Division of Infectious Diseases

UUntitled-2ntitled-2 1 110/29/130/29/13 9:399:39 AMAM Division of Infectious Diseases at and Th e Miriam Hospital

Th e Division of Infectious Diseases at Rhode Island and Th e Miriam provides comprehensive inpatient and out- patient medical care to patients with infectious diseases. Our hospitals are major teaching affi liates of Th e Warren of . In collaboration with the medical school, our mission is to provide state-of-the-art care for all patients with any type of infectious disease; to teach and mentor medical students, house offi cers and fellows in the art and science of infectious diseases; and, to pursue clinical and basic research that investigates the manifestations and treatment of infectious diseases.

Th e division has a number of areas of expertise including bacteriology, global health, human immunodefi ciency virus (HIV) and acquired immune defi ciency syndrome (AIDS), infection control, virology and sepsis research. It is active in clinical, translational, and basic science research and annually receives close to $12 million in external funding.

Eleft herios Mylonakis, MD, PhD, FIDSA, is the chief of infectious diseases at Rhode Island Hospital and Th e Miriam Hospital, and is also the Dean’s Professor of Medical Sci- ences at Th e Warren Alpert Medical School of Brown University. He is recognized for his research on the study of microbial pathogenesis and host responses. His investigations have identifi ed novel factors, cross kingdom pathogen-pathogen interactions, novel agents and evolutionarily conserved traits that are involved in host virulence and immune responses during infection. His research has resulted in more than 160 peer- reviewed scientifi c articles. Mylonakis has edited fi ve books on infectious diseases and is the founding editor-in-chief of Virulence.

CCoverover 13SEP13.indd13SEP13.indd 1 110/29/130/29/13 9:419:41 AMAM M A

3 5 : 8

Infectious Diseases Outpatient Care

3 1 / 9 2 / 0 1 10/29/13 8:53 AM . consul- ese include ed in infectious diseases ed in infectious and er expertise in a variety of infectious dis- er expertise infectious of in a variety Center Diseases Immunology e Infectious and physicians, includes team collaborative e center’s Infectious Diseases Consultation Th dis- services infectious about consultation provides England. New in southern communities eases for Th staff administrative and assistant a physician nurses, Faculty board certifi board Faculty off fellows Th setting. eases in the outpatient as as well in the community, providers with tations diseases infectious with patients for care follow-up hospitalizations. during acquired rough rough Infectious Diseases Outpatient Care DiseasesInfectious Outpatient e Miriam Hospital coordinates coordinates Hospital e Miriam e Miriam Hospital, is the larg- Hospital, e Miriam 1

d d n i . 3 1 g u A 5 1

e Infectious Diseases and Immunology Cen- Diseases Immunology e Infectious and Diseases Infectious an also of supports e Division s e Th Th at located ter, in Rhode Island care outpatient of est provider diseases. Th infectious with patients for Disease Infectious Pre- Community the center’s Clinic, Th vention to Health of Department Island Rhode the with and testing counseling, prevention, key provide transmitted sexually services HIV, for treatment tuberculosis. and diseases viral hepatitis (STDs), Th expand to helps that trials program clinical extensive HIV, for therapy access to and about knowledge diseases. infectious other and viral hepatitis s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 1 Th e center sees patients with a diverse range of infec- Lyme Disease Clinic tions, including but not limited to: Located at Th e Miriam Hospital, the Lyme Disease • Central nervous system infections Clinic specializes in the diagnosis and treatment of patients with Lyme disease. Th e clinic’s team of infec- • Chronic or refractory infections tious diseases specialists treats patients with acute and chronic Lyme disease and other tick-borne illnesses, • Viral infections such as ehrlichiosis and babesiosis. • Endocarditis For more information about the Lyme Disease Clinic, • Nosocomial infections please call 401-793-4020.

• Infections in immunocompromised patients, including patients with cancer Travel Clinic

• Osteomyelitis Th e University Medicine Travel Clinic, located at Th e Miriam Hospital, provides up-to-date preventive care Furthermore, we facilitate outpatient parenteral anti- for international travelers. Services include both rec- microbial therapy for patients following hospitaliza- ommended and required vaccinations, and counseling tions, which involves close monitoring of patients on infectious diseases prevention in infants, children and coordination of care with various facilities and and adults. Taking the recommended precautions health care providers involved in parenteral manage- against infections and illness is the fi rst step to safe ment. Every month we see more than 100 patients who travel. Prevention counseling may include advice on require consultation for infectious diseases. preventing malaria, as well as on preventing and treat- ing traveler’s diarrhea. For more information, please call 401-793-4020. Vaccines available at the travel clinic include: hepatitis A, hepatitis B, hepatitis A and B combination, infl u- enza, Japanese encephalitis, Gardisil for HPV, mea- sles-mumps-rubella (MMR), meningococcal, pneumo- coccal, polio, rabies, shingles, tetanus, TDAP, typhoid, varicella and yellow fever. Protective sprays, lotions and rehydration salts are also available.

Th e clinic is a yellow fever vaccination center autho- rized by the Rhode Island Department of Health. Vac- cinated patients will also be given the International

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 2 110/29/130/29/13 8:538:53 AMAM M A

3 5 : 8

Infectious Diseases Outpatient Care

3 1 / 9 2 / 0 1 10/29/13 8:53 AM e ers ers a standards e Miriam Hospital’s (repository)er specimen storage has been It campus. Hospital e Miriam e CFAR Immunology Research Laboratory is Laboratory Research Immunology e CFAR For more information about clinical trials, please clinical about information more For or www.miriamhospital. visit www.clinicaltrials.gov us or contact directly: org/aids-hiv-care, 401-793-4769 assistant, research Delgado, Patricia RN, 401-793-4971 Poethke, Pamela 401-793-7152 MD, Tashima, Karen 401-793-7152 MD, Rana, Aadia Center For Aids Research (CFAR) Immunology Research Laboratory Th Level 2 laboratory Biosafety a 2,800-square-foot Th on located into has grown 1997 and of since August in existence is that laboratory specimen processing a research peers. Th its among respected well and known well Th follows laboratory Commis- as the Joint as well practice, laboratory for off and CAP standards, and OSHA GCLP, sion, wide range of research specimen processing abilities, abilities, specimen processing research of wide range and HIV-1 for techniques molecular using including off We co-infections. basis. a fee-for-service on community the research to Manager, Laboratory Kurpewski, Jaclynn 401-793-4538 Director, Laboratory MD, Tashima, Karen 401-793-7152 e infection, are being con- being are infection, is comprised of physi- of is comprised stud- ACTG of e priority cile uenza and hepatitis C (with and and C (with hepatitis uenza and ammatory state, thereby leading to leading to thereby state, ammatory 3

Diseases Infectious Hospital’s e Miriam

d d e Miriam Hospital have served as chairs chairs as served have Hospital Miriam e n i . Clostridium diffi 3 1 cate of Vaccination, which is needed to travel travel which is needed to of cate Vaccination, g u A 5 1

who travelers for care also clinic provides e travel Diseases Infectious Clinical Hospital’s e Miriam s e ducted at Th Unit. Clinical Trials Certifi vaccine. fever the yellow require that countries to Th employ- provides illness and an with home return a walk-in basis. How- on vaccinations ment-related is required. a physician from referral ever, Medi- University the about information more For 401-793-4075 or visit please call Clinic, Travel cine http://www.umfmed.org/travel/. Clinical Trials Unit Th HIV for new treatments has investigated Unit Trials since 1997. Th infection C (HCV) hepatitis and staff experienced research coordina- a regulatory manager, a data nurses, cians, personnel. laboratory and tor, has site (ACTG) Group Our AIDS Clinical Trials Health of Institutes National the been funded by the with in association currently since 2000, and Investiga- Unit. Clinical Trials Harvard/Partners Th tors at better research to studies ACTG of co-chairs and HIV in the HIV and drug-resistant for treatments Th women. tract of genital with HIV infection to new test approaches ies is to reducing and HIV infection eradicating of the aims infl the chronic new of studies Cutting-edge healthier outcomes. infl for medications vaccines to of and injections), interferon without prevent s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 3 Comprehensive HIV Primary as specialized care of HIV-infected pregnant women and Specialty Care in collaboration with their obstetricians HIV/AIDS is a leading cause of death in the world; • Th e country’s fi rst HIV and menopause clinic approximately four million new infections occur • An HIV program for adolescents that off ers each year. Th e Immunology Center employs world- intensive care and long-term support renowned infectious diseases physicians dedicated to helping those with HIV/AIDS live longer, fuller lives. • One of the country’s fi rst HIV/viral hepatitis co-infection treatment programs Th e goal of the center is to provide comprehensive, up-to-date and compassionate care for all persons liv- • Infectious diseases and HIV-related clinical trials ing with HIV. Th e multidisciplinary practice involves sponsored by the federal government and pharma- clinical care as well as a strong research component that ceutical companies off ers patients early access to promising new therapies. • Free active outreach care and HIV/STD preven- Th e center provides comprehensive care to more than tion for substance abusers (particularly heroin and 1,500 patients with HIV, provided by a team of physi- cocaine needle users), off ered in collaboration with cians who are leaders in the recognition, diagnosis and AIDS Care Ocean State treatment of HIV and STDs; nurses; social workers and case managers. More than 70 percent of the indi- • HIV care that is linked to the community at the viduals in Rhode Island who are HIV-infected are con- state prison and substance abuse treatment sites nected with primary medical care through the center. • Participation in four federally funded HIV preven- Th e center off ers: tion programs for adolescents, high-risk women, and men and women leaving prison • Comprehensive care for HIV-infected patients Th e Immunology Center is a major component of the • A program for HIV-infected women that off ers case Lifespan/Tuft s/Brown Center for AIDS Research—one management, clinical trials and gynecological care, of 19 centers located at leading AIDS research insti- including colposcopy tutions nationwide that are focused on exploring new opportunities for HIV/AIDS research through inter- • Preconception counseling for HIV-infected women disciplinary collaboration and shared resources. and men, including serodiscordant couples, as well For more information about HIV primary and specialty care at the Immunology Center, please call 401-793-2928, or visit www.miriamhospital.org/immunology.

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 4 110/29/130/29/13 8:538:53 AMAM M A

3 5 : 8

Infectious Diseases Outpatient Care

3 1 / 9 2 / 0 1 10/29/13 8:53 AM drug use population clinic health mental and abuse substance with viduals disorders HIV and HCV for treatment use substance health, and mental medicine, individuals HCV-infected and HIV- needs of Enhancing care for co-existing alcohol and and alcohol co-existing for care Enhancing our among infection HCV Eliminating indi- for interventions behavior Evidence-based receiving individuals for care health Mental the behavioral investigating initiatives Research • • • • •

please contact: information, more For RN, 401-793-2899 Chapman, Stacey 401-793-4620 MD, E. Taylor, Lynn provide: we addition, In Pink- Megan please contact information, more For 401-793-3582. MA, PhD, Camp, ston 5

d d n i . 3 1 g u A including liver cancer liver including psychologist our with care individual and 5 1 Promptly diagnosing and treating viral hepatitis viral hepatitis treating and diagnosing Promptly infections new viral hepatitis Preventing viral hepatitis about patients Educating disease, liver of forms other Screening for group support via a weekly patients Supporting in co-infection research Facilitating

pro- Program Co-infection Hepatitis e HIV/Viral s • • • • • • e HIV/Viral Hepatitis Co-infection Program Th persons HIV-infected to care vides multidisciplinary hepatitis and/or C (HCV) hepatitis who also have the pro- of in 2001, the goals Established B (HBV). include: gram s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 5 HIV Menopause Clinic Integrated HIV, STD and Th e HIV Menopause Clinic is committed to help- Viral Hepatitis Testing ing HIV-positive women who are also dealing with Th e Miriam Hospital off ers testing for HIV/AIDS, menopause. Antiretroviral therapy has revolution- syphilis, gonorrhea, chlamydia, trichomonas, and ized the treatment of individuals infected with HIV hepatitis. Testing is off ered at several locations: and has caused dramatic reductions in morbid- ity and mortality. Th e result is a rapidly growing • Testing for HIV, STDs and HCV is off ered at Th e population of women who will experience meno- Miriam Hospital’s 1125 North Main Street offi ce pausal transition and other health matters related to on a walk-in basis every Friday from 1:30 to 3:30 aging while HIV infected. Menopause may induce p.m. and at other days and times by appoint- many of the same metabolic changes that are being ment. Testing is provided free for those without observed with HIV infection, which may complicate insurance. For more information, please call the health and quality of life of aging women with 401-793-2928. HIV infection. • Free testing for HCV, HBV and HIV is off ered in Th e HIV Menopause Clinic provides comprehen- collaboration with AIDS Care Ocean State at the sive evaluation of women’s gynecological and bone Broad Medical Building at 557 Broad Street in health, and evaluates risk factors for cardiovascular Providence on Tuesdays and Wednesdays from 1 and metabolic complications. It also gathers data to 3 p.m. and on Th ursdays from 10 a.m. to 1 p.m. about how menopause aff ects those with HIV and For more information, please call 401-781-0665. its treatment. Th e clinic’s multidisciplinary team includes an obstetrician/gynecologist, an infectious diseases specialist, a nurse and a medical assistant. The Viral Hepatitis Initiative Th e Miriam Hospital off ers a consultation and treat- ment program for persons diagnosed with viral Community Infectious Diseases hepatitis. Services are provided regardless of insur- Prevention Clinic ance status and include clinical evaluation, assess- Th e Miriam Hospital has been a key partner with the ment of the extent of liver injury, and treatment Rhode Island Department of Health and other com- when indicated. Treatment for hepatitis C is rapidly munity agencies in providing prevention counsel- evolving, with new therapies available that both sig- ing and testing services for infectious diseases that nifi cantly reduce the side eff ects and complications impact the health of the community. Th ese diseases of treatment and off er treatment opportunities for include HIV, STDs, viral hepatitis and tuberculosis. those who were not able to be cured with currently Th ese prevention services are additionally supported approved treatment regimens. Th rough the clinical through a broad array of testing and prevention ini- trials program, Th e Miriam Hospital supports access tiatives through the Lifespan/Tuft s/Brown Center to and evaluation of novel therapies for hepatitis C. for AIDS Research. Care for patients with cirrhosis is provided in part-

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 6 110/29/130/29/13 8:538:53 AMAM M A

3 5 : 8

Infectious Diseases Outpatient Care

3 1 / 9 2 / 0 1 10/29/13 8:53 AM e ects. the by recommended is program, 7

d d n i . 3 1 g u A 5 1

the Rhode with Clinic partners Island e RISE also the clinic by provided care e comprehensive s e nership with the Division of Gastroenterology. As As Gastroenterology. of the Division with nership linked are services, patients consultation our of part care. medical needed to ini- hepatitis viral the about information more For and consultation hepatitis for referrals or for tiative 401-793-2912. please call treatment, RISE Clinic Clinic is in 2000, the RISE being established Since in the (TB) clinic tuberculosis dedicated the only the Rhode by is supported and Rhode of Island, state is trans- which TB, Health. of Department Island space, air shared through person to person mitted health disease. local a global Th public and remains all for care and expert consultation provides clinic as evalu- as well TB, latent and both active of forms been exposed potentially who have patients of ation risk. at are and Th in the epidemiology division Health’s of Department all patients for observed directly of therapy provision Th TB. active with Dis- for the Centers and Organization Health World all active that ensures Prevention, and ease Control com- limit to works and cured, until treated cases are minimize drug side eff and exposure munity Th diagnostic the most up-to-date access to includes eval- for as the newest drug as well regimens tests, both to care Providing TB infection. latent of uation family-cen- Clinic’s the RISE adults, and children to members all family also allows approach tered setting. in a single access expert care RISE Clinic, the about information more For 401-793-2427. please call s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 7 Global and Local Health Programs

Global and Local Health Programs Global Health Initiative Physicians and researchers from the Division of Infec- Th e Global Health Initiative is a multidisciplinary tious Diseases are involved in programs around the eff ort to reduce health inequalities among underserved world that seek to provide excellent medical care to populations locally and worldwide through education, patients and to address disparities in the provision research, service and the development of partner- of health care. Part of their mission is to advocate ships. With current projects and programs in 33 coun- for underserved populations and to seek positive tries, the Global Health Initiative is particularly well policy changes that benefi t various groups in need of positioned to expand and to accelerate global health better care. eff orts. Th e initiative encompasses a wide range of practitioners and researchers across medicine, public health, biomedical research, social science, and engi- neering to provide sustainable solutions in partnership with communities and institutions around the globe.

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 8 110/29/130/29/13 8:538:53 AMAM M A

3 5 : 8

Global and Local Health Programs

3 1 / 9 2 / 0 1 10/29/13 8:53 AM rough cult-to-reach cult-to-reach population, clini- 9

d d n i . 3 1 g u A 5 1

e Center for Prisoner Health and Human Rights, Rights, Human and Health Prisoner for e Center s e HIV Care for Rural Women among treatment and medical care to Adherence public for concern is a vital patients HIV-infected to order In health. individual’s an as for as well health, diffi one to care extend evaluating projects lead ongoing group our from cians treatment and HIV care to adherence impact that factors in Mississippi women HIV-infected postpartum among in Ghana. and The Center for Prisoner Health and Human Rights Th Diseases, Infectious seeks of based to in the Division and prisoners of rights human the health and advance and education, research, through populations other other HIV and diseases, Infectious including advocacy. as as well tuberculosis, C, and B and hepatitis STDs, diseases, other are many illness and mental addiction, indi- other and prisoners among prevalent more much Th system. in the criminal justice involved viduals profession- care health and doctors of a collaboration activists, community lawyers, researchers, als, faculty, pro- health educate to strives the center students, and the general and makers, policy opinion and fessionals, sound, into research world-class translate to and public, the address evidence-based that practices policies and human health and this public of dimensions multiple crisis.rights s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 9 Do One Thing Living in a neighborhood with high rates of HIV infec- tion can increase one’s risk of coming in contact with, and thus contracting, the virus. Oft en the most heavily aff ected neighborhoods have few medical resources. To bring higher levels of testing to one such community with high rates of HIV infection, members of our division established “Do One Th ing,” an HIV and hepatitis C testing and treatment campaign that addresses an unmet need for HIV testing and care services in one southwest Philadelphia neighbor- hood that is disproportionately aff ected by the diseases. Th is campaign aims to both dramatically stimulate demand for and provide HIV testing in the zip code 19143 area, Philly Faith in Action and to retain as many people as possible in HIV treatment Philly Faith in Action is a collaboration between Brown and care. University’s Global Health Initiative and more than 100 “Do One Th ing” includes: faith and community leaders in Philadelphia. Philly Faith in Action works to reduce racial disparities in HIV infec- • Large-scale media partnerships, all coordinated and tion; promote HIV/AIDS awareness in congregations designed to remove the stigma of HIV infection and to across the city of Philadelphia; off er testing and treatment; promote HIV testing in the ZIP code 19143 area and fi ght stigma. Philly Faith in Action provides educa- tional materials and training for clergy and community • Extensive community outreach and mobilization members about HIV/AIDS, and also engages in local, state • Partnership with a federally qualifi ed health center in and federal advocacy to promote the health, interests and southwest Philadelphia that off ers routine HIV testing welfare of those living with and aff ected by HIV/AIDS. To learn more, visit www.phillyfaithinaction.org. • A city block based HIV testing program in which trained counselors and testers link HIV-positive individuals to treatment and care services

• Other community testing events at houses of worship, businesses and other community organizations in the ZIP code 19143 area

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 1010 110/29/130/29/13 8:538:53 AMAM M A

3 5 : 8

Education and Training

3 1 / 9 2 / 0 1 10/29/13 8:53 AM Hospital. e Miriam cally rigorous laboratory, clinical clinical laboratory, rigorous cally s University and Th and s University Train and mentor foreign scientists in the conduct of eth- of in the conduct scientists foreign mentor and Train scientifi and sound ically HIV/AIDS to related research socio-behavioral and Pro- Research and Training AIDS International e Fogarty to: are goals e program’s The Fogarty AIDS International Training and Research Program Th Health of Institutes the National (AITRP), funded by gram among is a collaboration Center, International – Fogarty Tuft University, Brown Th • e Warren Warren e Education and Training and Education e Miriam Hospital and 1 1

d d the is the focus of Clinical training hospitals. liated n i . 3 1 g u A 5 1

Th at Program Diseases e Infectious Fellowship s rst year, with inpatient consultation rotations at the hospi- at rotations consultation inpatient with year, rst e Infectious Diseases Fellowship Program Th is a multi-hos- University Brown School of Alpert Medical Th based at program training pital Alpert Medical other as at as well Hospital, Rhode Island affi School fi focus of in the second year is a major research tals. Scholarly opportunities training research additional and the fellowship, infectious the clinical of completion following available are diseases fellowship. s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 11 • Foster the development of a cadre of international site-spe- cifi c scientists who can become competent independent researchers and can address critical issues facing their own countries’ HIV/AIDS epidemics

AITRP is committed to AIDS research and education in the developing world, and currently supports established research training programs at partner sites in India, the Philippines, • Ghana Ghana, Kenya and Cambodia. Th e University of Ghana Medical School is affi liated with the Korle-Bu Teaching Hospital, which is home to one of • India the largest clinics providing care for people living with HIV. One of the AITRP’s collaborating training sites is YR Gai- Short-term and long-term degree training is provided by tonde Center for AIDS Research and Education in Chen- the AITRP, with a focus on nursing, pharmacology and nai, India. Th e center is the largest community-based AIDS nutrition related to HIV. service organization in India and currently cares for more than 13,000 people living with HIV. More than a dozen of • Kenya the center’s laboratory, clinical, behavioral and nutritional Our partners in Eldoret, Kenya include Moi University investigators have received advanced training via AITRP. School of Medicine, Moi Teaching and Referral Hospital and AMPATH, the Academic Model Providing Access to Christian Medical College, Vellore is one of the oldest med- Healthcare. AMPATH is one of the largest HIV treatment ical schools in India and a major tertiary referral center for programs in sub-Saharan Africa, providing care to more the country. Th e college’s trainees have conducted basic than 130,000 HIV-infected persons. Activities include a suc- laboratory investigations of mucosal immunology and the cessful bilateral medical exchange program and multidisci- natural history of cryptosporidiosis and other water-borne plinary research collaborations. parasitic infections in the HIV-infected populations in southern India. Th ey have also done large fi eld studies to • Cambodia understand the impact of HIV and tuberculosis in large cen- Th e National Center for HIV/AIDS Dermatology and STD sus tracts in the communities surrounding Vellore. (NCHADS) is the Cambodia Ministry of Health body • Philippines responsible for HIV surveillance, diagnosis, treatment and prevention in Cambodia. AITRP trainees from NCHADS Trainees from the University of the Philippines, including have returned to develop pivotal surveillance projects and physicians and other clinicians, social and behavioral sci- participate in development of the national program. Siha- entists, basic scientists and administrators, have come to nouk Hospital Center of HOPE has one of the largest pro- Brown University for HIV/AIDS training under the AITRP grams providing HIV care in Cambodia. AITRP trainees program. A number of former AITRP trainees now occupy have returned to conduct independent studies of the spec- key positions at the university and the major hospitals and trum of disease in newly diagnosed patients, gynecologic have continued to be active leaders in HIV/AIDS research complications in HIV-infected women, and the response of in the Philippines. plasma and genital tract virus to antiretroviral therapy.

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 1212 110/29/130/29/13 8:538:53 AMAM M A

3 5 : 8

Research Programs

3 1 / 9 2 / 0 1 10/29/13 8:53 AM not acceptable given the rapidly increasing of drug- of prevalence increasing the rapidly given acceptable not pathogens. resistant numerous has been by limited however, drug discovery, Antibiotic micro- new identify to cultivable the failure obstacles, including compounds or compounds toxic of a high background organisms, compound in synthetic properties poor pharmacokinetic with leads penetrate to most synthetic of the inability and libraries, Gram-negative barrier of pump resistance the multi-drug across these of some bypassed have division in our bacteria. Researchers screens high-throughput whole-animal, developing obstacles by as elegans Caenorhabditis nematode the well-studied utilize that u- Research Programs Research discovery of is is rate 3 1

d d n i . 3 1 g u A 5 1

e Division of Infectious Diseases’s researchers conduct conduct researchers Diseases’s Infectious of e Division s e Th including: areas, of in a wide variety studies ongoing Antimicrobial Drug Discovery to is imperative it that agreement is widespread there Although new anti- of the rate agents, newidentify antibacterial classes of the meet the expected to need for discovery is unlikely biotic fl tigecycline, of the possible exception With future. foreseeable truly broad-spectrum anti- of the last class were oroquinolones Gram-negative and both Gram-positive against active microbials Th bacteria in the past 40 years. developed s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 13 a model host to simultaneously identify new classes of antimi- crobials with antivirulence or immunomodulatory effi cacy and evaluate toxicity and effi cacy.

Bacteriology Our research in bacteriology focuses on the “ESKAPE” pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneu- moniae, Acinetobacter baumanii, Pseudomonas aeruginosa and Enterobacter species), a group that includes some of the most sig- nifi cant microbial pathogens exhibiting antimicrobial resistance. Data from the Centers for Disease Control and Prevention show enemase-producing Enterobacteriaceae colonization in patients rapidly increasing rates of infection due to methicillin-resistant of skilled care facilities; and the epidemiology and prevention of Staphylococcus aureus (MRSA), vancomycin-resistant E. faecium extraventricular drain neurosurgical infections. (VRE), and fl uoroquinolone-resistant P. aeruginosa. For example, Staphylococcus aureus bloodstream infection is associated with Mycology high mortality that was calculated at 39 percent for MRSA and 24 percent for methicillin-sensitive Staphylococcus aureus. Even in Th e major focus of our work in mycology is the study of fungal the pediatric age group Staphylococcus aureus bacteremia is asso- pathogenesis. For example, Candida spp. can carry several molec- ciated with an estimated annual of 6.5 cases per 100,000 ular mechanisms that induce resistance to many of the available population. Overall, more people now die of MRSA infection in antifungal agents, including the ability to form an impenetrable our nation’s hospitals than of HIV/AIDS and tuberculosis com- biofi lm on medical devices. Overall, Candida spp. are the fourth bined. As noted above, bloodstream infections that are not treated leading cause of nosocomial bloodstream infections, and mortal- eff ectively can result in sepsis. More than 751,000 Americans each ity from candidemia is over 30 to 40 percent. A decade ago, the year are diagnosed with sepsis with an estimated prevalence of overall excess cost attributable to candidemia was estimated to be 90.4 cases per 100,000 patients. greater than $1 billion per year and more recent studies estimated that in the the annual cost for candidemia is greater than $2 billion per year. Infection Control and Hospital Epidemiology Rhode Island Hospital infection control and hospital epidemi- We use molecular biology and surrogate invertebrate hosts to iden- ology research is focused on understanding the epidemiology, tify novel antifungal compounds and study basic, evolutionarily pathogenesis, and prevention of health care associated infections. conserved aspects of fungal virulence and host response. Taken Recent work has focused on MRSA colonization, the impact of in their totality, our results indicate that a common, fundamen- chlorhexidine bathing for prevention of nosocomial infections, tal set of molecular mechanisms is employed by fungal pathogens epidemiology of carbapenemase-producing Enterobacteriaceae, against a widely divergent array of metazoan hosts. Th ese inves- and intravascular catheter infections. Current research projects tigations have identifi ed novel virulence factors, cross kingdom deal with control and public reporting of nosocomial Clostridium pathogen-pathogen interactions, novel antifungal agents, and diffi cile infection; epidemiology of extended-spectrum, beta-lac- evolutionarily conserved traits that are involved in host virulence tamase-producing, Gram-negative bacterial infections; carbap- and immune responses during fungal infection.

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 1414 110/29/130/29/13 8:538:53 AMAM M A

3 5 : 8

Research Programs

3 1 / 9 2 / 0 1 10/29/13 8:53 AM nancial and grant grant and nancial University e Brown s/Brown CFAR. s/Brown ect of small interfering (si) small interfering ect of AIDS. Th against ght the Lifespan/Tuft of liates s/Brown CFAR investigators at international sites engag- sites international at investigators CFAR s/Brown e Prevention Science Core supports HIV prevention HIV prevention Science supports Core e Prevention e Developmental Core provides developmental awards awards developmental provides Core e Developmental sup- Core Populations Underserved and e HIV in Women Lifespan/ supports GI Core and Metabolism e Nutrition, col- and services, consultation provides Core e Biostatistics translational basic and supports Core e Retrovirology Th sciences—inte- behavioral and in the biomedical research fi in the gral partners AIDS Program (BRUNAP) serves as the educational arm of of arm serves as the educational (BRUNAP) AIDS Program Science Core. falls under the Prevention and CFAR Th and new research encourage to process a peer-review through as to as well HIV/AIDS research, to new investigators attract members. faculty junior to opportunities mentoring provide Th understanding on focusing research clinical ports basic and the disease of in complications HIV and of the progression bet- developing on and underserved and populations, women HIV treatments. ter Th Tuft including nutrition/metabolism, HIV and on in research ing disease, cardiovascular pharmacology, in hepatology, work HIV applied and nutrition, to related function neurocognitive metabolism. and outcomes clinical to virology related Th for aspects HIV research of quantitative to related laboration affi faculty Th highly during HIV persistence of studies including research, eff the therapy, antiretroviral active T lym- on HIV infection viral replication, molecules on RNA HIV infec- and drug resistance, and phocytes, HIV diversity neural tissues. on tion channels among the other cores, provide fi provide cores, the other among channels process. planning the strategic coordinate and management, • • • • • • e ort liated liated uid, uid, plasma, with substance abuse prob- abuse substance with s University and their affi and s University s/Brown Center for AIDS Research for Center s/Brown s/Brown CFAR is a joint research eff research is a joint CFAR s/Brown ; and support for prospective studies of alcohol alcohol of studies prospective for support ; and s/Brown CFAR consists of seven separate cores cores seven separate of consists CFAR s/Brown Lifespan/Tuft 5 1

d d n i . , division researchers engage in clinical, basic and trans- basic and in clinical, engage researchers , division e Lifespan/Tuft e 3 er state-of-the-art proteomic and transcriptome analysis; analysis; transcriptome and proteomic er state-of-the-art 1 g u e Administrative Core provides the administrative infra- the administrative provides Core e Administrative A Th communication maintain and establish to required structure 5 1

e Lifespan/Tuft e s e program emphasizes the importance of interdisciplinary collab- interdisciplinary of the importance emphasizes program and investigators, clinical especially basic and between oration, as investigators, young of mentoring and training also encourages minorities. and women of as the inclusion well Th services. core utilize to eligible are members all CFAR and hospitals and centers. It is one of 19 centers located at academic at located 19 centers of is one It centers. and hospitals the of part are that States the United throughout medical centers Th Health. of Institutes the National of program CFAR national peripheral blood mononuclear cell) obtained from patients patients from cell) obtained bloodperipheral mononuclear (HPV) or papillomavirus human HCV, HBV, HIV, with infected Helicobacter pylori history. HIV natural and abuse Tuft and University Brown among Basic Virology viral infections. in several chronic interested are Our researchers of laboratory the CFAR by supported in HIV are Basic studies CD4/CD8 T lym- viral load testing, provides that retrovirology all research for assays drug resistance and phocyte enumeration the proteomic include interest research of areas Active studies. disease and acquisition HIV-1 of acid determinants nucleic and HIV on abuse alcohol drug and of the impact and progression facilities core by supported are researchers Division infection. off that fl cerebrospinal specimens (tissue, a repository of HIV/AIDS the of part As (CFAR) treat- and prevention the improve designed to research lational racial and women, focus on a major HIV/AIDS, with of ment individuals and ethnic minorities, Th lems. • s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 15 Our Team

Curt G. Beckwith, MD Angela M. Caliendo, MD, PhD Co-leader of the Prisoner Health and Human Rights Chief of General Internal Medicine, Rhode Island Hospital Scientifi c Program, Lifespan/Tuft s/Brown Center for and Th e Miriam Hospital AIDS Research Executive Vice Chair of the Department of Medicine, Infectious Diseases Physician, Rhode Island Hospital and Th e Warren Alpert Medical School of Brown University Th e Miriam Hospital Associate Professor of Medicine, Th e Warren Alpert Medical Charles C.J. Carpenter, MD School of Brown University Director, Lifespan/Tuft s/Brown Center for AIDS Research Director, Brown University Infectious Diseases Infectious Diseases Physician, Rhode Island Hospital and Fellowship Program Th e Miriam Hospital Professor of Medicine, Th e Warren Alpert Medical School of Brown University

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 1616 110/29/130/29/13 8:538:53 AMAM M A

3 5 :

Our Team 8

3 1 / 9 2 / 0 1 10/29/13 8:53 AM e Warren Warren e Alpert e Warren Medical Alpert e Warren Hospital e Miriam Hospital e Miriam Hospital e Miriam Alpert Medical School of Brown University Brown of School Medical Alpert Director of Transplant Infectious Diseases, Diseases, Infectious Transplant of Director Hospital Rhode Island and Hospital Island Rhode Physician, Diseases Infectious Th Th Medicine, of Professor Associate University Brown of School and Hospital Island Rhode Physician, Diseases Infectious Th and Medicine of Professor Science, Medical of Professor Dean’s Th Practice, and Services, Policy Health of Professor Th Dietitian, Research Chief Th (Clinical), Medicine of Professor Associate University Brown of School Medical Staci A. Fischer, MD A. Fischer, Staci MD Flanigan, P. Timothy LDN RD, Mary Flynn, PhD, Alpert e Warren Alpert e Warren Hospital e Miriam Medical Alpert e Warren Medical Alpert e Warren Medicine (Research), Th (Research), Medicine Th (Research), Medicine 7 1

d d n i . 3 1 g u A Hospital e Miriam Hospital e Miriam Hospital e Miriam 5 rey Coleman, PhD 1 Director, Brown Kenya Exchange Program Exchange Kenya Brown Director, Th Medicine, of Professor Associate University Brown of School Services, Prevention and Testing HIV/STD Director, Center, Immunology and Diseases Infectious Th and Hospital Island Rhode Physician, Diseases Infectious Th Assistant Professor of Medicine, Th University Brown of School Postdoctoral Research Associate, Th of Professor Assistant University Brown of School Medical Hospital Rhode Island Scientist, Research of Professor Assistant University Brown of School Medical Attending Physician, Infectious Diseases and Immunology, Th University Brown Initiative, Health Global Director,

s e E. Jane Carter, MD Carter, E. Jane A. Chan, MD Philip PhD Mia Coetzer, Jeff MD Cu-Uvin, Susan s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 17 Rami Kantor, MD Internal Medicine and Infectious Diseases Physician, Rhode Island Hospital and Th e Miriam Hospital Director of Research, Brown-Kenya Program Director, Immunology Center and HIV Drug Resistance Labo- ratory, Th e Miriam Hospital Associate Professor of Medicine, Th e Warren Alpert Medical School of Brown University

Bettina M. Knoll, MD, PhD Infectious Diseases Physician, Rhode Island Hospital and Th e Miriam Hospital Helen E. Burgwyn Fuchs, PhD Assistant Professor of Medicine (Clinical), Th e Warren Alpert Research Scientist, Rhode Island Hospital Medical School of Brown University

Fizza Gillani, PhD Erna Milunka Kojic, MD Center for AIDS Research, Th e Miriam Hospital Director, Infectious Diseases and Immunology Center, Assistant Professor of Medicine (Research), Th e Warren Alpert Th e Miriam Hospital Medical School of Brown University Associate Professor of Medicine, Th e Warren Alpert Medical School of Brown University Stephen H. Gregory, PhD Research Associate, Rhode Island Hospital Awewura Kwara, MD, MPH Associate Professor of Medicine (Research), Th e Warren Alpert Infectious Diseases Specialist in Public Health and Tropical Medical School of Brown University Medicine, Th e Miriam Hospital Associate Professor of Medicine, Th e Warren Alpert Medical Erica Hardy, MD, MMSc School of Brown University Attending Physician in Infectious Diseases, Co-director, Brown University-University of Ghana Higher Th e Miriam Hospital Education Initiative for HIV/AIDS Assistant Professor of Medicine (Clinical), Th e Warren Alpert Medical School of Brown University Michelle A. Lally, MD Director, Brown University AIDS Program (BRUNAP), Austin Huang, PhD Th e Miriam Hospital Postdoctoral Research Associate, Th e Miriam Hospital Associate Professor of Medicine and Associate Professor of Assistant Professor of Medicine (Research), Th e Warren Alpert Health Services, Policy and Practice Medicine, Th e Warren Medical School of Brown University Alpert Medical School of Brown University

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 1818 110/29/130/29/13 8:538:53 AMAM M A

3 5 :

Our Team 8

3 1 / 9 2 / 0 1 10/29/13 8:53 AM Medi- Alpert e Warren Medical Alpert e Warren Medical Alpert e Warren Hospital e Miriam Hospital e Miriam Hospital e Miriam of School Medical Alpert e Warren of School Medical Alpert e Warren PhD MD, herios Mylonakis, Hospital e Miriam Hospital e Miriam Hospital e Miriam Brown University Brown Chief of Infectious Diseases, Rhode Island Hospital and and Hospital Island Rhode Diseases, Infectious of Chief Th Th Sciences, Medical of Professor Dean’s Th Scientist, Research Assistant Professor of Medicine and Assistant Professor of Th Health, Public University Brown Development, Research Cancer for Center COBRE Director, Hospital Rhode Island Attending Physician, Rhode Island and Hospital Th Th Medicine, of Professor Associate University Brown of School Retention and Adherence Center Immunology Director, (ICARE), Th Program Physician, Diseases Infectious and Medicine Internal Th and Hospital Island Rhode Assistant Professor of Medicine, Th University Brown of School and Hospital Island Rhode Medicine, of Physician-in-Chief Th Professor Family Joukowsky and Medicine of Chairman Th Medicine, of cal School of Brown University Brown of School cal Eleft ScD Nunn, Amy MD Ramratnam, Bharat Rana, MD Aadia Rice,Louis MD B. Alpert e Warren Alpert e Warren Medical Alpert e Warren Medical Alpert e Warren Medical Alpert e Warren Hospital e Miriam Hospital e Miriam of School Medical Alpert e Warren Medicine (Clinical), Th (Clinical), Medicine Th (Research), Medicine Hospital e Miriam 9 1

d d n i . 3 1 g u A 5 1 Medical School of Brown University Brown of School Medical Director, Inpatient Infectious Diseases Consultation Service, Consultation Diseases Infectious Inpatient Director, Hospital Rhode Island of Professor Assistant Hospital Rhode Island Fellow, Research of Professor Assistant University Brown of School Medical Rhode Physician, Medicine Emergency Diseases Infectious Th and Hospital Island Th Medicine, of Professor Associate University Brown of School Infection and Epidemiology of Department Director, Medical Hospital Rhode Island Control, Th Medicine, of Professor University Brown Th Clinic, Travel Director, Th Medicine, of Professor Associate University Brown of School Th Care, Hepatitis Viral HIV and Assistant Professor of Medicine, Th University Brown of School

s e Jerome M. Larkin, MD Jerome Li,Ming PhD R. Lonks, MD John ScM DO, Leonard A. Mermel, MD Mileno, D. Maria MS, MPH DO, Montague, Brian s a e s i D

s u o i t c e f n I Infectious Diseases 15Aug13.indd 19 Josiah D. Rich, MD, MPH Edward J. Wing, MD Director, Center for Prisoner Health and Human Rights, Infectious Diseases Specialist, Th e Miriam Hospital Immunology Center, Th e Miriam Hospital Professor of Medicine, Th e Warren Alpert Medical School of Professor of Medicine and Epidemiology, Th e Warren Alpert Brown University Medical School of Brown University Nickolas D. Zaller, PhD Xiaoli Tang, PhD Research Associate, Th e Miriam Hospital Research Associate, Rhode Island Hospital Assistant Professor of Medicine (Research), Th e Warren Alpert Assistant Professor of Medicine (Research), Th e Warren Alpert Medical School of Brown University Medical School of Brown University Panagiotis Ziakas, MD, PhD Karen T. Tashima, MD Research Scientist, Rhode Island Hospital Director, HIV Clinical Studies and Site Instructor in Medicine (Research), Th e Warren Alpert Medical Leader of the AIDS Clinical Trials Unit, Th e Miriam Hospital School of Brown University Professor of Medicine, Th e Warren Alpert Medical School of Brown University

Lynn E. Taylor, MD Director, HIV/Viral Hepatitis Co-infection Program, Th e Miriam Hospital Assistant Professor of Medicine, Th e Warren Alpert Medical School of Brown University

Allan R. Tunkel, MD, PhD, MACP Infectious Diseases Physician, Rhode Island Hospital and Th e Miriam Hospital Professor of Medicine and Associate Dean for Medical Educa- tion, Th e Warren Alpert Medical School of Brown University

Jacob van den Berg, PhD Research Scientist, Th e Miriam Hospital Assistant Professor of Medicine (Research), Th e Warren Alpert Medical School of Brown University

IInfectiousnfectious DiseasesDiseases 15Aug13.indd15Aug13.indd 2020 110/29/130/29/13 8:538:53 AMAM CCoverover 13SEP13.indd13SEP13.indd 2 110/29/130/29/13 9:309:30 AMAM Rhode Island Hospital 593 Eddy Street Providence, RI 02903

Th e Miriam Hospital 164 Summit Avenue Providence, RI 02906

LSMC 0913

CCoverover 13SEP13.indd13SEP13.indd 3 110/29/130/29/13 9:419:41 AMAM