Department of Pediatrics Annual Report – 2020
Infectious Diseases
Our diverse research portfolio promotes enhanced care
The Division of Infectious Diseases reflects the multidisciplinary approach essential to the practice of medicine and medical research. Our faculty are involved in patient care, hospital epidemiology, basic science, clinical research activities, clinical trials, and teaching. Division members have diverse and interrelated interests ranging from very basic mechanisms of molecular pathogenesis to the cascades of care required to ensure that adolescents receive appropriate treatment for sexually transmitted infections (STIs). We are actively engaged in medical education with undergraduate, graduate, medical, and postdoctoral students from all of Columbia's health sciences divisions. The division staffs the hospital antibiotic stewardship program, which reviews antibiotic use and positive cultures daily and guides providers on appropriate and safe antibiotic use. Division members have diverse research interests and collaborate widely with other investigators at Columbia, as well as at other institutions.
New Programs
Program in Vaccine Education (2020): Established by Lawrence Stanberry, MD, PhD, at Columbia Vagelos College of Physicians and Surgeons to educate medical students and inform health care professionals, public health experts, academic, government and industry researchers, policymakers, global health non-governmental organizations, journalists, and the general public about cutting-edge advances and challenges in modern vaccine development.
Pediatric Outpatient Antibiotic Therapy TeleHealth (OATTH) Program (2019): Under the direction of Candace Johnson, MD, OATTH provides outpatient follow-up via a virtual visit platform for patients discharged home on parenteral or long-term oral antibiotic therapy. Follow-up includes regular monitoring of patients’ labs to assess for treatment response and drug toxicity, recommendations for antibiotic changes in the event of adverse effects or poor treatment response, and antibiotic refills as necessary. Infectious disease specialists answer questions or address concerns that arise between visits via email and telephone.
Antibiotic Stewardship Program (ASP): Since 2017 the ASP program (directed by Philip Zachariah, MD, MS) has decreased broad-spectrum antibiotic use at NewYork-Presbyterian Morgan Stanley Children's Hospital by 30% through a combination of formulary restriction and daily review of all antibiotic prescriptions and positive microbiology. Using benchmarking data from peer hospitals, our antibiotic use has decreased from the 75th percentile to the 50th percentile. We created the first set of treatment guidelines for common pediatric infections for NYP and the first guidelines for empiric antibiotic use in our neonatal intensive care units. ASP education has been incorporated into the pediatric residency curriculum and into annual hospital training. We also led clinician decision support for antibiotic prescribing using the electronic health record. ASP’s scholarly output has led to presentations at national meetings, multiple peer-reviewed manuscripts, and pilot funding from the Irving Institute.
Promotions
- Natalie Neu, MD, MPH, Associate Professor to Professor, 2019
- Shivang Shah, MD, PhD, Fellow of the Year, 2019; Promotion to Assistant Professor, 2020
- Jason Zucker, MD, Promotion to Instructor, 2019
Honors and Awards
Anne Gershon, MD
- Maxwell Finland Award for Scientific Achievement, National Foundation for Infectious Diseases, 2019
Major Grants
- VZV in the enteric nervous system: pathogenesis and consequences. NIH/National Institute of Diabetes and Digestive and Kidney Diseases; R01DK093094-08. Principal Investigator: Anne Gershon, MD.
- Varicella zoster virus identification program. Merck, Inc. Principal Investigator: Anne Gershon, MD.
- Clinical Immunization Safety Assessment (CISA) Project. Centers for Disease Control and Prevention. Contributing Contractor: Philip LaRussa, MD.
- Innate immune clearance of host-adapted pulmonary pathogens. NIH/National Heart, Lung, and Blood Institute; R35HL135800-04. Principal Investigator: Alice Prince, MD.
- S. Aureus adaptation to the CF lung. Cystic Fibrosis Foundation. Principal Investigator: Alice Prince, MD.
- Metabolic adaptation drives pseudomonas aeruginosa infection in the CF lung. Vertex Pharmaceuticals/Vertex Cystic Fibrosis Research Innovation Award. Principal Investigator/Mentor: Alice Prince, MD. Award recipient/lead investigator: Sebastian Riquelme Colet, PhD (CFF Post-doctoral fellowship).
- Assessing effectiveness of infection prevention and control in CF. CF Foundation. (PI:Muhlebach); Co-Principal Investigator: Lisa Saiman, MD, MPH.
- The burden of healthcare-associated RSV in children < 18 years of age. Merck, Inc. Investigator: Lisa Saiman, MD, MPH.
- Incidence of respiratory syncytial virus infection in hospitalized adults and evaluation of children. Merck, Inc. Investigator: Lisa Saiman, MD, MPH.
- Training in pediatric infectious diseases. NIH T32 Training Grant. Principal Investigators: Alice Prince, MD and Lisa Saiman, MD, MPH.
- Children’s Hospitals in Africa Mapping Project (CHAMP). ELMA Philanthropies; Co-PIs: Philip Larussa, MD and Lawrence Stanberry, MD, PhD.
Selected Publications
Gershon M, Gershon A. Varicella-zoster virus and the enteric nervous system. The Journal of Infectious Diseases. 2018; 218: S113-S119.
Gershon, AA. Tale of two vaccines: differences in response to herpes zoster vaccines. The Journal of Clinical Investigation. 2018; 128: 4245-4247.
Wong Fok Lung T, Monk I, Acker K., Mu A, Wang N, Riquelme S, et al. Staphylococcus aureus small colony variants impair host immunity by activating host cell glycolysis and inducing necroptosis. Nature Microbiology. 2019. doi: 10.1038/s41564-019-0597-0.
Gabryszewski SJ, Wong T, Annavajhala M, Tomlinson K, Riquelme S, Khan I, Noguera L, Wickersham M, Zhao A, Mulenos A, Peaper D, Koff J, Uhlemann AC, Prince A. Metabolic adaptation supports persistent methicillin-resistant S. aureus pulmonary infection. Am J Resp Cell Mol Biol. 2019 Vol 61, Iss 2, pp 185-197.
Riquelme SA, Lozano C, Moustafa AM, Liimatta K, Gill S, Narechania A, Azcona-Gutierrez J, Di Mango E, Saenz Y, Planet P, Prince AS. PTEN-dependent mitochondrial metabolism determines susceptibility to infection. Sci. Transl. Med. 2019 July 3; 11: eaav4634.
Riquelme SA, Liimatta K, Wong Fok Lung T, Fields B, Ahn D, Chen D, Lozano C, Sáenz Y, Uhlemann AC, Kahl BC, Britto CJ, DiMango E, and Prince A. Pseudomonas aeruginosa Utilizes Host-Derived Itaconate to Redirect Its Metabolism to Promote Biofilm Formation. Cell Metab. 2020 Jun 2; 31(6): 1091-1106.e6. doi: 10.1016/j.cmet.2020.04.017.
Rosenbaum M, Stanberry L. Children are the most neglected and vulnerable stakeholders in climate change. The Hill. 2019 May 28; 03:31 PM EDT. https://thehill.com/opinion/healthcare/445776-children-are-the-most-neglected-and-vulnerable-stakeholders-in-climate
Zachariah P, Johnson CL , Halabi KC, Ahn D, Sen AI, Fischer A, Banker SL, Giordano M, Manice CS, Diamond R, Sewell TB, Schweickert AJ, Babineau JR, Carter RC, Fenster DB, Orange JS, McCann TA, Kernie SG, Saiman L, Columbia Pediatric COVID-19 Management Group. Epidemiology, clinical features, and disease severity in patients with coronavirus disease 2019 (COVID-19) in a children's hospital in New York City, New York. JAMA Pediatr. 2020 Jun 3; e202430. doi: 10.1001/jamapediatrics.2020.2430.
Highlights
Feared Pathogen Turns Our Lung Defenses Against Ourselves
The “superbug” Pseudomonas aeruginosa is an especially dangerous bacterium, resists many antibiotics, and often causes intractable pneumonia and death when it infiltrates the lungs. A new study from Sebastián Riquelme and Alice Prince at the Vagelos College of Physicians and Surgeons at Columbia University Irving Medical Center now reveals how P. aeruginosa use our own immune defenses to multiply and persist in our lungs.
CUIMC News
2019 NFID Maxwell Finland Award for Scientific Achievement: Anne A. Gershon, MD
Anne A. Gershon, MD, acceptance of 2019 Maxwell Finland Award for Scientific Achievement.
National Foundation for Infectious Diseases
Prince Lab
The Prince laboratory studies the interaction of the host and bacterial pathogens in both the airway and skin.