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  • Infectious Diseases Research

    Researchers with the Division of Infectious Diseases conduct ongoing studies in a wide variety of areas, including:

    • Antimicrobial Drug Discovery: Although there is widespread agreement that it is imperative to identify new classes of antibacterial agents, the rate of new antibiotic discovery is unlikely to meet the expected need for the foreseeable future. Infectious diseases researchers are working to identify new classes of antimicrobials with antivirulence or immunomodulatory efficacy.

    • Bacteriology: Research in bacteriology focuses on the “ESKAPE” pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa and Enterobacter species), a group that includes some of the most significant microbial pathogens exhibiting antimicrobial resistance. Data from the Centers for Disease Control and Prevention show rapidly increasing rates of infection due to methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant E. faecium (VRE), and fluoroquinolone-resistant P. aeruginosa. Overall, more people now die of MRSA infection in our nation’s hospitals than of HIV/AIDS and tuberculosis combined.

    • Infection Control and Hospital Epidemiology: Rhode Island Hospital’s research on infection control and hospital epidemiology is focused on understanding the epidemiology, pathogenesis, and prevention of health care associated infections. Recent work has focused on MRSA colonization, the impact of chlorhexidine bathing for prevention of nosocomial infections, the epidemiology of carbapenemase-producing Enterobacteriaceae, and intravascular catheter infections. Current research projects deal with control and public reporting of nosocomial Clostridium difficile infection; the epidemiology of extended-spectrum, beta-lactamase-producing, Gram-negative bacterial infections; carbapenemase-producing Enterobacteriaceae colonization in patients of skilled care facilities; and the epidemiology and prevention of extraventricular drain neurosurgical infections.

    • Mycology: The major focus of mycology research is the study of fungal pathogenesis. For example, Candida spp. can carry several molecular mechanisms that induce resistance to many of the available antifungal agents, including the ability to form an impenetrable biofilm on medical devices. Overall, Candida spp. are the fourth leading cause of nosocomial bloodstream infections, and mortality from candidemia is over 30 to 40 percent. Researchers use molecular biology and surrogate invertebrate hosts to identify novel antifungal compounds and study basic, evolutionarily conserved aspects of fungal virulence and host response. Investigations have identified novel virulence factors, cross kingdom pathogen-pathogen interactions, novel antifungal agents, and evolutionarily conserved traits that are involved in host virulence and immune responses during fungal infection.

    • Basic Virology: Researchers are investigating several chronic viral infections. Basic studies in HIV are supported by the CFAR laboratory of retrovirology that provides viral load testing, CD4/CD8 T lymphocyte enumeration, and drug resistance assays for all research studies. Active areas of research interest include the proteomic and nucleic acid determinants of HIV-1 acquisition and disease progression and the impact of drug and alcohol abuse on HIV infection. Division researchers are supported by core facilities that offer state-of-the-art proteomic and transcriptome analysis; a repository of specimens (tissue, cerebrospinal fluid, plasma, peripheral blood mononuclear cell) obtained from patients infected with HIV, HBV, HCV, human papillomavirus (HPV) or Helicobacter pylori; and support for prospective studies of alcohol abuse and HIV natural history.

    • HIV/AIDS: Researchers at The Miriam Hospital received an $8.5 million, five-year renewal grant from the National Institutes of Health to support the continued growth of the Lifespan/Tufts/Brown Center for AIDS Research (CFAR). As part of CFAR, division researchers engage in clinical, basic and translational research designed to improve the prevention and treatment of HIV/AIDS, with a major focus on women, racial and ethnic minorities, and individuals with substance abuse problems. The Lifespan/Tufts/Brown CFAR is a joint research effort among Brown University and Tufts University and their affiliated hospitals and centers, and is one of 19 centers located at academic medical centers throughout the United States that are part of the national CFAR program of the National Institutes of Health. Currently, more than 60 CFAR investigators, from fields including infectious diseases, virology, behavioral medicine, biostatistics and nutrition, are collaborating across institutions on basic science, clinical and behavioral studies, and translational research to advance the prevention, detection and treatment of HIV/AIDS. The program emphasizes the importance of interdisciplinary collaboration, especially between basic and clinical investigators, and also encourages training and mentoring of young investigators, as well as the inclusion of women and minorities.