Faculty Clinical Research Profiles
The Epidemiology of Antimicrobial-Resistant Bacteria
Dr. Erika D'Agata studies the epidemiology of antimicrobial-resistant bacteria in a variety of settings, including the hospital, out-patient dialysis units, nursing homes and long-term care facilities. Mechanisms of transmission and acquisition are investigated in these settings using classic epidemiological study designs, mathematical modeling and molecular typing techniques. Other areas of study focus on developing prediction rules to identify patients at high-risk of harboring these resistant pathogens and studies focusing on patient outcomes.
International HIV
Dr. Roger Shapiro works in the field of international HIV. He is a co-investigator of a large randomized trial in Botswana to determine optimal strategies to prevent mother-to-child HIV transmission, and to determine safe methods for feeding infants born to HIV-infected women. He is the principal investigator studying the etiology and outcome of diarrheal diseases in infants born to HIV-infected women, and is also leading the immunologic, virologic, and pharmacologic analyses of breast milk among women in this cohort. Dr. Shapiro is also involved in the initiation of HIV antiretroviral treatment studies in Botswana.
Epidemiology of Nosocomial Infection
Drs. Erika D'Agata and Dr. Sharon Brodie Wright pursue studies directed at the epidemiology of nosocomial infection and the spread of resistant organisms in the hospital environment. Dr. D'Agata, in addition, is studying the epidemiology of resistant bacteria in the hemodialysis and elderly population and the factors associated with the emergence and spread of multidrug-resistant gram-negative bacilli. Dr. Wright also focuses on quality improvement in infection control and education of staff, specifically related to surgical site infections, hand hygiene, and isolation precautions.
HIV-HPV coinfection - natural history and prevention
Dr. Lori Panther is the clinical director of the Infectious Diseases Dysplasia Clinic (IDDC), which provides screening and preventive care of patients with HPV-related anogenital disease. The IDDC was created in 1999 and provides multispecialty care in the screening and treatment of high-grade anal dysplasia. Next to UCSF, the IDDC longitudinally follows the second-largest population of patients in the U.S. with HPV-related anogenital disease. Epidemiological and clinical data generated from this clinic are kept in a relational database, which is the foundation of several epidemiologic investigations into the risk factors for pre-malignant and malignant HPV-related anogenital disease. In addition, one therapeutic trial of an agent to reverse the progression of high-grade anal dysplasia is underway, one NIH/AMC-sponsored trial of infrared therapy of high-grade internal anal dysplasia has been completed, and several other therapeutic interventional trials are under consideration.
Acute and Early HIV Infection
Dr. Sigall Bell participates as a collaborator in clinical studies on acute HIV infection, working with a referral cohort comprised of patients from MGH, BWH, BIDMC, Fenway Community Health Center and several other affiliated centers. Her area of clinical research focuses on the effects of early therapy on immunologic and virologic outcomes. She is also interested in the early inflammatory response during acute HIV infection and its potential role as a predictor of disease progression. In addition, she is involved in HIV QA initiatives and in medical education research projects including the role of narrative medicine and reflective writing practices in a longitudinal third year medical student clerkship.
