Infectious Disease Medicine Research & Publications

Research interests in the Section of Bone and Joint Infections includes improvement in diagnostic algorithms using traditional and newer molecular techniques, prosthetic joint infections with drug-resistant pathogens, and improvement in processes of outpatient intravenous antibiotic therapy of bone and joint infections.

Members of the Section participated in a recently-completed trial comparing daptomycin, a newer antibiotic, to traditional drug treatment in staphylococcal infections of prosthetic knees and hips. Members of the Section have presented research and invited lectures at national meetings and serve on the Infectious Diseases Society of America’s panel constructing guidelines on the diagnosis and management of vertebral osteomyelitis (spine infections).

1. Duggal A, Barsoum W, Schmitt SK. Patients with prosthetic joint infection on IV antibiotics are at high risk for readmission. Clin Orthop Relat Res 467 (7): 1727-31, 2009.
2. Lalani T, Boucher HW, Cosgrove SE, Fowler VG, Kanafani ZA, Vigliani GA, Campion M, Abrutyn E, Levine DP, Price CS, Rehm SJ, Corey GR, Karchmer AW. Outcomes with daptomycin versus standard therapy for osteoarticular infections associated with Staphylococcus aureus bacteraemia. J Antimicrob Chemother 61 (1): 177-82, 2008.
3. Patel AR, Sabanegh ES, Jones JS, Gordon SM, Ballin M, Ruggieri PM, Stephenson AJ. Bacillus Calmette-Guerin Osteomyelitis Mimicking Spinal Metastasis from Urothelial Cell Carcinoma of the Bladder. Eur Urol, 2009.
4. Schmitt, SK. Infections of Joints and Bones. In The Merck Manual for Healthcare Professionals, 19th ed., 2008, in press (available at http://www.merck.com/mmpe/sec04/ch039/ch039a.html)
5. Schmitt SK. Infections of Bones and Joints. In The Merck Manual Home Edition, 3rd ed., 2008, in press (available at http://www.merck.com/mmhe/sec05/ch065/ch065a.html).
6. Schmitt, SK. Treatment and prevention of osteomyelitis following trauma. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2011.

The Cardiovascular Infections section of the Department of Infectious Disease is actively engaged in academic work describing our experience with complex patients treated for infective endocarditis, infections of cardiac implantable electrophysiological devices (CIEDs), and left ventricular assist devices.

Opportunities also exist for other patient populations with infections of the cardiovascular system including those with infections of peripheral vascular bypass grafts and those who have undergone endovascular repair of aortic aneurysms.

The focus of current projects has included the descriptive epidemiology of surgically and medically treated endocarditis, diagnostic and therapeutic approach to patients with infected CIEDs, metastatic complications of assist device infections, and the bioethical issues involved in the treatment of patients with assist device infection. The academic work of this section has been multidisciplinary and has included our cardiology, cardiac surgery, and bioethics colleagues.

2011 Publications

1. Idrees J, Albacker TB, Gordon SM, Shin J, Menon V, Roselli EE. Bartonella infective endocarditis of a prosthetic aortic valve with a subvalvular abscess. J Card Surg. 2011 Sep;26(5):483-485.
2. O'Donoghue RD, Duncan AE, Fraser TG, Thomas JD. An echocardiographic evaluation of valvular function and ventricular patch repair during surgical exclusion of left ventricular pseudoaneurysm. Anesth Analg. 2011 Oct;113(4):713-716.
3. Shrestha NK. Cardiovascular implantable electronic device infection: A complication of medical progress. Cleve Clin J Med. 2011 Aug;78(8):500-504.

Previous Publications

1. Kim A, Keys T. Infective endocarditis prophylaxis before dental procedures: new guidelines spark controversy. Cleve Clin J Med 75 (2): 89-92, 2008.
2. Navia JL, Al-Ruzzeh S, Gordon S, Fraser T, Aguero O, Rodriguez L. The incorporated aortomitral homograft: a new surgical option for double valve endocarditis. J Thorac Cardiovasc Surg 139 (4): 1077-81, 2010.
3. Rehm S, Campion M, Katz DE, Russo R, Boucher HW. Community-based outpatient parenteral antimicrobial therapy (CoPAT) for Staphylococcus aureus bacteraemia with or without infective endocarditis: analysis of the randomized trial comparing daptomycin with standard therapy. J Antimicrob Chemother 63 (5): 1034-42, 2009.
4. Rehm SJ, Boucher H, Levine D, Campion M, Eisenstein BI, Vigliani GA, Corey GR, Abrutyn E. Daptomycin versus vancomycin plus gentamicin for treatment of bacteraemia and endocarditis due to Staphylococcus aureus: subset analysis of patients infected with methicillin-resistant isolates. J Antimicrob Chemother 62 (6): 1413-21, 2008.
5. Tarakji KG, Chan EJ, Cantillon DJ, Doonan AL, Hu T, Schmitt S, Fraser TG, Kim A, Gordon SM, Wilkoff BL. Cardiac implantable electronic device infections: presentation, management, and patient outcomes. Heart Rhythm 7 (8): 1043-7, 2010.
6. van Duin D, Goldfarb J, Schmitt SK, Tomford JW, Tuohy MJ, Hall GS. Nontuberculous mycobacterial blood stream and cardiac infections in patients without HIV infection. Diagn Microbiol Infect Dis 67 (3): 286-90, 2010.

• Learn More About the Infectious Disease Clinic

In addition to the research focus areas, academic work is ongoing in general Infectious Diseases-related topics as well as collaborative efforts with the Quality Patient Safety Institute’ Healthcare Epidemiology and Infection Prevention section. Areas of interest include influenza infections, clinical microbiology, multi-drug resistant organisms, S. aureus infections, and infections in older adults.

Our department has intensive ties with the microbiology department, which has resulted in a number of publications. In addition, we are working with basic science investigators at the Lerner Research Institute of the Cleveland Clinic on various translational projects. Other ongoing collaborations include a multicenter effort to describe gram-negative resistance in the greater North-East Ohio region.

2011 Publications

1. Bonilla MF, Avery RK, Rehm SJ, Neuner EA, Isada CM, van Duin D. Extreme alkaline phosphatase elevation associated with tigecycline. J Antimicrob Chemother. 2011 Apr;66(4):952-953.
2. Chahine LM, Khoriaty RN, Tomford WJ, Hussain MS. The changing face of neurosyphilis. Int J Stroke. 2011 Apr;6(2):136-143. Chamberlain B, Rehm S. Issues up close. American Nurse Today. 2011 Jan;6(1):33-34.
3. Connor MJ, Jr., Salem C, Bauer SR, Hofmann CL, Groszek J, Butler R, Rehm SJ, Fissell WH. Therapeutic drug monitoring of piperacillin-tazobactam using spent dialysate effluent in patients receiving continuous venovenous hemodialysis. Antimicrob Agents Chemother. 2011 Feb;55(2):557-560.
4. Counts MM, Rehm SJ. Pneumococcal vaccination: Shifting attention to a neglected public health weapon. J Am Acad Nurse Pract. 2011 May;23(5):223-225.
5. Demirjian SG, Raina R, Bhimraj A, Navaneethan SD, Gordon SM, Schreiber MJ, Jr., Guzman JA. 2009 influenza A infection and acute kidney injury: incidence, risk factors, and complications. Am J Nephrol. 2011;34(1):1-8.
6. Doleh TY, Rehm SJ, Isaacson JH. A 49-year-old woman with a persistent cough. Cleve Clin J Med. 2011 Aug;78(8):521-528.
7. Fong KS, Fatica C, Hall G, Procop G, Schindler S, Gordon SM, Fraser TG. Impact of PCR testing for Clostridium difficile on incident rates and potential on public reporting: is the playing field level? Infect Control Hosp Epidemiol. 2011 Sep;32(9):932-933.
8. Fong KS, Fatica C, Hall G, Procop G, Schindler S, Gordon SM, Fraser TG. Reply to Goldenberg [Public reporting of Clostridium difficile and improvements in diagnostic tests]. Infect Control Hosp Epidemiol. 2011 Dec;32(12):1233.
9. Fraser TG, Gordon SM. CLABSI rates in immunocompromised patients: A valuable patient centered outcome? Clin Infect Dis. 2011 Jun;52(12):1446-1450.
10. Frey AB, Wilson DA, Lasalvia MM, Tan CD, Rodriguez ER, Shrestha NK, Hall GS, Procop GW. The detection and differentiation of methicillin-resistant and methicillin-susceptible Staphylococcus aureus endocarditis by using the BD GeneOhm StaphSR assay. Am J Clin Pathol. 2011 Nov;136(5):686-689.
11. Gordon SM, Shrestha NK, Rehm SJ. Transitioning antimicrobial stewardship beyond the hospital: The Cleveland Clinic's community-based parenteral anti-infective therapy (CoPAT) program. J Hosp Med. 2011 Jan;6 Suppl 1:S24-S30.
12. Mashir A, Paschke KM, van Duin D, Shrestha NK, Laskowski D, Storer MK, Yen-Lieberman B, Gordon SM, Aytekin M, Dweik RA. Effect of the influenza A (H1N1) live attenuated intranasal vaccine on nitric oxide (FE(NO)) and other volatiles in exhaled breath. J Breath Res. 2011 Sep;5(3):037107.
13. Neuner EA, Yeh JY, Hall GS, Sekeres J, Endimiani A, Bonomo RA, Shrestha NK, Fraser TG, van Duin D. Treatment and outcomes in carbapenem-resistant Klebsiella pneumoniae bloodstream infections. Diagn Microbiol Infect Dis. 2011 Apr;69(4):357-362.
14. Neuner EA, Sekeres J, Ristich A, Skok J, Rosenblatt M, Fatica C, Fraser TG. Implementation of a pharmacy-driven program to improve nasal mupirocin use. Am J Health Syst Pharm. 2011 Dec 1;68(23):2222-2228.
15. Phelan MP, Schils JP, Burval D, Isada CM. Methicillin-resistant staphyloccocus aureus heel abscess: an uncommon emergency department diagnosis. J Emerg Med. 2011 Sep;41(3):e55-e58.
16. Poretz DM, Rehm SJ. Managing an elusive pathogen: Treatment of methicillin-resistant Staphylococcus aureus infections in a variety of care settings. Infect Dis Clin Pract (Baltim Md ). 2011;19(3):150-155.
17. Schilling A, Neuner E, Rehm SJ. Vancomycin: A 50-something-year-old antibiotic we still don't understand. Cleve Clin J Med . 2011 Jul;78(7):465-471.
18. Shrestha NK, Scalera NM, Wilson DA, Brehm-Stecher B, Procop GW. Rapid identification of Staphylococcus aureus and methicillin resistance by flow cytometry using a peptide nucleic acid probe. J Clin Microbiol. 2011 Sep;49(9):3383-3385.
19. Shrestha NK, Scalera NM, Wilson DA, Procop GW. Rapid differentiation of methicillin-resistant and methicillin-susceptible Staphylococcus aureus by flow cytometry after brief antibiotic exposure. J Clin Microbiol. 2011 Jun;49(6):2116-2120.
20. van Duin D. Suppression of urinary tract infections with fosfomycin and trimethoprim-sulfamethoxazole: a case report. J Chemother. 2011 Feb;23(1):55-56.
21. van Duin D, Miranda C, Husni E. Cytomegalovirus viremia, pneumonitis, and tocilizumab therapy. Emerg Infect Dis. 2011 Apr;17(4):754-756.
22. Zaytoun OM, Vargo EH, Rajan R, Berglund R, Gordon S, Jones JS. Emergence of fluoroquinolone-resistant Escherichia coli as cause of postprostate biopsy infection: Implications for prophylaxis and treatment. Urology. 2011 May;77(5):1035-1041.

Previous Publications

1. Atreja A, Gordon SM, Pollock DA, Olmsted RN, Brennan PJ. Opportunities and challenges in utilizing electronic health records for infection surveillance, prevention, and control. Am J Infect Control 36 (3 Suppl): S37-46, 2008.
2. Bakri SJ, Sears JE, Procop GW, Shrestha R, Gordon SM. Excellent visual outcome following Aspergillus flavus endogenous endophthalmitis-farmer's lung disease. Int Ophthalmol 30 (1): 99-101, 2010.
3. Blaine KP, Tuohy MJ, Wilson D, Procop GW, Tisch DJ, Shrestha NK, Hall GS. Progression to bacteremia in critical care patients colonized with methicillin-resistant Staphylococcus aureus expressing Panton-Valentine leukocidin. Diagn Microbiol Infect Dis 68 (1): 28-33, 2010.
4. Bravo LT, Gordon SM, Underwood D, Brainard J. A pseudo-outbreak of yeast in cell blocks associated with the use of human plasma. Diagn Cytopathol 38 (6): 465-7, 2010.
5. Bravo LT, Procop GW. Recent advances in diagnostic microbiology. Semin Hematol 46 (3): 248-58, 2009.
6. Bravo LT, Tuohy MJ, Shrestha NK. Successful pyrosequencing of GC-rich DNA sequences by partial substitution of deoxyguanosine with deoxyinosine. Diagn Mol Pathol 19 (2): 123-5, 2010.
7. Connor MJ, Jr., Salem C, Bauer SR, Hofmann CL, Groszek J, Butler R, Rehm SJ, Fissell WH. Therapeutic drug monitoring of piperacillin-tazobactam using spent dialysate effluent in patients receiving continuous venovenous hemodialysis. Antimicrob Agents Chemother 55 (2): 557-60, 2011.
8. Deshpande A, Pant C, Jain A, Fraser TG, Rolston DD. Do fluoroquinolones predispose patients to Clostridium difficile associated disease? A review of the evidence. Curr Med Res Opin 24 (2): 329-33, 2008.
9. Fraser TG, Fatica C, Gordon SM. Necessary but not sufficient: a comparison of surveillance definitions of Clostridium difficile-associated diarrhea. Infect Control Hosp Epidemiol 30 (4): 377-9, 2009.
10. Fraser TG, Fatica C, Scarpelli M, Arroliga AC, Guzman J, Shrestha NK, Hixson E, Rosenblatt M, Gordon SM, Procop GW. Decrease in Staphylococcus aureus colonization and hospital-acquired infection in a medical intensive care unit after institution of an active surveillance and decolonization program. Infect Control Hosp Epidemiol 31 (8): 779-83, 2010.
11. Gordon SM. Update on 2009 pandemic influenza A (H1N1) virus. Cleve Clin J Med 76 (10): 577-82, 2009.
12. Kanafani ZA, Arduino JM, Muhlbaier LH, Kaye KS, Allen KB, Carmeli Y, Corey GR, Cosgrove SE, Fraser TG, Harris AD, Karchmer AW, Lautenbach E, Rupp ME, Peterson ED, Straus WL, Fowler VG, Jr. Incidence of and preoperative risk factors for Staphylococcus aureus bacteremia and chest wound infection after cardiac surgery. Infect Control Hosp Epidemiol 30 (3): 242-8, 2009.
13. Leger MM, Rehm SJ. Pneumococcal disease: swinging away at a dangerous killer. Jaapa 23 (9): 10, 2010.
14. Miller K, Fraser T. Q: What is the role of probiotics in the treatment of acute Clostridium difficile-associated diarrhea? Cleve Clin J Med 76 (7): 391-2, 2009.
15. Mossad SB. Influenza in long-term care facilities: preventable, detectable, treatable. Cleve Clin J Med 76 (9): 513-21, 2009.
16. Mossad SB. The resurgence of swine-origin influenza A (H1N1). Cleve Clin J Med 76 (6): 337-43, 2009.
17. Putukian M, O'Connor FG, Stricker P, McGrew C, Hosey RG, Gordon SM, Kinderknecht J, Kriss V, Landry G. Mononucleosis and athletic participation: an evidence-based subject review. Clin J Sport Med 18 (4): 309-15, 2008.
18. Rehm SJ, Farley MM, File TM, Jr., Hall WJ, Hopkins R, Levine OS, Nichol KL, Nuorti P, Zimmerman RK, Schaffner W. Higher pneumococcal disease vaccination rates needed to protect more at-risk US adults. Postgrad Med 121 (6): 101-5, 2009.
19. Rehm SJ, Tice A. Staphylococcus aureus: methicillin-susceptible S. aureus to methicillin-resistant S. aureus and vancomycin-resistant S. aureus. Clin Infect Dis 51 Suppl 2: S176-82, 2010.
20. Scalera NM, Mossad SB. The first pandemic of the 21st century: a review of the 2009 pandemic variant influenza A (H1N1) virus. Postgrad Med 121 (5): 43-7, 2009.
21. Schaffner W, Rehm SJ, File TM, Jr. Keeping our adult patients healthy and active: the role of vaccines across the lifespan. Phys Sportsmed 38 (4): 35-47, 2010.
22. Shrestha NK, Hamrock DJ. Successful treatment of disseminated human papillomavirus infection with pegylated interferon and ribavirin. Clin Infect Dis 51 (1): e4-6, 2010.

Research in granulomatous infections has centered on several areas. In the area of tuberculosis, we are interested in evaluating the implementation and interpretation of novel testing such as interferon-gamma release assays for latent tuberculosis, infection control of active tuberculosis, and novel diagnostics involving M. tuberculosis. We are also involved in clinical cohort studies of histoplasmosis in various hosts, such as solid organ transplant recipients and older adults. Lastly, we study the manifestations and outcomes of infections with non-tuberculous mycobacteria.

1. Bravo LT, Tuohy MJ, Ang C, Destura RV, Mendoza M, Procop GW, Gordon SM, Hall GS, Shrestha NK. Pyrosequencing for rapid detection of Mycobacterium tuberculosis resistance to rifampin, isoniazid, and fluoroquinolones. J Clin Microbiol 47 (12): 3985-90, 2009.
2. Cuellar-Rodriguez J, Avery RK, Lard M, Budev M, Gordon SM, Shrestha NK, van Duin D, Oethinger M, Mawhorter SD. Histoplasmosis in solid organ transplant recipients: 10 years of experience at a large transplant center in an endemic area. Clin Infect Dis 49 (5): 710-6, 2009.
3. Fraser TG, Kowalczyk J, Schmitt S, Bernstein J, Terpeluk P, Tomford JW, Gordon SM. Active tuberculosis in a healthcare worker: are you ready? Infect Control Hosp Epidemiol 30 (1): 80-2, 2009.
4. Kobayashi N, Fraser TG, Bauer TW, Joyce MJ, Hall GS, Tuohy MJ, Procop GW. The use of real-time polymerase chain reaction for rapid diagnosis of skeletal tuberculosis. Arch Pathol Lab Med 130 (7): 1053-6, 2006.
5. Miranda C, Tomford JW, Gordon SM. Interferon-gamma-release assays: Better than tuberculin skin testing? Cleve Clin J Med 77 (9): 606-11, 2010.
6. Miranda C, Yen-Lieberman B, Terpeluk P, Tomford JW, Gordon S. Reducing the rates of indeterminate results of the QuantiFERON-TB Gold In-Tube test during routine preemployment screening for latent tuberculosis infection among healthcare personnel. Infect Control Hosp Epidemiol 30 (3): 296-8, 2009.
7. Nguyen CT, Tomford JW, Desai MM. Retroperitoneal cold abscess caused by mycobacteria chelonae abscessus after percutaneous nephrolithotomy in India: strategies for detection, management, and prevention in the United States. Urology 73 (1): 209 e13-5, 2009.
8. Sahni R, Miranda C, Yen-Lieberman B, Tomford JW, Terpeluk P, Quartey P, Johnson LT, Gordon SM. Does the implementation of an interferon-gamma release assay in lieu of a tuberculin skin test increase acceptance of preventive therapy for latent tuberculosis among healthcare workers? Infect Control Hosp Epidemiol 30 (2): 197-9, 2009.
9. van Duin D, Goldfarb J, Schmitt SK, Tomford JW, Tuohy MJ, Hall GS. Nontuberculous mycobacterial blood stream and cardiac infections in patients without HIV infection. Diagn Microbiol Infect Dis 67 (3): 286-90, 2010.

The HIV research group at the Cleveland Clinic receives external funding from several sources including the National Institutes of Health, and the Bill and Melinda Gates Foundation. Two externally funded research programs are highlighted here:

Dr. Tungsiripat's main reseearch interests focus on the study of the metabolic complications associated with HIV infection and its treatment. In particular, she is interested in the metabolic complications of cardiovascular disease, insulin resistance, and fat redistribution. She presently holds a NIH mentored career development award for the investigation of body fat distribution and cardiovascular complications of HV infection. Current studies are targeted towards understanding the mechanisms of these complications with the goal of preventing their development.

Dr. Abbas’ research interests cover mathematical and computational infectious disease epidemiology with a particular focus on HIV/AIDS. Her research group develops mathematical, statistical and computational models of the HIV epidemic and analyses the potential impact of prevention, treatment and control strategies. She is currently studying the impact of antiretroviral drugs used for pre-exposure prophylaxis (PrEP) and treatment (ART) of HIV, on the spread of HIV and drug resistance in resource-limited settings, such as South Africa.

She is the principal investigator on two research grants, awarded by the National Institutes of Health and the Bill & Melinda Gates Foundation. She is mentoring two full-time research fellows: Robert Glaubius, PhD; Computer Science and Engineering, and Anuj Mubayi, PhD; Applied Mathematics. Her collaborators include investigators at the University of Pittsburgh, Pittsburgh Supercomputing Center, Carnegie Mellon University and Imperial College London. Dr. Abbas is a participant of the HIV PrEP modeling meetings convened by the UNAIDS.

Areas of interest include:

• HIV metabolic abnormalities of mitochondrial function, lipid metabolism and bone disease
• Modeling studies of the HIV epidemic
• Clinical trials of new drug therapeutics
• Clinical metabolic bone disease
• Organ transplantation in HIV infected patients
• Other clinical and outcomes studies in HIV infection

2011 Publications

1. Abbas UL. Uptake of biomedical interventions for prevention of sexually transmitted HIV. Curr Opin HIV AIDS. 2011 Mar;6(2):114-118.
2. Abbas UL, Hood G, Wetzel AW, Mellors JW. Factors influencing the emergence and spread of HIV drug resistance arising from rollout of antiretroviral pre-exposure prophylaxis (PrEP). MPLoS ONE. 2011;6(4):e18165.
3. Lederman MM, Calabrese L, Funderburg NT, Clagett B, Medvik K, Bonilla H, Gripshover B, Salata RA, Taege A, Lisgaris M, McComsey GA, Kirchner E, Baum J, Shive C, Asaad R, Kalayjian RC, Sieg SF, Rodriguez B. Immunologic failure despite suppressive antiretroviral therapy is related to activation and turnover of memory CD4 cells. J Infect Dis. 2011 Oct;204(8):1217-1226.
4. Taege A. Seek and treat: HIV update 2011. Cleve Clin J Med. 2011 Feb;78(2):95-100.
5. Tungsiripat M, El-Bejjani D, Rizk N, Dogra V, O'Riordan MA, Ross AC, Hileman C, Storer N, Harrill D, McComsey GA. Carotid intima media thickness, inflammatory markers, and endothelial activation markers in HIV patients with lipoatrophy increased at 48 weeks regardless of use of rosiglitazone or placebo. AIDS Res Hum Retroviruses. 2011 Mar;27(3):295-302.

Previous Publications

1. Abbas UL. Uptake of biomedical interventions for prevention of sexually transmitted HIV. Curr Opin HIV AIDS 6(2):114-118, March 2011.
2. Abbas UL, Anderson RM, Mellors JW. Potential impact of antiretroviral chemoprophylaxis on HIV-1 transmission in resource-limited settings. PLoS One 2 (9): e875, 2007.
3. Armstrong WS, Taege AJ. HIV screening for all: the new standard of care. Cleve Clin J Med 74 (4): 297-301, 2007.
4. El-Bejjani D, Hazen SL, Mackay W, Glass NE, Hulgan T, Tungsiripat M, McComsey GA. Higher plasma myeloperoxidase levels are not associated with an increased risk for cardiovascular events in HIV-infected adults. HIV Clin Trials 9 (3): 207-11, 2008.
5. Lloyd RM, Jr., Burns DA, Huong JT, Mathis RL, Winters MA, Tanner M, De La Rosa A, Yen-Lieberman B, Armstrong W, Taege A, McClernon DR, Wetshtein JL, Friedrich BM, Ferguson MR, O'Brien W, Feorino PM, Holodniy M. Dried-plasma transport using a novel matrix and collection system for human immunodeficiency virus and hepatitis C virus virologic testing. J Clin Microbiol 47 (5): 1491-6, 2009.
6. Ross AC, Rizk N, O'Riordan MA, Dogra V, El-Bejjani D, Storer N, Harrill D, Tungsiripat M, Adell J, McComsey GA. Relationship between inflammatory markers, endothelial activation markers, and carotid intima-media thickness in HIV-infected patients receiving antiretroviral therapy. Clin Infect Dis 49 (7): 1119-27, 2009.
7. Taege A. Seek and treat: HIV update 2011. Cleve Clin J Med 78 (2): 95-100, 2011.
8. Tungsiripat M, Bejjani DE, Rizk N, O'Riordan M A, Ross AC, Hileman C, Storer N, Harrill D, McComsey GA. Rosiglitazone improves lipoatrophy in patients receiving thymidine-sparing regimens. Aids 24 (9): 1291-8, 2010.
9. Tungsiripat M, Drechsler H, Sarlone C, Amyot K, Laffey E, Aberg J. Prevalence and significance of G6PD deficiency in patients of an urban HIV clinic. J Int Assoc Physicians AIDS Care (Chic) 7 (2): 88-90, 2008.
10. Tungsiripat M, El-Bejjani D, Rizk N, Dogra V, O'Riordan MA, Ross AC, Hileman C, Storer N, Harrill D, McComsey GA. Carotid Intima Media Thickness, Inflammatory Markers, and Endothelial Activation Markers in HIV Patients with Lipoatrophy Increased at 48 Weeks Regardless of Use of Rosiglitazone or Placebo. AIDS Res Hum Retroviruses, 2010.
11. Tungsiripat M, Kitch D, Glesby MJ, Gupta SK, Mellors JW, Moran L, Jones L, Alston-Smith B, Rooney JF, Aberg JA. A pilot study to determine the impact on dyslipidemia of adding tenofovir to stable background antiretroviral therapy: ACTG 5206. Aids 24 (11): 1781-4, 2010.
12. Tungsiripat M, McComsey G. Pathogenesis and management of lipoatrophy. Curr HIV/AIDS Rep 5 (2): 55-63, 2008.
13. Tungsiripat M, O'Riordan MA, Storer N, Harrill D, Ganz J, Libutti D, Gerschenson M, McComsey GA. Subjective clinical lipoatrophy assessment correlates with DEXA-measured limb fat. HIV Clin Trials 10 (5): 314-9, 2009.

Organ Transplant Infection Prevention

Dr. Robin Avery is the principal investigator for the Cleveland Clinic site of the OTIP (Organ Transplant Infection Prevention) Study. The OTIP study is a six-center study funded by the Centers for Disease Control and Prevention (CDC), which follows a large group of lung and stem cell transplant recipients over time in order to understand risk factors for fungal and other infections. A related OTIP study is examining the clinical course and viral shedding in transplant patients treated for influenza. The goal is to provide a basis for more effective measures to manage these infections in the future.

Members of the section of transplant infectious diseases are involved in a variety of research studies addressing several topics in this field, including:

• Novel therapy of cytomegalovirus infection
• Effects of viral infections on transplanted organs
• Safety & effectiveness of vaccination in transplant recipients
• Epidemiology & treatment of influenza in transplant recipients
• Respiratory viral infections, including rhinovirus in transplant recipients
• Outcome studies of donor lung bronchial cultures in lung transplant recipients
• Epstein-barr virus infection in lung transplant recipients
• Outcome studies of Staphylococcus aureus bacteremia in transplant recipients
• Genetic markers predicting risk of infection, such as Killer Immunoglobulin Receptor (KIR), following transplantation
• Strongyloidiasis in transplant candidates & recipients
• Transplantation in HIV infected patients
• The use of home intravenous antibiotics in transplant recipients
• Pre-transplantation screening to decrease the risk of post-transplant infections
• The use of probiotics to limit recurrences of Clostridium difficile infections

2011 Publications

1. Avery RK. Low-dose valganciclovir for cytomegalovirus prophylaxis in organ transplantation: is less really more? Clin Infect Dis. 2011 Feb;52(3):322-324.
2. Avery RK. Antifungal prophylaxis in lung transplantation. Semin Respir Crit Care Med. 2011 Dec;32(6):717-726.
3. Finlen Copeland CA, Davis WA, Snyder LD, Banks M, Avery R, Davis RD, Palmer SM. Long-term efficacy and safety of 12 months of valganciclovir prophylaxis compared with 3 months after lung transplantation: A single-center, long-term follow-up analysis from a randomized, controlled cytomegalovirus prevention trial. J Heart Lung Transplant. 2011 Sep;30(9):990-996.
4. Gordon CR, Avery RK, Abouhassan W, Siemionow M. Cytomegalovirus and other infectious issues related to face transplantation: specific considerations, lessons learned, and future recommendations. Plast Reconstr Surg. 2011 Apr;127(4):1515-1523.
5. Gordon CR, Abouhassan W, Avery RK. What is the true significance of donor-related cytomegalovirus transmission in the setting of facial composite tissue allotransplantation? Transplant Proc. 2011 Nov;43(9):3516-3520.
6. Hannan MM, Husain S, Mattner F, Danziger-Isakov L, Drew RJ, Corey GR, Schueler S, Holman WL, Lawler LP, Gordon SM, Mahon NG, Herre JM, Gould K, Montoya JG, Padera RF, Kormos RL, Conte JV, Mooney ML. Working formulation for the standardization of definitions of infections in patients using ventricular assist devices. J Heart Lung Transplant. 2011 Apr;30(4):375-384.
7. Husain S, Mooney ML, Danziger-Isakov L, Mattner F, Singh N, Avery R, Ison M, Humar A, Padera RF, Lawler LP, Fisher A, Drew RJ, Gould KF, Sole A, Studer S, Munoz P, Singer LG, Hannan M. A 2010 working formulation for the standardization of definitions of infections in cardiothoracic transplant recipients. J Heart Lung Transplant. 2011 Apr;30(4):361-374.
8. Kaul DR, Stoelben S, Cober E, Ojo T, Sandusky E, Lischka P, Zimmermann H, Rubsamen-Schaeff H. First report of successful treatment of multidrug-resistant cytomegalovirus disease with the novel anti-CMV compound AIC246. Am J Transplant. 2011 May;11(5):1079-1084.
9. Kumar D, Blumberg EA, Danziger-Isakov L, Kotton CN, Halasa NB, Ison MG, Avery RK, Green M, Allen UD, Edwards KM, Miller G, Michaels MG. Influenza vaccination in the organ transplant recipient: review and summary recommendations. Am J Transplant. 2011 Oct;11(10):2020-2030.
10. Mangi AA, Mason DP, Nowicki ER, Batizy LH, Murthy SC, Pidwell DJ, Avery RK, McCurry KR, Pettersson GB, Blackstone EH. Predictors of acute rejection after lung transplantation. Ann Thorac Surg. 2011 Jun;91(6):1754-1762.
11. Mason DP, Murthy SC, Yun JJ, Machuzak M, Shrestha R, Avery RK, McCurry KR, Budev MM, Pettersson GB. Lung transplantation in a recipient with novel 2009 H1N1 influenza: Lessons learned. Thorac Cardiovasc Surg. 2011 Mar;59(2):126-127.
12. Mossad SB. Region-specific challenges for minimizing endemic donor-transmitted infections. Liver Transpl. 2011 Nov;17(11):1241-1243.
13. Sobecks RM, Askar M, Thomas D, Rybicki L, Kalaycio M, Dean R, Avery R, Mossad S, Copelan E, Bolwell BJ. Cytomegalovirus reactivation after matched sibling donor reduced-intensity conditioning allogeneic hematopoietic stem cell transplant correlates with donor killer immunoglobulin-like receptor genotype. Exp Clin Transplant. 2011 Feb;9(1):7-13.
14. Watcharananan SP, Avery R, Ingsathit A, Malathum K, Chantratita W, Mavichak V, Chalermsanyakorn P, Jirasiritham S, Sumethkul V. Adenovirus disease after kidney transplantation: course of infection and outcome in relation to blood viral load and immune recovery. Am J Transplant. 2011 Jun;11(6):1308-1314.

Previous Publications

1. Avery R, Clauss H, Danziger-Isakov L, Davis J, Doucette K, van Duin D, Fishman J, Gunseren F, Humar A, Husain S, Isada C, Julian K, Kaul D, Kumar D, Martin S, Michaels M, Morris M, Silveira F, Subramanian A. Recommended curriculum for subspecialty training in transplant infectious disease on behalf of the American Society of Transplantation Infectious Diseases Community of Practice Educational Initiatives Working Group. Transpl Infect Dis 12 (3): 190-4, 2010.
2. Avery RK. Aspergillosis in hematopoietic stem cell transplant recipients: risk factors, prophylaxis, and treatment. Curr Infect Dis Rep 11 (3): 223-8, 2009.
3. Avery RK. Classic concepts and modern developments in transplant infectious disease: the work of Robert H. Rubin. Curr Opin Organ Transplant 13 (6): 601-3, 2008.
4. Avery RK. Infectious disease following kidney transplant: core curriculum 2010. Am J Kidney Dis 55 (4): 755-71, 2010.
5. Avery RK. Low-dose valganciclovir for cytomegalovirus prophylaxis in organ transplantation: is less really more? Clin Infect Dis 52 (3): 322-4, 2011.
6. Avery RK. Update in management of ganciclovir-resistant cytomegalovirus infection. Curr Opin Infect Dis 21 (4): 433-7, 2008.
7. Avery RK, Kaplan B. Immunosuppressive agents and CMV risk in the VICTOR study. Am J Transplant 10 (8): 1727-8, 2010.
8. Avery RK, Marty FM, Strasfeld L, Lee I, Arrieta A, Chou S, Tatarowicz W, Villano S. Oral maribavir for treatment of refractory or resistant cytomegalovirus infections in transplant recipients. Transpl Infect Dis 12 (6): 489-96, 2010.
9. Avery RK, Michaels MG. Strategies for safe living following solid organ transplantation. Am J Transplant 9 Suppl 4: S252-7, 2009.
10. Avery RK, Mossad SB, Poggio E, Lard M, Budev M, Bolwell B, Waldman WJ, Braun W, Mawhorter SD, Fatica R, Krishnamurthi V, Young JB, Shrestha R, Stephany B, Lurain N, Yen-Lieberman B. Utility of leflunomide in the treatment of complex cytomegalovirus syndromes. Transplantation 90 (4): 419-26, 2010.
11. Cuellar-Rodriguez J, Avery RK, Lard M, Budev M, Gordon SM, Shrestha NK, van Duin D, Oethinger M, Mawhorter SD. Histoplasmosis in solid organ transplant recipients: 10 years of experience at a large transplant center in an endemic area. Clin Infect Dis 49 (5): 710-6, 2009.
12. Cuellar-Rodriguez J, Bravo LT, Oethinger M, Fraser T, Mossad SB. Disseminated fusariosis in a recipient of a bone-marrow transplant. Lancet Infect Dis 9 (8): 520, 2009.
13. Fischer SA, Avery RK. Screening of donor and recipient prior to solid organ transplantation. Am J Transplant 9 Suppl 4: S7-18, 2009.
14. Kumar D, Michaels MG, Morris MI, Green M, Avery RK, Liu C, Danziger-Isakov L, Stosor V, Estabrook M, Gantt S, Marr KA, Martin S, Silveira FP, Razonable RR, Allen UD, Levi ME, Lyon GM, Bell LE, Huprikar S, Patel G, Gregg KS, Pursell K, Helmersen D, Julian KG, Shiley K, Bono B, Dharnidharka VR, Alavi G, Kalpoe JS, Shoham S, Reid GE, Humar A. Outcomes from pandemic influenza A H1N1 infection in recipients of solid-organ transplants: a multicentre cohort study. Lancet Infect Dis 10 (8): 521-6, 2010.
15. Mawhorter S, Yamani MH. Hypogammaglobulinemia and infection risk in solid organ transplant recipients. Curr Opin Organ Transplant 13 (6): 581-5, 2008.
16. Mossad SB. Larger dose of intradermal influenza vaccination may be more immunogenic in transplant recipients. Am J Transplant 8 (5): 1073, 2008.
17. Mossad SB. Preventing CMV viremia and disease 3-6 months after renal transplantation. Am J Transplant 10 (9): 2184, 2010.
18. Palmer SM, Limaye AP, Banks M, Gallup D, Chapman J, Lawrence EC, Dunitz J, Milstone A, Reynolds J, Yung GL, Chan KM, Aris R, Garrity E, Valentine V, McCall J, Chow SC, Davis RD, Avery R. Extended valganciclovir prophylaxis to prevent cytomegalovirus after lung transplantation: a randomized, controlled trial. Ann Intern Med 152 (12): 761-9, 2010. Watcharananan SP, Suwatanapongched T, Wacharawanichkul P, Chantratitaya W, Mavichak V, Mossad SB. Influenza A/H1N1 2009 pneumonia in kidney transplant recipients: characteristics and outcomes following high-dose oseltamivir exposure. Transpl Infect Dis 12 (2): 127-31, 2010.