Infectious Diseases

In 2001, the Division on Infectious Diseases atChildrens Hospital Los Angeles continued its high level of clinical and academic activity in the institution. Division members continued to provide superior in-patient primary care, consultative services, and outpatient infectious disease care for our pediatric population. During the year, division members acted as primary attending physicians for 479 patients with infectious diseases admitted to the hospital. There were 554 infectious disease consultations performed, and 656 patients seen in consultation or as follow-up in the Infectious Disease Clinic. In addition, 75 patients were seen in the Kawasaki Disease Clinic, attended by Dr. Wilbert Mason.

Teaching has remained a high priority also for division members who participated in three Grand Rounds presentations, numerous house staff presentations, and weekly appearances for several division members at Morning Report rounds. In addition, Dr. Wilbert Mason and Dr. Aninda Das delivered lectures to the second year USC medical students during the Year 2 Microbiology Course.

Research activity has also remained strong within the division. Areas of research conducted by division members include microbial pathogenesis of bacterial meningitis, diagnosis and management of infections in patients who have undergone bone marrow or solid organ transplantation, and in the area of epidemiology and pathogenesis of Kawasaki Disease. Also, three division members are primary investigators with NIH funding.

Dr. Prasadarao Nemani continues his work in the pathogenesis of gram-negative meningitis, investigating the mechanisms by which E. coli bacteria invade the blood brain barrier. He continues to hold an R01 grant investigating brain endothelial receptors for E. coli and several other grants evaluating various aspects of molecular pathogenesis of gram-negative meningitis.

Dr. Sheng He Huang also continued to have funding throughout 2001, studying the genomics of microbial infections and methods to use this approach to assess for virulence factors related to bacterial pathogenecity. Dr. Huang had a total five publications this year in this area including two invited articles, which were seminal state of the art reports.

Dr. Hoffman also continued publication in the area of the pathogenecity of E. coli with regard to human brain microvascular endothelial cells. She also has begun to expand her scope of investigation into micro array analysis of specimens from lung transplant patients assessing for immunologic markers suggesting poor outcomes in these patients. She has also begun work with Dr. Clark Inderlied to provide rapid identification of specific bacterial pathogens using molecular techniques. Finally, she published an important paper in the bone marrow transplant literature, which for the first time suggests a successful anti-viral approach to adenoviral infections in bone marrow transplant patients.

Dr. Mason has continued his clinical and epidemiologic investigations and the epidemiology, pathogenesis and outcome of Kawasaki Disease. He participated in The Seventh International Symposium on Kawasaki Disease in Hakone, Japan and presented along with Dr. Masato Takahashi, five papers and posters at that meeting.

The division, through the efforts of William La Via also entered into clinical trial work, initiating several studies measuring the efficacy and safety of new anti-microbial agents for use in pediatrics. This included studies on new anti-fungal agents, including voriconazole and a new anti-bacterial agent, ertapenem.

Dr. Lawrence Ross continued his very active teaching career and participated in a number of continuing medical education conferences on a national basis for organizations, which included conferences sponsored by organizations, such as the American Academy of Pediatrics. He chairs the CME Committee for University Childrens Medical Group and coordinates their nationally recognized conferences.

Offices Held

Wilbert Mason, MD

• Secretary, Chapter 2, District IX of the American Academy of Pediatrics.

Publications

Number of articles in peer-reviewed scientific journals 10
Number of book chapters published 2
Number of abstracts published 9

Institutional Collaborations

Dr. Mason has also continued his work in the area of pediatric health outcomes and medical safety. He has participated for six years in the Child Health Accountability Initiative (CHAI), which consists of largely freestanding pediatric hospitals who are dedicated to study and implementation of interventions, which improve pediatric, care, collect data on pediatric outcomes, and enhance medical safety within our institutions. This year he became co-medical director for this collaborative body and participated in a number of projects that have resulted in national and international presentations. Among these were a workshop at the Pediatric Academic Society Meeting in Baltimore in 2001, on medication safety in pediatric hospitals and a poster presentation at the Institute for Healthcare Improvement on a medication errors trigger list tool for identification of medication errors.

He was the co-author of two articles in Pediatrics on a literature synthesis of acute otitis media, which was supported by subcontract through the Agency for Health Care Research & Quality.

Other Highlights

Members of the Division of Infectious Diseases continue to provide extraordinary support in the area of quality of care and performance improvement (PI). Dr. Ross, as Infection Control Officer, has lead a task force to reduce and control aspergillus infections in our vulnerable patient populations. The efforts of this group have resulted in a significant reduction in cases of this often-fatal infection over the last 2 years.

Dr. Mason continues to provide leadership to the hospital and faculty in Quality and PI through his role as Medical Director for Quality Systems Management. Activities in the areas of medication safety, clinical guideline development and cost effectiveness have contributed greatly to the quality of clinical care and efficiency at Childrens Hospital Los Angeles.