A CHOC investigator-initiated trial into neonates with necrotizing enterocolitis (NEC) has discovered key microbial and survival differences in patients who develop blood stream infections. These findings may help explain why premature infants with intestinal pathology experience more complications and higher mortality rates. CHOC Infectious Diseases Medical Director Antonio Arrieta, M.D., and his team have also described better outcome of bacteremia in full-term neonates when it is associated with urinary tract infections (UTI). This, they hope, will lead to changes in how both populations are managed.
Dr. Arrieta and CHOC Resident Jordan Fisher, M.D., presented their UTI data in November 2011 at the World Society of Pediatric Diseases in Melbourne. In May 2012, the data on NEC was presented to the European Society for Pediatric Infectious Diseases in Greece.
These are two of the many investigatorinitiated research trials Dr. Arrieta and his team conduct with CHOC residents to answer questions they hope will ultimately impact children everywhere.
“Our investigator-initiated trials are a small portion of the total research we do, but these are our ideas. We develop the concepts, write the protocols, seek funding, and hope to change the lives of children throughout the world.” — CHOC Infectious Diseases Medical Director Antonio Arrieta, M.D.
CHOC Infectious Diseases also participates in several collaborative pharmacokinetic (PK) trials to reassess the efficacy, safety and dosing of new antimicrobial agents. Many of these trials are industry-sponsored and focus on neonatal, oncology and cystic fibrosis patients. CHOC Infectious Diseases is also collaborating with Duke University in a Eunice Kennedy Shriver National Institute of Child Health and Human Development-funded grant to conduct PK trials for neonates, and with the University of California, Los Angeles on a NIH grant for pediatric HIV.
Training Tomorrow’s “Clinician Scientists”
During his medical training, Dr. Arrieta was taught to “always stay curious and answer questions with research.” He passes that philosophy on to CHOC residents by encouraging them to also participate in research and submit their results. As a bonus, the resident gets to present any accepted poster or paper. In recent years, CHOC residents have presented at meetings in Australia, Switzerland and France.
“We believe emphatically in training scientific doctors because answering questions through research is integral to being a clinician,” Dr. Arrieta said. “Without that, they will not be complete. Many CHOC residents have gone on to become scientists and teachers, and that makes us very proud of what we do.”
Preliminary Pneumococcal Vaccine Data Soon Available
CHOC Infectious Diseases is assessing the impact of a new vaccine in reducing invasive pneumococcal disease and pneumonia. Similar to previous work conducted after the introduction of the first pneumococcal conjugate vaccine, and published in the Journal of Pediatric Infectious Diseases in 2011, CHOC is conducting an annual three-year interim analysis and then a final five-year study. Initial results will be available soon to share with parents about the importance of immunization. To learn more about Research at CHOC, please visit www.choc.org/research.
