New in JAMA Internal Medicine: a study led by Rishi Chanderraj and Mike Sjoding using a 15-month drug shortage (piperacillin-tazobactam) to determine the effects of unneeded anti-anaerobic antibiotics in the empiric treatment of sepsis.
In prior animal models (link, link) and observational cohort studies (link, link), depleting the gut of anaerobic commensals has been associated with worse outcomes. Our team used the 2015-16 national piperacillin-tazobactam shortage as a natural experiment. We found that treatment with piperacillin-tazobactam (which has potent activity against gut anaerobes) was associated with a 5% increase in 90-day mortality when compared to cefepime (which has no activity against anaerobes).
Most patients with sepsis have no indication for anti-anaerobic antibiotics, yet most get them anyway. Our findings suggest that we should reserve them for patients with a legitimate indication.
We got together at Casa Dominick’s to say goodbye to Anna and Brody and welcome Sam to the lab.
In the current issue of JAMA, Robert Dickson and U.S. Representative Debbie Dingell have published a Viewpoint essay titled “Urgent Need for Regulatory Oversight of Human Cells, Tissues, and Cellular and Tissue–Based Products.”
The essay describes the case of Shandra Eisenga, who contracted tuberculosis from a contaminated bone graft and ultimately died from the infection and its consequences. Her case launched a CDC outbreak investigation, which identified additional patients infected via the same infected tissue donor. This was the second tuberculosis outbreak since 2021 due to TB-contaminated bone graft tissue.
Dr. Dickson and Rep. Dingell have been working together to resolve the regulatory gaps that have allowed these outbreaks to occur. Two items of legislation (one named after Shandra) have been introduced to Congress to prevent further outbreaks from occurring due to these poorly regulated products.
At the annual UM Department of Medicine Research Symposium, Lily Maynard presented the work that she and Kale Bongers have been conducting to determine the role of gut microbiota in the catabolism of adipose tissue in sepsis. It was Lily’s first poster presentation, and she did great!
Nature has run an article summarizing the past decade of research into the lung microbiome and its potential role in disease (and as a therapeutic target). The article features Robert Dickson, along with numerous friends and collaborators of the lab.
“Exploring the lung microbiome’s role in disease” by Anthony King
Jenn Baker and Brody Mayoras both presented their work at the annual meeting of the Michigan chapter of the American Society for Microbiology. Jenn was awarded Best Poster for graduate students. Congrats, Jenn!
Kale Bongers was awarded an ASCI Emerging Generation Award, and was invited to share his work in Chicago at the 2024 ASCI Meeting.
Note that his tie is actually Figure 2A from his recent AJRCCM publication.
Jenn Baker has been awarded the “Excellence in Leadership Award” by the UM Office of Graduate & Postdoctoral Studies. Jenn was selected from among grad students across the medical school. This award reflects Jenn’s impressive leadership activities, both within our lab, among M&I graduate students, and as a science communicator. Well-earned, congrats Jenn!
Jennifer Baker
Callie Drohan has been selected to serve as Chief Fellow for the 2024-2025 academic year for the University of Michigan Pulmonary & Critical Care Medicine Fellowship Program. In this role, Callie will participate in fellowship leadership, including recruitment, advocacy, and administration. Prior to fellowship, Callie served as Chief Medical Resident at the University of Pittsburgh Medical Center.
Congrats to Callie!
Callie Drohan
On February 27th at 3pm Eastern, Robert Dickson will speak on the topic of “Writing Impactful Significance & Innovation Sections” as part of the ATS RCMB Assembly’s Grant Writer's Toolkit: K to R - Transition to Independence Series. Dr. Dickson’s talk will be followed by roundtable discussions and small-group workshops. Registration link here.
Katie Winner has received a highly fundable score on her F31 application! This award will support Katie’s project studying the role of gut microbiota in the pathogenesis of acute kidney injury in sepsis. Congrats Katie!
Katie Winner
Michael Combs and Robert Dickson have a new study in the Blue Journal: “The Lung Microbiome Predicts Mortality and Response to Azithromycin in Lung Transplant Patients with Chronic Rejection.”
In this study, we discovered that among lung transplant recipients with newly diagnosed rejection (Chronic Lung Allograft Dysfunction), lung microbiota predict mortality and differ among patients that do and don’t respond to azithromycin. Additionally, we find microbiome-associated differences in alveolar immunity across otherwise similar patients, and report a novel ex vivo approach to determine how differences in the alveolar microenvironment contribute to selective bacterial growth. Congrats to Michael!
Citation: Combs MP, Luth JE, Falkowski NR, Wheeler DS, Walker NM, Erb-Downward JR, Wakeam E, Sjoding MW, Dunlap DG, Admon AJ, Dickson RP, Lama VN. The Lung Microbiome Predicts Mortality and Response to Azithromycin in Lung Transplant Patients with Chronic Rejection. Am J Respir Crit Care Med. 2024 Jan 25. doi: 10.1164/rccm.202308-1326OC. PMID: 38271553.
Michael Combs
Kale Bongers has been awarded a 2024 ASCI Emerging Generation Award.
“The Emerging Generation Awards (E-Gen Awards) recognize post-MD, pre-faculty appointment physician-scientists who are meaningfully engaged in immersive research.”
Kale is one of 33 recipients, and will receive his award in April at the annual ASCI meeting in Chicago.
Kale Bongers
Ryan Hsieh is a University of Michigan medical student who’ll be joining the lab. Ryan is participating in the NIH-funded Short-Term Biomedical Research Training Program (STBR), which will provide him some protected time to participate in research during his clinical training years. Ryan will be working with Robert Dickson and Rishi Chanderraj, investigating whether hyperoxia (which we have discovered alters respiratory and gastrointestinal microbiota) and hyperoxemia (which we have found is startlingly common among mechanically ventilated patients and predictive of mortality) are associated with increased rates of bacteremia with gut microbiota. Welcome, Ryan!
Ryan Hsieh
Michael Combs has received word from the NHLBI that he will be awarded a K23 (Mentored Patient-Oriented Research Career Development Award) as of January 1! Michael will study the role of the lung microbiome in the development and progression of CLAD (chronic lung allograft dysfunction) in lung transplant recipients. He will be co-mentored by Robert Dickson and Vibha Lama. Congrats to Michael!
Robert Dickson, Michael Combs
Robert Dickson has been elected to the American Society for Clinical Investigation. He was one of five inductees from the University of Michigan (including friend-of-the-lab and collaborator Carl Koschmann), out of 100 total new inductees. The induction ceremony will occur on April 5 at the ASCI meeting in Chicago.
The lab got together at Jolly Pumpkin as an early holiday celebration, as well as a bittersweet send-off of Goda (who’ll be returning to Kiel later this month following completion of his rotation with us).
Robert Dickson was part of a team of investigators who have published a new original research manuscript in Nature Medicine: “Robust airway microbiome signatures in acute respiratory failure and hospital-acquired pneumonia.” This study both (1) meta-analyzed patient-level lung microbiome data from 17 published studies and (2) validated key findings in a new cohort of 136 mechanically ventilated patients. These results confirm the biological and clinical significance of respiratory microbiota in critical illness.
This study was a result of a European Union Horizon 2020 award (HAP2) to which Robert Dickson contributed microbiome data and analyses, led by Antoine Roquilly (senior author).
Huge congrats to Kale Bongers, whose K08 (Career Development Award) application received a spectacular, highly fundable score! No guarantees until the Notice of Award, but we’re highly optimistic about Kale’s chances! Kale is co-mentored on his application by Kathleen Stringer.
It’s been an extraordinary year for career development awards in the lab. Rishi Chanderraj (VA CDA), Michael Combs (K23), and Kale (K08) have all received fundable scores on their career development award applications in 2023.
Robert Dickson, Kale Bongers, Kathleen Stringer