Infectious Diseases & Global Health

Overview

Jennifer Pisano, MD

Chief, Section of Infectious Diseases and Global Health

**University of Chicago**
Department of Medicine

Section Chief’s Welcome

Welcome to Infectious Diseases and Global Health, a section with a long tradition of clinical excellence and research accomplishment. Recently the section has been revitalized, with recruitments designed to advance clinical programs and subspecialty training programs, clinical and laboratory research, and global health programs. The vision for the Section is to achieve excellence areas across a wide range of the discipline. This includes a commitment to be at the forefront for infectious diseases that are serious threats to the public health, particularly HIV infection, antimicrobial-resistant pathogens, agents of bioterror, and other emerging infectious diseases, here in our communities and also abroad.

About the Section

The Section of Infectious Diseases and Global Health has recently increased staffing to 16 full time faculty, with a commitment from the Department of Medicine to continue expansion and expand capacity for basic laboratory investigation. Although a small group, the special interests and expertise of the faculty are quite complimentary. All the faculty members are outstanding clinicians, with expertise in the management of a wide variety of infections, from common conditions to rare or complicated life-threatening infections. In addition, there is special expertise in the major disciplines that compromise Infectious Diseases: Healthcare Epidemiology and Infection Control, Healthcare-associated Infections, Infections in Immunocompromised Hosts, Sexually Transmitted Infections, HIV/AIDS, Antimicrobial Therapy and Antimicrobial Resistance, Travel Medicine, and International Infectious Diseases Prevention and Treatment Programs.

Research

Research activities in the Section of Infectious Diseases and Global Health are quite diverse. Investigations range from epidemiology, outbreak investigation- employing state-of-the-art molecular methods for strain typing, clinical trials, and basic laboratory studies. Active epidemiologic investigations include an examination of the risks for and outcomes of antimicrobial-resistant infections in hospitalized elderly patients, Clostridium difficile infections among stem cell transplant recipients, epidemiology of HIV and STIs in India and China and risk factor analysis for hospital-acquired fungal infections. Clinical studies include determining factors that affect adherence with antiretroviral regimens, studies of new antiretroviral therapies for HIV infection, and studies of the safety and efficacy of new antimicrobial agents. The section is collaborating with Transplant Surgery in a multi-center study of solid organ transplantation in HIV-infected patients. There is also translational research in immunodeficiency states, with laboratory studies of ex vivo leukocyte apoptosis and immune reconstitution in HIV infection and phagocytic cell function in transplant recipients. Basic lab investigations into the mechanisms of probiotic formulations in inflammatory bowel disease are also being conducted in a collaborative effort with the Section of Gastroenterology. Two ID faculty members are leading operational research efforts in global health programs in China, India, and Africa. There is a commitment to expand the basic laboratory program in Infectious Diseases, with an active search underway for a Clinical Scientist.

Education and Training

The faculty members of Infectious Diseases are deeply involved in teaching. The faculty is recognized as outstanding educators, within the institution and across the country. The group is active in courses for the medical school, both clinical teaching, at the bedside in the hospital and in the clinics, and didactics in a number of the basic science courses. We offer courses for first and fourth year medical students on HIV/AIDS. Residents in the Internal Medicine Residency program rotate on both in patient consult services and receive training in outpatient infections, with an emphasis on HIV, during their ambulatory care rotations. The Section offers a Global Health Track Program that offers an international health curriculum and in-country practicum for residents and medical students led by section faculty, and an HIV curriculum for 25 private medical colleges in India. The Section also created a project to reform medical education with an emphasis on infectious diseases and public health training with Wuhan University in China that includes opportunities for faculty, fellow, and student exchanges, and for participation in health worker training and public health systems reforms. Faculty members are also active participants in a number of departmental and residency program conferences, and several faculty are regular invitees to Medical Residents Morning report. Finally, the Section of Infectious Diseases offers a robust program in fellowship training with 2 slots available per year.

Clinical Activities

The Infectious Diseases inpatient consultation services are the busiest in the institution. The variety of infections seen in this large, tertiary medical center is truly amazing and requires the input of sub-specialists from our Section. In response to clinical need and and provide greater continuity of care, the consultation service is divided between two services, the General Infectious Disease Service and a second consultation service, the Immunocompromised Host Service. The latter service provides expert advice on the management of infections complicating cancer therapy and transplantation, both bone marrow and solid organ.

In the ambulatory clinic our physicians manage a wide variety of infections. Patients with chronic infections or acute infections requiring follow up after hospital discharge can receive care. In addition, patients with unusual immune deficiencies, congenital and acquired, can be diagnosed and managed. This includes comprehensive care for patients living with HIV infection. In addition, there is a Travel Clinic, with comprehensive programs for providing education and preventive medicine to assure that travelers avoid tropical diseases and expert help in evaluating and managing imported diseases.

The Section has developed a comprehensive Adult HIV Care Program, both for clinical care and clinical research. In the last year the Section has received Ryan White Title 3 for Capacity Building grant. The goal is to expand the care of indigent patients in the outpatient setting for all patients who access care at UCH, offering them all the benefits or improved therapies and preventive medicine and keeping them healthy and avoiding hospitalization. The Section has also been selected as a site for the CPCRA (Community Clinical Research) a clinical trials consortium funded by the NIH. Other clinical trials funded by industry, both multi-center trials and local investigator-initiated trials, are quite active. The adult program is integrated with the Pediatric AIDS/HIV Care Treatment Program and the Women’s Program, allowing comprehensive primary and tertiary care for families with members living with HIV infection.

The Section of Infectious Diseases and Global Health supports the institution in many other ways. Other contributions include oversight of the Antimicrobial Stewardship Program, a service designed to help prevent the development of antibiotic resistance and foster cost-effective antimicrobial therapy. The section also participates in Institution Bio-Safety Committee activities, assuring that there is a safe environment not only in clinical care areas, but also for investigators and other laboratory workers in the basic sciences laboratories. The efforts of the Section are closely aligned with institutional programs in patient safety and clinical quality.

Faculty and trainees of the Section oversee the UC Infection Control Program. With 6 full time staff members, a dedicated microbiology and epidemiology laboratory, and state of the art analytical tools, close collaboration with other clinical and administrative units, the IC Program is recognized for its innovative approach to the control of healthcare associated infections. Section members have been active participants in efforts that have resulted in institutional reductions in central line related bloodstream infections and ventilator associated pneumonia by more than 60% over the past several years. Section members also collaborate with IC staff in outbreak investigations, often in collaboration with state and city departments of public health as well the CDC.