Division faculty and fellows are engaged in a wide variety of clinical, epidemiological, translational and basic science research related to the prevention and treatment of pediatric infectious diseases. Whether utilizing mobile technology to identify disease outbreaks, studying the basic mechanisms of infectious diseases pathogenesis, or developing strategies to reduce or eliminate infections through vaccination or other preventive methods, Division faculty are committed to improving the health of children in our community and internationally.
An important component of the research conducted by Division faculty is developing the next generation of clinical investigators and scientists. Domestic and international postdoctoral scholars and medical trainees work closely in established Division laboratories under the direct supervision and guidance of Division faculty and staff.
My laboratory studies the strategies pathogens utilize to colonize and subvert the epithelial barrier. We have focused on the epithelial junctions as a target for bacterial pathogens, since the cell-cell junctions serve as both a barrier to infection and also a major control site for epithelial function. In particular, we are interested in how the gastric pathogen Helicobater pylori may cause cancer by interfering with cell signaling at the epithelial junctions. More
Varicella-zoster virus (VZV) causes varicella (chickenpox) and zoster (shingles). Our laboratory investigates the molecular virology of VZV, focusing on the functional roles of particular viral gene products in pathogenesis and virus-cell interactions in differentiated human cells in SCID mouse models of VZV infection in vivo. More
My research interest is in viral infections commonly affecting immunocompromised patients, investigating the pathogenesis and anti-viral immunity of these “opportunistic” viruses. I have a special interest in latent and persistent viruses, such as CMV and BK virus, in solid organ transplant patients. I focus on the host immune response to these viral infections with the end goal of improving clinical practices. I collaborate with both individual and core viral and immunology laboratories to conduct my research. More
Clinical Associate Professor
My research interests are in the following areas: A) Development of guidelines for the management and prevention of congenital Toxoplasmosis in the U.S.; B) Epidemiology of Toxoplasmosis in the U.S. with particular interest in outbreaks of acute Toxoplasmosis within families; C) Exploration of the hypothesis of antibiotic-associated weight gain effect in children and adolescents analyzing population cohort data from large primary care organizations; D) Empirical evaluations of the strengths and limitations of the globalization of pediatric clinical research; E) Appraisal of the cost-effectiveness analyses studies of childhood vaccinations; More
The overarching theme of our research activities is human response to natural virus infection and to vaccines. We have conducted several studies of adult, toddler and infant immune response to initial infection with human cytomegalovirus (HCMV). Our largest was a project in which we screened 20,000 newborn infants at Stanford, El Camino and Santa Clara Valley Hospitals for evidence of congenital HCMV infection. Those infants identified as being infected were enrolled into a 3-year prospective study for medical, audiology and immunology screening. More
Severe malaria caused by Plasmodium falciparum is a leading cause of morbidity and mortality in the developing world, particularly among young children and pregnant women. In humans, these parasites exclusively infect red blood cells during the clinical stage of illness. Malaria has helped shape the human genome by selecting for certain red blood cell polymorphisms that protect individuals from severe disease. More
The focus of my laboratory is defining the immune response to viral vaccines evaluating the ontogeny of responses in infants and limitations in immunocompromised hosts. We have studied the memory effector T cells response in infants given an early two-dose measles vaccine regimen, measuring CD4+, CD4+CD45RO+ and CD4+CD45RO+CCR7-T cells that produce IFNg;. We have also analyzed key markers of activation, using cell surface markers CD69 and CD40-ligand. In addition, we have studied innate immunity and the interactions with the adaptive immune system. We have measured dendritic cell and monocyte populations and function in infants and children and the effects on measles-specific CD4+ T cell responses. More
Samantha Johnston, MD
Clinical Associate Professor
A. Desiree LaBeaud, MD, MS
Current Research and Scholarly Interests Arthropod-borne viruses are emerging and re-emerging infections that are spreading throughout the world. Our laboratory investigates the epidemiology of arboviral infections, focusing on the burden of disease and the long-term complications on human health. In particular, Dr. LaBeaud investigates dengue, chikungunya, and Rift Valley fever viruses in Kenya, where outbreaks cause fever, arthritis, retinitis, encephalitis, and hemorrhagic fever. Our main research questions focus on the risk factors for arboviral infections, the development of diagnostic tests that can be administered in the field to quickly determine what kind of arboviral infection a person has, and the genetic and immunologic investigation of why different people respond differently to the same infection. Our long-term goals are to contribute to a deeper understanding of arboviral infections and their long-term health consequences and to optimize control strategies to prevent these emerging infections. Our laboratory also investigates the effects of antenatal and postnatal parasitic infections on vaccine responses, growth, and development of Kenyan children.
Grace M. Lee, MD, MPH
My work focuses on developing quality metrics for use in pediatrics, evaluating the impact of payment policies on health outcomes, preventing healthcare-associated infections, and conducting near real-time surveillance to monitor the safety of medical product use.
Yvonne Maldonado, MD
Current Research and Scholarly Interests The research I have conducted has been focused on epidemiologic aspects of viral vaccine development and prevention of perinatal HIV transmission. A major project has been to identify the molecular epidemiology of factors affecting the immunogenicity of oral polio vaccine (OPV) among children living in developing areas of the world, where OPV immunogenicity is poor. We have identified several factors which affect the poor immunogenicity of OPV and will conduct clinical studies to attempt to improve immunogenicity. We are now working on ways to understand the transmission and circulation of polio vaccine derived viruses, which may cause polio, and how to use this information in global eradication of polio. I also work on perinatal HIV infection, including strategies to prevent breastfeeding transmission in developing settings as well as understanding how to maximize prevention strategies among pregnant women in developed countries. A second recent project has been to define the ontogeny of the immune response to measles vaccine among young infants. The purpose is to identify specific humoral and cell-mediated immune responses to measles vaccine which affect vaccine immunogenicity and induce the immunosuppressive effects associated with measles vaccination. A final project I have conducted since 1989 involves a long term natural history study of infants with perinatal HIV exposure and infection. This computer-based study involves following all HIV-exposed and infected infants living in the Northern California and defining factors associated with progression of HIV-related disease.
Roshni Mathew, MD
Clinical Associate Professor
Current Research and Scholarly Interests As the Associate Medical Director of Infection Prevention and Control (IPC) at Lucile Packard Children’s Hospital, I work with the IPC nurse specialists to oversee the infection prevention work that happens on a daily basis. This work includes steps toward preventing hospital acquired infections (HAIs) as well as identifying and formulating interventions when we encounter HAIs. I co-chair the Central Line Associated Blood Stream Infections (CLABSI) and Catheter Associated Urinary Tract Infections (CAUTI) Hospital Acquired Conditions committees for the hospital. The nursing and physician leads of all units of the hospital are members of these committees, whose goal is to reduce these hospital acquired conditions to zero. We have developed catheter insertion and maintenance bundles that are standardized across the hospital. The audits and process checks done on a regular basis help us understand barriers and opportunities for improvement and implementation of best practices. In addition, IPC team members develop procedures to prevent and manage exposures, including collaboration with hospital and county disaster groups to plan for infectious disease emergencies. IPC insures safe construction and renovation practices, provides education to all staff regarding infection control practices and explores new innovations that might prove beneficial in further reducing the number of HAIs.
James McCarty, MD
Current Research and Scholarly Interests "I have an interest in pediatric coccidioidomycosis and I am participating in several studies, in collaboration with the California Department of Public Health, of the epidemiology and natural history of this disease in children. I am also working with the Infectious Disease division at Valley Children's Hospital in Madera, CA on a study evaluating the inflammatory response, including cytokines and lymphocyte subsets, of children with acute coccidioidomycosis.
Sruti Nadimpalli, MD, MPH
Clinical Assistant Professor
Current Research and Scholarly Interests My research interests center around the diagnosis of pulmonary infections in immunocompromised children. I have a particular interest in the application of recently-developed, primarily molecular methods to bronchoalveolar lavage specimens in the diagnosis of these infections. Validation and refinement of these high-sensitivity methods carries implications for standardizing and improving the care of immunocompromised children, as well as optimizing infection-prevention and control strategies.
Trung Pham, MD, PhD
Current Research and Scholarly Interests Many pathogenic bacteria, such as Mycobacterium tuberculosis and Salmonella enterica, establish chronic latent infections to survive long-term within host tissues and continue community transmission. Chronic infections remain great clinical challenges as many infected individuals are asymptomatic in latent stage, and there is a paucity of effective means to monitor and modulate disease progression, therapy responsiveness, reactivation risk, and disease transmission. We utilize a novel latent murine Salmonella infection model to elucidate functions and mechanisms of innate immune responses during chronic bacterial infections. Our long-term goal is to identify critical molecular and cellular immune factors that can be exploited for diagnostic and therapeutic purposes.
Philip Pizzo, MD
Current Research and Scholarly Interests My contributions to science have spanned work in pediatric oncology, infectious diseases, immunology and also medical education and health policy. Some themes have included: 1) The Diagnosis, Treatment and Prevention of Infectious Complications in Compromised Hosts: These studies provided the foundation for the management of infection in cancer patients and other compromised hosts and led to reductions in morbidity and mortality in cancer patients, helping to make modern cancer therapy feasible. 2) Pathogenesis and Treatment of HIV and AIDS in Children: This work helped define the pathogenesis of HIV infection in children, focusing particularly on immuno- and neuropathogensis. The work of my group at NCI led many of the early preclinical and clinical trials in pediatric AIDS and enabled four antiretroviral agents to proceed from IND to NDA. 3) Pediatric Oncology: My work has spanned a number of decades of advances in childhood cancer and is partly codified in my textbook Principles and Practice of Pediatric Oncology, the 7th edition of which will be published in late 2015. 4) Health Policy and Healthcare Deliver: I have led a number of policy studies including issues in healthcare reform, medical and graduate medical education as well as important healthcare issues like chronic pain and end-of-life care. 5) Midlife Career Transformation: I am now leading a new program at Stanford, the Distinguished Careers Institute that uses higher education to give individuals in midlife a renewed purpose along with community building and a recalibration of wellness so that they can improve the world.
Charles Prober, MD
Current Research and Scholarly Interests My area of research interest is focused on the epidemiology, pathophysiology, prevention, and treatment of infections in children. Much of my research experience has focused on viral infections, especially those caused by herpes simplex virus (HSV). I have conducted a number of studies concerned with the epidemiology of HSV-2 infections in pregnant women, their partners, and neonates. Recently, I have extended these epidemiologic studies to adolescents. I have also conducted studies on the immunologic response to HSV infections, including humoral and cell mediated responses. Furthermore, I have participated in a number of studies evaluating optimal therapy of HSV infections in pregnant women and neonates and HSV vaccine protocols. My interest in antiviral therapy extends beyond HSV infections; I have been involved in a number of studies of therapy for respiratory viral and HIV infections. My interest in bacterial infections includes the evaluation of a number of antibacterial agents (Phase I-III studies). I also am interested in the evaluation and management of infections in compromised hosts including neonates, transplant and chemotherapy recipients. I also am interested in developing interventions to reduce the inappropriate utilization of antimicrobial agents in ambulatory and hospital environments. I am keenly interested in medical education at the undergraduate, medical school, residency, and fellowship level. My educational focus has centered on microbiology and infectious diseases and on the education of clinical research scientists.
Hayden Schwenk, MD, MPH
Clinical Associate Professor
In the face of rising rates of multidrug resistance, there has been a growing recognition that antimicrobial effectiveness must be regarded as a limited resource. As the Medical Director of the LPCH Antimicrobial Stewardship Program (ASP), I am interested in identifying and implementing strategies that improve antimicrobial utilization at our institution. At present, our program has focused on the role of audit and feedback and how stewardship findings can be reported back to prescribers in a way that is most likely to ensure improvement in antimicrobial prescribing. I have a particular interest in immunocompromised populations and the ways in which evidence-based practice can be used to improve antimicrobial utilization in these patients. I also enjoy quality improvement work and am currently collaborating with perioperative services on efforts to improve surgical site infection rates at our hospital.
Nivedita (Nita) Srinivas, MD
Clinical Associate Professor
My research interests focus on resident education and the training of future leaders within the field of Quality Improvement. I am currently the site lead for the ICAP (Improving Community Acquired Pneumonia management) quality improvement project through the American Academy of Pediatrics’ Value in Inpatient Pediatrics (VIP) Network. In addition, I have a strong interest in improving the management of other common pediatric infections such as bronchiolitis and urinary tract infections.
David Vu, MD
Current Research and Scholarly Interests My research interests center on molecular determinants of human immunity, in particular, to dengue virus. Dengue virus is estimated to infect up to 390 million people per year, and can cause symptoms ranging from fever, rash and bone and joint pain, to vascular leak leading to hypovolemic shock and death. There is no licensed vaccine, and our understanding of mechanisms of protection against developing dengue infection or disease is incomplete. Better understanding of human immune responses to dengue virus will aid in the development and evaluation of novel vaccines and/or therapeutics.