCT...
Penicillin and ciprofloxacin are important for invasive meningococcal disease (IMD) management prevention. IMD cases caused by penicillin- ciprofloxacin-resistant Neisseria meningitidis containing a ROB-1 β-lactamase gene (blaROB-1) mutated DNA gyrase (gyrA) have been recently reported in the United States.We examined 2097 genomes collected through US population-based surveillance from January 2011 to February 2020 identify strains with blaROB-1- or gyrA-mediated resistance. Antimicrobial...
Abstract Background Drug shortages are a common issue that healthcare systems face and can result in adverse health outcomes for patients requiring inferior alternate treatment. The United States recently experienced national drug shortage of intravenous immunoglobulin (IVIG). Several reported strategies to address the IVIG other have been proposed; however, there is lack evidence‐based methods protocol development implementation. Objective To evaluate efficacy introducing multidisciplinary...
Abstract Invasive fungal disease (IFD) remains a significant cause of morbidity and mortality in children undergoing transplantation. There is growing armamentarium novel antifungal agents recently approved for use or late stages clinical development. The overarching goal this review to discuss the mechanisms action, spectrum activity, stage development, pediatric-specific data following agents: encochleated amphotericin B deoxycholate, fosmanogepix, ibrexafungerp, isavuconazole, olorofim,...
ABSTRACT Invasive aspergillosis (IA) and mucormycosis (IM) cause significant morbidity mortality in immunocompromised and/or hospitalized patients. Isavuconazonium sulfate, a prodrug of the antifungal triazole isavuconazole, has been approved for treatment IA IM adults; was recently children. This study describes outcomes, safety, pharmacokinetics isavuconazole proven, probable, or possible In this phase 2, open-label, non-comparative study, patients aged 1 to <18 years with at least...
Abstract Background Our prior study findings suggest that Plasmodium falciparum is the cause of disease in both malaria retinopathy-positive (RP) and most retinopathy-negative (RN) cerebral (CM), absence retinopathy decreased severity RN CM may be due to shorter duration illness, lower parasite biomass, var gene expression compared RP CM. In present study, we assessed pathophysiology Methods We markers systemic central nervous system inflammation, oxidative stress, neuronal injury,...
Abstract Background Malaria retinopathy has been proposed as marker of “true” cerebral malaria (CM), ie, coma due to Plasmodium falciparum vs other causes, with incidental P parasitemia. Plasma histidine-rich protein-2 (PfHRP2) concentrations distinguish retinopathy-positive (RP) from retinopathy-negative (RN) CM but have not compared between RN and forms severe or asymptomatic parasitemia (AP). Methods We plasma PfHRP2 in 260 children (247 examined for retinopathy), 228 malarial anemia...
Patients with sickle cell disease (SCD) are at increased risk for osteomyelitis (OM). Diagnosis of OM in SCD is challenging as the clinical presentation similar to a vasoocclusive crisis (VOC) no diagnostic gold standard. We report characteristics and outcomes patients treated our center over 10-year period.We conducted retrospective analysis who were period (2006-2016). Cases identified utilizing radiology data mining software. Radiology reports medical charts potential cases...
Invasive candidiasis is the most common invasive fungal disease in children and adolescents, but there are limited pediatric-specific antifungal effectiveness data. We compared of echinocandins to triazoles or amphotericin B formulations (triazole/amphotericin B) as initial directed therapy for candidiasis.
Background: Transforming growth factor beta-1 (TGF-β1) is an important regulator of inflammation. Platelets are a major source TGF-β1 and reduced in severe malaria. However, the relationships between concentrations platelet counts, proinflammatory anti-inflammatory cytokine chemokine disease severity malaria have not been characterized. Methods: Platelet counts serum TGF-β1, interleukin-1beta (IL-1β), IL-6, IL-10, interferon (IFN)-γ, tumor necrosis (TNF)-α RANTES were measured at time...