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16th Annual St. Jude/PIDS Pediatric Infectious Diseases Research Conference St. Jude Children’s Research Hospital March 10-11, 2017 Memphis, Tennessee St. Jude Children’s Research Hospital Department of Infectious Diseases 262 Danny Thomas Place, Mailstop 320 Memphis, TN 38105-3678 Pediatric Infectious Diseases Society 1300 Wilson Boulevard Suite 300 Arlington, VA 22209 St. Jude – PIDS Pediatric Infectious Diseases Research Conference ii March 3, 2017 Dear Colleagues: On behalf of St. Jude Children’s Research Hospital and the Pediatric Infectious Diseases Society, we welcome you to Memphis, Tennessee and the 16th Annual St. Jude/PIDS Pediatric Infectious Diseases Research Conference! This year, nearly 200 faculty, fellows, and students will attend the meeting. The program features a “Frontiers in Infectious Diseases” symposium, with presentations from leading investigators in infectious diseases and microbiology. In addition, a series of career development workshops will be available, including sessions on career paths in global health, industry, clinical research and education. Perhaps most important, attendees will have an opportunity to present their original research to colleagues in pediatric infectious diseases, with over 40 abstract publications in basic science, clinical science, epidemiology, and health outcomes. We look forward to an excellent meeting and to meeting each of you over the next few days. Sincerely, Elaine I. Tuomanen, MD, FPIDS Chair, Department of Infectious Diseases St. Jude Children’s Research Hospital Buddy Creech, MD, MPH, FPIDS Chair, Research Affairs Committee Pediatric Infectious Diseases Society Research Affairs Committee Anne Blaschke, MD, PhD Betsy Herold, MD, FPIDS Scott James, MD Damian Krysan, MD, PhD Miriam Laufer, MD Elisa Margolis, MD, PharmD Ian Michelow, MD William Muller, MD, PhD, FPIDS Sallie Permar, MD, PhD Octavio Ramilo, MD, FPIDS David Rosen, MD, PhD Jessica Snowden, MD Paul Spearman, MD, FPIDS Stephen Spector, MD Joshua Wolf, MBBS St. Jude – PIDS Pediatric Infectious Diseases Research Conference iii PROGRAM AT A GLANCE Wednesday, March 8 6:00 – 8:00 PM Friday, March 10 7:30 AM 8:15 AM 8:30 AM 9:15 AM 10:00 AM 10:30 AM 11:30 AM 12:30 1:30 – 2:15 PM Satellite Registration Westin Memphis Beale Street Hotel - Tennessee Ballroom Marlo Thomas Center for Global Education and Collaboration (GECC) Breakfast Welcome and Announcements Elaine Tuomanen, MD Buddy Creech, MD, MPH Keynote Address The impact of praziquantel given at 12-16 weeks gestation on pregnancy outcomes: results of a double blind, placebo controlled trial Jennifer Friedman, MD, PhD Frontier Lectures in Infectious Diseases Congenital zika virus infections in macaque monkeys David O’Connor, PhD BREAK Using science to defeat malaria in sub-Saharan Africa Miriam Laufer, MD 2017 John H. Erskine Lecture in Infectious Diseases st Understanding measles in the 21 century Diane E. Griffin, MD, PhD Lunch Oral Abstract Presentations Clinical and molecular evidence to support school-based mass treatment of malaria Lauren Cohee, MD Regulation of IFN and cytosolic DNA responses by autophagy Anthony Orvedahl, MD, PhD 2:15 PM 2:30 PM One size does not fit all: evaluating decision support tools for resource limited settings Sheena Mukkada, MD BREAK Differentiating zika and dengue virus infections with a linear peptide array Emma Mohr, MD, PhD IFN-α induces RSV-specific IgA production in neonatal mice after RSV infection Diego Hijano, MD Investigation of viral virulence determinants of invasive neonatal HSV disease Lisa Akhtar, MD Gut microbiome predicts infectious complications in children with acute lymphoblastic leukemia Hana Hakim, MD 4:15 – 5:15 PM 6:30 PM Saturday, March 11 7:30 AM 8:00 AM Germinating spores as precursors of quiescent cryptococcal infection in the zebrafish J. Muse Davis, MD, PhD Poster Presentations St. Jude/PIDS Reception and Dinner Itta Bena Restaurant on Beale Street Marlo Thomas Center for Global Education and Collaboration (GECC) Breakfast Luminary in Pediatric Infectious Diseases Pertussis vaccines: opportunities & challenges Kathryn M. Edwards, MD 8:45 AM 9:30 AM 10:15 AM 10:30 AM 11:15 AM 12:00 PM 12:30 PM Frontier Lectures in Infectious Diseases Change the world: 16 years of molecular, translational, and clinical advances against fungi and where we are going now William Steinbach, MD The human microbiome during pregnancy and its possible role in premature labor David A. Relman, MD BREAK Career Development Presentations Mentorship: thriving in your mentor/trainee relationship Kathryn M. Edwards, MD Career Pathways Brief Talks Global Health: Miriam Laufer, MD Industry: William LaVia, MD Clinician-Educator: Angela Myers, MD, PhD Clinical Research: William Steinbach, MD Career Panel Discussion Lunch and Career Paths Breakout Discussions K Awards/Loan Repayment Program Jessica Snowden, MD and Scott James, MD Staying academic in a clinically-based career Angela Myers, MD, MPH 2:00 PM 3:00 PM Mock study section for grant review John Williams, MD; Betsy Herold, MD; Buddy Creech, MD, MPH; and Elaine Tuomanen, MD Research in the Global Health Setting Point of care clinical decision: resources and opportunities for developing countries— Charles Russell, PhD Global Research Panel Discussion Applying for grants and finding funding for global research projects – Stephen White, DPhil (Moderator), Hassan Zaraket, PhD and John P. DeVincenzo, MD Table of Contents Welcome Letter .................................................................................................................................................... iii Program at a Glance ............................................................................................................................................ iv General Information ..............................................................................................................................................1 Continuing Medical Education Information .......................................................................................................3 Presentation Summaries ........................................................................................................................................4 Invited Speakers/Oral Presenters Poster Presentations.............................................................................................................................................11 Attendee Listing ...................................................................................................................................................13 Map of St. Jude Children’s Research Hospital ................................................................................ Back Cover St. Jude/PIDS Pediatric Infectious Diseases Research Conference General Information Location of Conference Marlo Thomas Center for Global Education and Collaboration (GEC) St. Jude Children’s Research Hospital 262 Danny Thomas Place Memphis, TN 38105-3678 Headquarter Hotel Information Westin Memphis Beale Street Hotel 170 Lt. George W. Lee Avenue Memphis, TN 38103 (901) 334-5900 Registration Hours – Marlo Thomas Center for Global Education and Collaboration – St. Jude Children’s Research Hospital campus Wednesday, March 8: 6:00 – 8:00 pm (Satellite/Wine Reception – Tennessee Ballroom at the Westin Hotel) Friday, March 10: 7:30 a.m. – 5:30 p.m. Saturday, March 11: 7:30 a.m. – 4:00 p.m. Poster Session The Poster Session will take place on Friday, March 10, from 4:15 to 5:15 p.m. in the foyer of the GEC building. Travel Stipend Information Recipients of travel stipends must check in at the registration desk each day to verify attendance. Checks can be picked up at the registration desk on the last day of the conference. Mothers’ Room St. Jude Children’s Research Hospital offers several Mothers’ Rooms around the campus for conference registrants. These rooms can be used to breastfeed your infant or to express and store milk while at the conference. The closest rooms to use during conference hours are the Mothers’ Room located at the Chili’s Care Center and Danny Thomas Research Center. Please seek staff assistance at the Registration Desk before attempting to use this facility. Shuttle Bus Service Shuttle bus service is available for registrants to St. Jude Children’s Research Hospital from the Westin Memphis Beale Street Hotel. Registrants are responsible for providing their own transportation to any other destination while in Memphis. The following shuttle schedule will be posted at the registration desk. We encourage all attendees taking the shuttle to take earlier buses on Friday. Date Time Pick-up Site Friday, March 10 7:00, 7:20 and 7:40 a.m. Westin Memphis Beale Street Hotel St. Jude 5:15 and 5:30 p.m. St. Jude Westin Memphis Beale Street Hotel 5:45 p.m. St. Jude Itta Bena Restaurant 8:30 p.m. Itta Bena Restaurant St. Jude 7:15 and 7:45 a.m. Westin Memphis Beale Street Hotel St. Jude 4:15 p.m. St. Jude Westin Memphis Beale Street Hotel 4:15 p.m. St. Jude Airport Saturday, March 11 Destination Friday Night Event There will be a cocktail reception and dinner Itta Bena Restaurant on Friday, March 10. The restaurant is located 145 Beale Street (above BB King’s Restaurant) and is within walking distance from the Westin Memphis Beale Street Hotel. The cocktail reception starts at 6 p.m. with dinner starting at 6:30 p.m. Roundtrip shuttle bus services will be provided from St. Jude only. The buses will depart from St. Jude at 5:45 p.m. and return at 8:45 p.m. Internet Access St. Jude Children’s Research Hospital offers wireless Internet access through HopeNet. Staff Contact Information For onsite assistance, please contact Christy Phillips (202) 306-9545. St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 1 Continuing Medical Education Information Educational Objectives After attending this educational conference, you should be able to: • Describe original research related to childhood infections • Explain different career development paths for fellows and junior faculty in pediatric infectious diseases Please note that session objectives will be presented during the conference as appropriate. Accreditation Statement This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of St. Jude Children’s Research Hospital and the Pediatric Infectious Diseases Society. St. Jude Children’s Research Hospital is accredited by the ACCME to provide continuing medical education for physicians. Credit Designation St. Jude Children’s Research Hospital designates this live activity for a maximum of 13.75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Acknowledgement Please see the CME Addendum for information regarding commercial support of this activity. Claiming Credit To claim AMA PRA Category 1CreditTM or attendance credit for this activity, you must attend the sessions and follow the instructions below: • Go to www.stjude.org/cme-certificate • Enter the email address you used when registering for this conference and your password (if you do not remember your password or have not previously used this system, follow the instructions) • Enter the CME activity code 34554 • Choose the appropriate type of credit and enter the amount of time you spent at the conference (maximum 13.75 hours) to claim your credit (note that you will need to input a leading zero for credits < 10, eg, 05.00 for 5 credits) • Print and/or save your certificate If you have questions about claiming your CME or attendance certificate, please contact us at [email protected]. If you registered after February 28, 2017, or onsite, it may take 48 hours to have your information added to the CME system so that you may claim credit. Evaluation A link to the evaluation will be emailed to you after the conference. Your feedback is valuable to us, so please complete the evaluation. Disclosure of Financial Relationships All individuals in a position to control the content of this CME activity (such as faculty, presenters, and planners) were asked to complete a statement regarding all relevant financial relationships between themselves or their spouse/partner and any commercial interest (defined by the ACCME as “any entity St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 2 producing, marketing, re-selling, or distributing health care goods and services consumed by, or used on, patients”). St. Jude CME has reviewed and resolved any conflicts of interest that were identified. All relevant relationships are disclosed on the CME Addendum; no other speakers, planners, or other individuals with control over content have disclosed relevant financial relationships with commercial interests for themselves or their spouse/partner. St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 3 Session 1. Keynote Address Friday, 8:30 – 9:15 a.m. GEC Auditorium The impact of praziquantel given at 12-16 weeks gestation on pregnancy outcomes: results of a double blind, placebo controlled trial JENNIFER FRIEDMAN, Brown University, Providence, Rhode Island An estimated 40 million women of reproductive age are at risk of infection with schistosomiasis. Praziquantel was released in 1979, but was never studied in pregnant or lactating women and remains a United States Federal Drug Administration pregnancy Class B drug due to lack of well controlled trials during human pregnancy. This talk will address results of a randomized controlled trial of praziquantel given to pregnant women with S. japonicum infection in Leyte, The Philippines. A discussion of next steps to increase the number of women treated will be presented. Session 2a. Frontiers in Infectious Diseases Friday, 9:15 – 11:30 a.m. GEC Auditorium Congenital zika virus infections in macaque monkeys DAVID O’CONNOR, University of Wisconsin, Madison, Wisconsin The emergence of Zika virus in the Americas and its association with congenital abnormalities motivated researchers from around the world to study this enigmatic and previously ignored pathogen. This presentation will overview what has been learned studying Zika virus in nonhuman primates and will identify major research questions whose answers are still elusive. Using science to defeat malaria in sub-Saharan Africa MIRIAM LAUFER, University of Maryland School of Medicine, Baltimore, Maryland While there has been great progress in malaria control even in the hardest hit countries, malaria continues to kill one child every minute in sub-Saharan Africa. Dr. Laufer has spent her career investigating how malaria spreads and causes disease with the goal of introducing innovative interventions that will have long-lasting impact. This presentation will address several of the key challenges to malaria control and elimination in subSaharan Africa: infant susceptibility to infection, HIV-malaria interactions and silent reservoirs of malaria transmission in school-age children. Session 2b. 2017 John H. Erskine Lecturer in Infectious Diseases Friday, 11:30 a.m. – 12:30 p.m. GEC Auditorium Understanding measles in the 21st century DIANE GRIFFIN, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Measles remains an important cause of morbidity and mortality worldwide despite the availability of a safe and efficacious vaccine. Progress has been made in understanding the pathogenesis of measles virus infection with recognition that virus clearance is a prolonged process. During clearance there is both immune suppression and continued maturation of the measles virus-specific immune response likely responsible for establishing life-long immunity. To prevent outbreaks, high population immunity is needed and requires delivery of 2 doses of vaccine. Failure of measles virus control is due to difficulties with delivery in developing countries and resistance to vaccination in developed countries. St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 4 Session 3. Oral Presentations by PIDS and PIDS-St. Jude Fellows and Meeting Attendees Friday, 1:30 – 4:00 p.m. GEC Auditorium Clinical and molecular evidence to support school-based mass treatment of malaria Lauren Cohee, University of Maryland School of Medicine, Baltimore, Maryland Malaria remains a significant cause of morbidity and mortality worldwide. Current malaria control interventions primarily focus on prevention and treatment in those at highest risk of disease: children under five years of age and pregnant women. However, individuals who are infected but at lower risk of disease also contribute to the transmission of malaria. School-age children in Malawi have a high prevalence of subclinical P. falciparum infections and many of their infections contain gametocytes, the parasite stage required for transmission to the mosquito. School-based cohort studies in Malawi show that treatment for malaria in school age children improves their health and may decrease transmission in the community. Regulation of IFN and cytosolic DNA responses by autophagy ANTHONY ORVEDAHL, Washington University School of Medicine, St. Louis, Missouri Mice lacking genes for autophagy, a cell-intrinsic cytoplasmic recycling pathway, leads to inflammation due to an unknown trigger. We are investigating the role of autophagy in IFN responses using transcriptomics and CRISPR screening. To evaluate the role of endogenous retroelements as a potential inflammatory trigger we have developed an RNA-seq transcriptomics pipeline. The intersection of autophagy, IFN, and endogenous retroelements will be discussed. One size does not fit all: evaluating decision support tools for resource limited settings SHEENA MUKKADA, St. Jude Children’s Research Hospital, Memphis, Tennessee In low- and middle-income countries (LMICs), inconsistent management of infectious complications is a major contributor to treatment related mortality among pediatric oncology patients. Practice standardization through the use of clinical decision-support tools has been incompletely studied in settings with limited resources. Targeting the oncologic emergency of fever, we identify barriers at the patient, provider and institutional levels that demand adaptations to conventional management algorithms designed for highincome country settings. We also illustrate that monitoring adherence identifies priorities for improvement of care and resource utilization in LMIC. Differentiating zika and dengue virus infections with a linear peptide array EMMA MOHR, University of Wisconsin, Madison, Wisconsin Identifying women at risk of congenital Zika virus transmission is complicated by the lack of sensitive, specific, and scalable diagnostic tools. Conventional serologic assays, which are necessary to identify at-risk pregnancies in women who have already cleared viremia, cannot distinguish between Zika virus and closely related flaviviruses such as Dengue virus that are co-endemic. In order to develop Zika virus-specific serologic assays, ZIKV-specific epitopes that do not cross react with Dengue-specific epitopes must be identified. We utilized rhesus macaque serum from pre-ZIKV challenge, post-primary ZIKV challenge and post-secondary ZIKV challenge timepoints to identify linear B-cell epitopes unique to Zika virus. We designed a high density peptide array containing peptides representing a library of multiple Flavivirus polyproteins and measured the reactivity of pre-Zika challenge and post-Zika challenge rhesus macaque sera to the peptides. We identified two linear epitopes in the ZIKV envelope glycoprotein region that demonstrate reactivity with post-ZIKV challenge sera in three animals challenged with Asian lineage ZIKV at both the post-primary challenge and post-rechallenge timepoints. The pre-ZIKV challenge sera from these animals did not react with these linear peptides. Importantly, this ZIKV-immune sera did not cross react with the corresponding peptides in the envelope glycoprotein of Dengue serotypes 1, 2, 3 or 4. These unique linear epitopes may be utilized to develop diagnostic serologic assays for Zika virus infection. St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 5 IFN-α induces RSV-specific IgA production in neonatal mice after RSV infection DIEGO HIJANO, St. Jude Children’s Research Hospital, Memphis, Tennessee RSV is the leading viral respiratory pathogen in infants. Mucosal RSV vaccines have the potential to reduce RSV disease burden through herd immunity. Adult host response to vaccination often appears to center on early activation of innate, type 1 interferon dominated pathways (e.g. IFN- α), followed by pathways involved in B cell maturation that leads to antibody production. For both pathways, substantial age-dependent differences appear to exist. Little is known about the mucosal immune response capabilities at young ages. Five-day-old pups (neonates) or 6-8 week-old adults were infected intranasally (in) with RSV. Additionally, a group of five-day-old pups received IFN-α (in) prior to RSV infection. IgA was measured from nasal washes collected at different time points. Nasal associated lymphoid tissue (NALT) and lungs were stained by immunohistochemistry (IHC) for B cells, B cell activating factor (BAFF), and IgA. Adults infected with RSV had significantly more BAFF and IgA in NALT when compared to neonates upon primary infection. Neonates that received IFN- α prior to RSV infection had significantly higher levels of RSV specific IgA in nasal wash when compared to neonates that received vehicle control. Furthermore, RSV specific IgA levels in IFN-α treated neonates at 14 and 21 days post infection were similar to that of adult mice infected with RSV. Interestingly, upon reinfection neonatal mice that received IFN- α when compared to those who did not, had more IgA in lungs by IHC as early as 7 days post infection. B cell responses and IgA production are attenuated in neonates in response to RSV infection. IFN-α supplementation of neonates at the time of RSV infection induces IgA production to levels observed in adult mice during primary infection. Taken together, these data suggest that age differences in type 1 interferon dominated pathways are critical for antibody production during RSV infections. Investigation of viral virulence determinants of invasive neonatal HSV disease LISA AKHTAR, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Neonates infected with herpes simplex virus (HSV) at the time of birth have different clinical courses. The majority display infection of only the skin, eyes, or mouth (SEM disease). However, others develop invasive systemic (disseminated) or central nervous system (CNS) infections associated with significant morbidity and mortality. The factors that predispose a neonate to invasive HSV infection are not known. The goal of this study is to assess the contribution of variations within the viral genome to the observed clinical phenotype, and to identify viral virulence determinants of invasive disease. We obtained twelve HSV-2 isolates cultured from neonates with SEM, disseminated, or CNS disease. Viruses were minimally passaged and their complete viral DNA genomes were sequenced. This represents the largest group of neonatal HSV genomes sequenced to date. Isolates were characterized extensively in vitro with the number of plaque forming units produced (titer), number of genome copies produced, ratio of genome copies to overall titer, plaque size, and plaque morphology determined for each HSV isolate. Plaque size showed notable interstrain differences, with larger plaques more likely to have originated from neonates with invasive disease. Ongoing work aims to compare the consensus genome sequences of each HSV-2 isolate, and to identify nonsynonymous variations that segregate with clinical disease phenotypes and meaningful in vitro characteristics. This study represents the first-ever application of comparative pathogen genomics to neonatal HSV disease. Gut microbiome predicts infectious complications in children with acute lymphoblastic leukemia HANA HAKIM, St. Jude Children’s Research Hospital, Memphis, Tennessee Background: The gut microbial colonization in children with acute lymphoblastic leukemia (ALL) plays an important role in development of infections during chemotherapy. Methods: Children were enrolled at ALL diagnosis between 2012 and 2015. Stool specimens were collected before and after initiation of chemotherapy. The bacterial 16S gene was analyzed to obtain diversity and St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 6 composition of microbiome. Enteric viruses were detected using quantitative real-time PCR. Medical records were reviewed for development of febrile neutropenia (FN) over 6 months after ALL diagnosis, and for Clostridium difficile infections and antibiotic prophylaxis during induction. Results: Analysis included 361 stool samples from 187 patients. Shannon diversity index significantly decreased after induction chemotherapy. The richness of the gut with commensal bacterial taxa significantly decreased while that of pathogenic bacteria increased after chemotherapy. Multivariate analysis adjusting for race, gender, age, and ALL risk classification showed that only the abundances of Clostridiaceae and Proteobacteria before initiation of chemotherapy were independent predictors for subsequent FN episodes. Compared to no prophylaxis or other prophylaxis, levofloxacin eliminated the risk of Clostridium difficile infection during induction chemotherapy. Percent of stool specimens with detected enteric viruses increased after initiation of chemotherapy. Using next-generation sequencing of the gut virome, Astrovirus, other human viruses and bacteriophage were detected in stool specimens with widespread diversity between patients. Conclusions: Gut microbiome and enteric viruses change during chemotherapy for children with ALL. Richness of gut microbiome with Clostridiaceae and Proteobacteria, but not diversity, before initiation of chemotherapy predicted subsequent FN episodes. Microbiome analysis may serve to stratify risk of infection. Germinating spores as precursors of quiescent cryptococcal infection in the zebrafish J. MUSE DAVIS, University of Wisconsin, Madison, Wisconsin Cryptococcal meningitis is a devastating invasive fungal disease of the brain, seen in over one million patients each year and killing ~600,000. Although it most often strikes immunocompromised hosts, people with no immune deficiency can also be affected. Infection occurs in the lungs, usually without symptoms, and meningitis may not appear for years. In urban settings seropositivity for Cryptococcus is greater than 60% in 10 year old children, despite the fact that clinical disease is extremely rare in the pediatric population. Thus, many future victims of cryptococcal meningitis now carry the fungus in a dormant state. Understanding how the host and fungus develop this quiescent relationship is a critical first step in determining which individuals are most at risk for disease and what can be done to prevent it. Cryptococcus exists in the environment in association with trees, soil, and bird droppings. Studies using mice have shown that both yeast and spores can establish lung infections and cause meningitis. It is unknown whether human infection is initiated by spores, yeast, or both. Using a model of cryptococcal infection using the zebrafish larva, we have demonstrated that, as in mice, both spores and yeast can cause disseminated disease in zebrafish larvae, including meningitis. One unique property of spores in this model is the ability, at low inoculae, to establish a prolonged, non-progressive infection, in which germinated spores persist within tissue macrophages but do not replicate. We propose this state as a possible precursor to long-term latency. In parallel experiments in vitro, we find evidence for a distinct stage of germination with yeast morphology but without vegetative growth. By combining these in vitro studies of the regulation of germination with in vivo observations of host-cryptococcal interactions, we propose a timeline of events that parallel the early establishment of latent infection. Session 4. Poster Session Friday, 4:15 – 5:15 p.m. GEC Foyer St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 7 Session 5. Luminary in Pediatric Infectious Diseases Saturday, 8:00 – 8:45 a.m. GEC Auditorium Pertussis vaccines: opportunities & challenges KATHRYN M. EDWARDS, University of Vanderbilt Prominent local and systemic reactions to whole cell pertussis vaccines in the early 1980s resulted in declining vaccination rates with outbreaks occurring in a number of countries. In the United States litigation associated with these reactions forced several manufacturers to cease producing whole cell pertussis vaccines and increasing numbers of parents were fearful of this vaccine. This concern stimulated research on the biology of the pertussis organism and the generation of new vaccines containing one or more purified pertussis antigens. These “acellular vaccines” were extensively tested and found to be less reactive, immunogenic and efficacious for the prevention of pertussis disease. They were soon licensed in many of the developed countries and totally replaced the whole cell vaccines. However, in the past decade the acellular vaccines have been associated with outbreaks, suspected to be due to waning immunity. The outbreaks have also been associated with the deaths of infants too young to be immunized. Maternal immunization programs have been shown to be effective in reducing the burden of infant pertussis and have been recommended for each pregnancy in the United States. Studies of the memory responses to whole cell and acellular vaccines and nonhuman primate models of pertussis have elucidated some reasons why the acellular vaccines are associated with waning immunity. Memory responses seen after whole cell pertussis vaccine priming reflect better long term protection against pertussis disease. Although acellular vaccines generate higher levels of antigen specific IgG to the antigens included in the acellular pertussis vaccines, there are many more pertussis antigens included in whole cell vaccines. In addition, acellular pertussis vaccine priming is associated with skewing of the immune response to a more Th2 like response, while whole cell priming is associated with a Th1/Th17 response. Repeated booster doses of acellular vaccine in children primed with acellular vaccine have also been shown to result in progressively shorter duration of protection against disease. This may be explained by the generation of higher levels of antigen specific IgG4, which does not bind complement and leads to a suboptimal inflammatory response and impaired phagocytosis and antimicrobial defense. In contrast, whole cell priming followed by acellular pertussis vaccine boosting results in better opsonization, phagocytosis, and complement mediated killing through the preferential induction of IgG1. How the acellular vaccines can be made more immunogenic and can be programmed to generate a more Th1/Th17 response will be discussed. The study of pertussis vaccines over the past 40 years has been a challenging endeavor and one that continues to evolve. Session 6. Frontiers in Infectious Diseases Pt. 2 Saturday, 8:45 – 10:15 a.m. GEC Auditorium Change the world: 16 years of molecular, translational, and clinical advances against fungi and where we are going now WILLIAM STEINBACH, Duke University, Durham, North Carolina With continued medical advances and an expanding immunosuppressed patient population, there is an everincreasing importance placed on the most deadly of infections in immunocompromised hosts – invasive St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 8 fungal infections. Dr. Steinbach will go over the advances his laboratory has made in understanding the molecular basis for invasive aspergillosis, and also how (with the multi-national collaboration) they are developing new insights into pediatric invasive fungal disease epidemiology, diagnosis, and treatment. The human microbiome during pregnancy and its possible role in premature labor DAVID A. RELMAN, Stanford University, Palo Alto, California The human indigenous microbial communities (microbiota) play critical roles in health and may be especially important for mother and fetus during pregnancy. In previous work, based on a case-control study of 49 women—including 15 of whom delivered preterm, we characterized weekly variation in the vaginal, gut and oral microbiota during and after pregnancy. Of note, an altered vaginal microbial community early in pregnancy was associated with subsequent preterm birth. In addition, we discovered an abrupt change in the vaginal microbiota at delivery that persisted in some cases for at least one year. These and more recent findings of ours suggest that pregnancy outcomes might be predicted by features of the microbiota early in gestation, and reinforce the concept that the microbiota helps to shape the gestational environment of the developing fetus with potential long-term consequences for child health. Session 7. Career Development Presentation Saturday, 10:30 –11:15 a.m. GEC Auditorium Mentorship: thriving in your mentor/trainee relationship KATHRYN M. EDWARDS, Vanderbilt University, Nashville, Tennessee Productive mentoring relationships markedly enhance the academic careers of both the mentee and the mentor. However, for these relationships to be successful they must include several aspects. First there must be reciprocity in the relationship with both individuals benefitting from the interactions. Second, there must be mutual respect with both individuals working together to attain the goals of the research. Third, there must be clear expectations for both the mentor and the mentee that are outlined at the onset of the relationship and both must be accountable for meeting the projected goals. Finally, these should be a personal connection between the mentee and mentee where you have shared values and a common ground. How to achieve and sustain these productive mentorship relationships will be discussed. Session 8. Career Pathways Brief Talks/Panel Discussion Saturday, 11:15 a.m. – 12:30 p.m. GEC Auditorium The career pathways session will bring together several faculty members with differing career paths. Each panelist will provide a short talk that introduces the audience to their field and touch on the pros/cons of this career option. After all panelists have given their short talk, they will join each other on stage and answer questions related to career development. There will be a few facilitated questions, but the majority of the discussion will be driven by attendees’ questions. Session 9. Career Paths Breakout Discussions Saturday, 12:15 – 1:45 p.m. GEC Conference Rooms K Awards/Loan Repayment Program In this session, faculty will discuss the structure and requirements of the NIH’s K series awards (Career Development), as well as the Loan Repayment Program. In addition, Drs. James and Snowden will provide St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 9 advice on avoiding specific application pitfalls, tips for highlighting the strengths of your application and answer questions from participants on both programs. Staying academic in a clinically-based career Are you interested in a career as a clinician educator? This talk will provide an overview of different opportunities available to educators and those who aspire to be educators. Dr. Myers will also focus on the top 5 things learned so far in her career as an educator. Mock study section for grant review In this session, faculty will create an environment that simulates a typical study section, including general approach to reading grants, ways to avoid specific grant pitfalls, and the importance of a clear presentation of your proposed work. Session 10. Research in the Global Health Setting Saturday, 2:00 – 4:00 p.m. GEC Conference Rooms Point of care clinical decision: resources and opportunities for developing countries CHARLES RUSSELL, St. Jude Children’s Research Hospital Respiratory virus transmission, disease, and treatment: perspectives from the basic scientist collaborator Respiratory viruses are a leading cause of illness worldwide and exert a greater burden on public health in developing countries. Clinical care decision-making and medical advances can benefit by partnerships between point-of-care physicians and basic scientists. This presentation will highlight various partnership models from the point-of-view of the collaborating basic scientist. Joint interests in such partnerships may include pathogen surveillance, determination of mechanisms of pathogen spread and emergence, and modeling clinical disease symptoms in animal models to both understand and develop new preventative and therapeutic strategies. Global Research Panel Discussion Applying for grants and finding funding for global research projects STEPHEN WHITE, St. Jude Children’s Research Hospital HASSAN ZARAKET, American University of Beirut JOHN P. DEVINCENZO, University of Tennessee Center for Health Sciences St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 10 Poster Presentations Friday, 4:15 – 5:15 p.m. GEC Foyer #1 A novel antibody assay strongly predicts children with S. aureus musculoskeletal infections #2 Adherence to guidelines for the care of children with cancer and high-risk febrile neutropenia #3 Assessing the impact of incorporating the CDC bloodstream infection surveillance protocol on infection rates among pediatric cancer patients in Mexico City #4 Association between asymptomatic maternal malaria infections and birth weight in Myanmar #5 Bacteria involved in bloodstream infections in pediatric hematological patients in Lima, Peru #6 Burden of central-line associated bloodstream infections at a pediatric cancer center in El Salvador #7 Candida infection of a limb-sparing prosthesis in a teenager with osteosarcoma #8 Characteristics and outcomes of fungal infections in patients with cancer at a hospital in Mexico #9 Characterization of astrovirus-associated gastroenteritis in hospitalized children <5 in Lebanon #10 Characterization Argentina #11 Complication and clinical outcomes of using PICC lines in pediatric oncology patients #12 Detection of OXA-48 in Klebsiella oxytoca: an unusual finding #14 Effectiveness of parent education to decrease HAP at a pediatric cardiology unit in Mexico #15 Enteric fever with S. typhii progressing to hemophagocytic lymphohistiocytosis: a case report #16 Epidemiology of healthcare-associated infections in patients with cancer in San Pedro Sula, Honduras #17 Etiology of bacteremia and antimicrobial resistance in pediatric patients with malignancy in Ecuador #18 Etiology of primary bloodstream infections among children with cancer at a hospital in Guatemala #19 Follow-up of pediatric patients presenting for “Rule out Sexual Assault” placed on nPEP for HIV #24 Healthcare-associated bloodstream infections in a pediatric cancer unit in Honduras #25 How quickly do human viral-induced inflammatory responses resolve after viral replication ceases? #28 Lymphadenitis-first and facial nerve palsy in an older child: unusual presentations of Kawasaki's #29 Nasopharyngeal colonization with non-typable H. influenzae: innate immunity and disease severity of respiratory viral infections in children with St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 11 cancer in posadas, #30 Penicillin resistance identified in a case of thoracic actinomycosis #31 Predictive value of birth dose of hepatitis B Vaccine on vaccination status at 18 months #32 Pro-inflammatory mediators may distinguish infection from trauma in a rat model of shunt infection #33 Propagation of astrovirus VA1, a recently identified neurotropic human astrovirus, in cell culture #34 Respiratory virus infection characteristics among children with cancer in Lebanon #35 Surveillance for influenza C infection, Minnesota, 2013-2016 #36 Towards a collaborative, e-learning approach for disseminating infection prevention policies #37 Treatment of neonatal chlamydial conjunctivitis: a systematic review and meta-analysis #38 Trends in the clinical course of pediatric fatalities to visceral leishmaniasis in Teresina, Brazil #39 Uncommon cases of bacterial meningitis in children #40 Viral respiratory panel (VRP) testing in a Tertiary neonatal intensive care unit (NICU) #41 Intraventricular amikacin in MDR Klebsiella pneumonia shunt-associated ventriculitis #42 Rothia mucilaginosa infections in immunocompromised pediatric patients #43 Characteristics of coronavirus infection in immunocompromised vs. non-immunocompromised children St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 12 Attendee Listing Abbasi, Khurshid, MBBS, PhD Consultant Pediatrician [email protected] Baker, Amira, MD University of California, Los Angeles [email protected] Abou-El-Hassan, Hadi, BSc American University of Beirut [email protected] Barmer, Karen, BS St. Jude Children’s Research Hospital [email protected] Acker, Karen, MD Columbia University - New York Presbyterian [email protected] Baviskar, Prady, DVM, PhD St. Jude Children's Research Hospital [email protected] Adderson, Elisabeth, MD St. Jude Children's Research Hospital [email protected] Beneri, Christy, DO Stony Brook Children's Hospital [email protected] Akhtar, Lisa, MD, PhD Children's Hospital of Philadelphia [email protected] Bhalodi, Amira, PharmD Allergan [email protected] Al Hammoud, Roukaya, MD University of Texas Health-McGovern Medical School [email protected] Bloch, Deborah, MD Emory University [email protected] Alawdah, Laila, MBBS Boston Children's Hospital [email protected] Aldrich, Aileen, MD University of Nebraska Medical Center [email protected] Andrews, Shannon, MD University of Minnesota [email protected] Arias de la Garza, Eduardo, Pediatric Infectology Instituto Nacional de Pediatria [email protected] Bagga, Bindiya, MD University of Tennessee Health Sciences Center [email protected] Bluestone, Hira, PA-C Seattle Children's Hospital [email protected] Bullington, Craig, BE UTHSC [email protected] Busby, Kenneth, BS Edward Via College of Osteopathic Medicine [email protected] Carrillo, Fanny, Pediatrician Hospital Nacional de Niños Benjamin Bloom [email protected] Cassat, Jim, MD, PhD Vanderbilt University Medical Center [email protected] Chang, Alicia, MD UNOP [email protected] St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 13 Attendee Listing Chang, Yeh-Chung, MD Children's Hospital of Philadelphia [email protected] Englund, Janet, MD Seattle Children's Hospital [email protected] Chuang, Ming Jung, MD St. Jude Children's Research Hospital [email protected] Erickson, Kelley, MSN Children's Hospital of Philadelphia [email protected] Clark, Tammy, RN, BSN Sanofi [email protected] Escobedo, Griselda, PhD, MD Hospital Civil de Guadalajara [email protected] Cortez, Valerie, PhD St. Jude Children's Research Hospital [email protected] Espinoza, Darrell, MD La mascota Nicaragua [email protected] Cross, Shane, PharmD St. Jude Children's Research Hospital [email protected] Essner, Kasie, PharmD, BCPS Saint Francis Medical Center [email protected] Darling, Victoria, BS St. Jude Children's Research Hospital [email protected] Flynn, Pat, MD St. Jude Children's Research Hospital [email protected] Davis, Muse, MD, PhD University of Wisconsin [email protected] Forrest, Heather, DVM St. Jude Children's Research Hospital [email protected] Del Valle Mojica, Coralee, MD, MPH Lucile Packard Children's Hospital, Stanford [email protected] Friedman, Jennifer, MD, PhD Center for International Health Research and Alpert Medical School of Brown University [email protected] Denison, Mark, MD Vanderbilt University Medical Center [email protected] Dixit, Avika, MBBS MPH Boston Children's Hospital [email protected] Edwards, Kathryn, MD Vanderbilt University School of Medicine [email protected] Emslie, Tami, Bachelor's UC Davis Medical Center [email protected] Garbini, Cecilia, MD Hospital nacional Alejandro Posadas [email protected] Garcia-Maurino, Cristina, MD Nationwide Children's Hospital Cristina.Garcia [email protected] Gavigan, Patrick, MD St. Jude Children's Research Hospital [email protected] St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 14 Attendee Listing Gomez, Sergio, MD Hospital De Niños [email protected] Hobbs, Athena, PharmD Baptist Memorial Hospital-Memphis [email protected] Gonzalez, Miriam, MD St. Jude Children's Research Hospital [email protected] Homsi, Maysam, MPH St. Jude Children's Research Hospital [email protected] Habbal, Sarah, MD St. Jude Children's Research Hospital [email protected] Hong, David, MD Karius, Inc [email protected] Haffey, Margaret, MSW Boston Medical Center [email protected] hutto, cecelia, MD UAB School of Medicine, Department of Pediatrics [email protected] Halasa, Natasha, MD, MPH VUMC (Vanderbilt) [email protected] Hamdy, Rana, MD, MPH Children's National Health System [email protected] Hassouneh, Linda, MD University of Texass Southwestern MedicalCenter [email protected] Hazleton, Joy, MD, PhD Children's Hospital Colorado/University of Colorado School of Medicine [email protected] Helgeson, Matthew, PharmD Theravance Biopharma [email protected] Hernandez Orozco, Hilda Gpe, MSc National Pediatric Institute [email protected] Hijano, Diego, MD St. Jude Children's Research Hospital [email protected] Ippagunta, Sirish Kumar, PhD St. Jude Children's Research Hospital [email protected] Janowski, Andrew, MD Washington University School of Medicine [email protected] Jones, Lillian, MS, CCRP St. Jude Children's Research Hospital [email protected] Kanthula, Ruth, MD, MPH University of Washington [email protected] Karandikar, Manjiree, MD, MBS Boston Children's Hospital [email protected] Keaton, Amelia, MD Children's Hospital of Philadelphia [email protected] Kietzman, Colin, PhD St. Jude Children's Research Hospital [email protected] Kirby, Jeannette, MPH St. Jude Children's Research Hospital [email protected] St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 15 Attendee Listing Kitt, Eimear, MB, BCh, BAO(NUI) The Children's Hospital of Philadelphia [email protected] Medzihradsky, Oliver, MD, MPH, MS University of California San Francisco [email protected] Kumar, Madan, DO Children's National Medical Center [email protected] Melgar, Mario, MD UNOP [email protected] La Via, William, MD [email protected] Mohr, Emma, MD, PhD University of Wisconsin-Madison [email protected] Lanata, Mariana, MD Nationwide Children's Hospital [email protected] Morley, Sharon Celeste, MD, PhD Washington University School of Medicine [email protected] Laufer, Miriam, MD, MPH Institute for Global Health, University of Maryland School of Medicine [email protected] Mostafa, Heba, MD, PhD St. Jude Children's Research Hospital [email protected] Li, Ying, MD St. Jude Children's Research Hospital [email protected] Myers, Angela, MD, MPH Children's Mercy Hospital [email protected] Loera, Adriana, MD Hospital General Tijuana [email protected] Nava, Alejandra, MD Hospital de Especialidades Pediatricas [email protected] Lugo, Debra, MD Mattel Children's Hospital UCLA [email protected] O'Brien, Brigid, DO Tulane University [email protected] Madigan, Theresa, MD Mayo Clinic [email protected] Obringer, Emily, MD University of Chicago Comer Children's Hospital [email protected] Margolis, Ellie, MD PhD Seattle Children's Hospital [email protected] Max, Anita, FNP St. Jude Children's Research Hospital [email protected] McHenry, Megan, MD Indiana University School of Medicine [email protected] Odegbami, Bukola, Doctor Lagos University Teaching Hospital [email protected] Ogimi, Chikara, MD Seattle Children's Hospital [email protected] Olarubofin, Tokunbo, MBBS (Doctor) Lagos University Teaching Hospital [email protected] St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 16 Attendee Listing Ordonez, Sara, MD Hospital Escuela Universitario Honduras [email protected] Ristagno, Elizabeth, MD University of Louisville School of Medicine [email protected] Ouellette, Christopher, MD Nationwide Children's Hospital [email protected] Rodriguez, Juan Pablo, Pediatrician Infectologist Hospital del Niño Dr. Ovidio Aliaga Uria [email protected] Owens, Christina, CPhT, CCRP St. Jude Children's Research Hospital [email protected] Paulsen, Grant, MD Cincinnati Children's Hospital [email protected] Penkert, Rhiannon, PhD St. Jude Children's Research Hospital [email protected] Pitkin, Julia, BS Vanderbilt University School of Medicine [email protected] Poole, Claudette, MD University of Alabama, Birmingham [email protected] Purandare, Amol, MD Children's National Medical Center [email protected] Raabe, Vanessa, MD, MSc Emory University [email protected] Ramirez, Moises, Doctor Intituto Nacional de Pediatria [email protected] Rathore, Mobeen, MD University of Florida / UF Health [email protected] Richardson, Katherine, MD Children's Mercy Hospital Kansas City [email protected] Romero Reyes, Luis, MD Hospital Mario Catarino Rivas [email protected] Russo, Michael, MD Children's Hospital of Philadelphia [email protected] Saccoccio, Frances, MD, PhD Duke University Hospital [email protected] Sato, Alice, MD, PhD Rocky Mountain Hospital for Children [email protected] Scaggs Huang, Felicia, MD Cincinnati Children's Hospital Medical Center [email protected] Schneider, Jack, MD Indiana School of Medicine [email protected] Schultz-Cherry, Stacey, PhD St. Jude Children's Research Hospital [email protected] Sharma, Akshay, MBBS St. Jude Children's Research Hospital [email protected] Sharma, Tanvi, MD, MPH Boston Children's Hospital [email protected] Snowden, Jessica, MD University of Nebraska Medical Center [email protected] St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 17 Attendee Listing Somarriba, Maria, Infectology Pediatric Hospital Infantil Manuel de Jesus Rivera [email protected] Williams, John, MD Children's Hospital of Pittsburgh [email protected] Spearman, Paul, MD Cincinnati Children's Hospital Medical Center [email protected] Wohrley, Julie, MD University of Chicago, Comer Children's Hospital [email protected] Statler, Victoria, MD University of Louisville [email protected] Stronski, Lauren, BSN St. Jude Children's Research Hospital [email protected] Thielen, Beth, MD, PhD University of Minnesota [email protected] Thomsen, Isaac, MD Vanderbilt University Medical Center [email protected] Tinoco, Ivan, MD Hospital Materno Infantil de Badajoz [email protected] Wolf, Joshua, MBBS St. Jude Children's Research Hospital [email protected] Xu, Corey, PhD St. Jude Children's Research Hospital [email protected] Xu, Peng, PhD St. Jude Children's Research Hospital [email protected] Yeganeh, Nava, MD UCLA [email protected] Zaidi, Hina, MD Stony Brook Children's Hospital [email protected] Tribble, Alison, MD C.S. Mott Children's Hospital, University of Michigan [email protected] Zaramella, Renan, MD St. Jude Children's Research Hospital [email protected] Tuomanen, Elaine, MD St. Jude Children's Research Hospital [email protected] Zhu, Frank, MD Children's Hospital of Michigan [email protected] Vora, Surabhi, MD, MPH Seattle Children's Hospital [email protected] Zuber, Janie, MD University of Maryland [email protected] Waddell, Joel, DO Children's Mercy Hospital [email protected] Weinberg, Jason, Pediatrics University of Michigan [email protected] St. Jude/PIDS Pediatric Infectious Diseases Research Conference Page 18 :Notes St. Jude/PIDS Pediatric Infectious Diseases Research Conference :Notes St. Jude/PIDS Pediatric Infectious Diseases Research Conference :Notes St. Jude/PIDS Pediatric Infectious Diseases Research Conference :Notes St. Jude/PIDS Pediatric Infectious Diseases Research Conference • Entrance Gate (1-5) ~ Patient Only Parking Marlo Thomas Center Kay Kafe Mail Room ~ Dock (1-7) @ @ © @ ® ® @ ® CD Danny Thomas/ALSAC Pavilion Patient Care Center Richard C. Shadyac ALSAC Tower Danny Thomas Research Center Integrated Research Center Central Energy Plant AutoZone Garage 1 Incinerator/Hazardous Waste Chili's Care Center ® Q) ® © ~ ® @ (@ ® Kay Research & Care Center 545 Danny Thomas Place 595 Building 567 Danny Thomas Place 505 Building 305 Building Tamer-Rashid (ALSAC HQ) Domino's Event Center AutoZone Garage 2 @ ® ® © @ @ @) ® ® Kmart St. Jude Life Center Longinotti Building Barry Building Tri Delta Place ALSAC Gift Shop St. Jude GMP Facility 448 North Second 160 Shadyac Avenue Garage 3