doctor looking through microscope in lab

Infectious Diseases Research

The Division of Infectious Diseases has a strong basic science and translational investigation program that includes virology, bacteriology, microbial diversity, mycology, and the intestinal microbiome. There is also a research component in our HIV/AIDS Treatment Program, Transplant Infectious Disease Service, Fecal Microbiota Transplant Program and the Antimicrobial Stewardship Program.

 

The Division of Infectious Diseases is currently researching several areas of interest, including:

  • Basic mechanisms of immune system evasion by HIV - HIV establishes a chronic progressive infection despite an immune response that responds to the virus
  • Basic mechanisms of viral evolution - the AIDS pandemic and the resurgence of influenza highlight the ability of viruses to evolve, mutate, and avoid traditional approaches to their control - vaccines and antiviral drugs
  • Interactions of retroviruses, including HIV, with human cellular factors
  • Molecular and cellular mechanisms responsible for viral assembly and antiviral responses
  • Basic physiology and ecology of microbes - Microbial communities are diverse in multiple environments, including the soil and in mammalian microbiomes
  • GI Microbiome - The GI microbial community is sizable and much of it remains unknown by standard culture techniques
  • No-touch room disinfection - Rates of hospital-acquired infections in units where pulsed xenon UV light (PX-UV) are added to cleaning routines

Significant Research Achievements

New findings in HIV research have offered a path forward in the development of drugs that could potentially help cure HIV. Research by Kathleen Collins, MD, and her lab has revealed that HIV latency is driven by limited viral factors like Trans-activator of transcription (or Tat), which can be overcome to reactivate latent virus and viral protein R (Vpr) facilitates viral spread by degrading PU.1, weakening immune defenses. Other work has shown that HIV manipulates endosomal acidification by reducing NHE6 to promote immune evasion, with distinct roles for the Vif and Nef proteins in this process.

Our division continues to investigate COVID-19, its variants, and its effect on vulnerable patient populations:

Adam Lauring, MD, PhD, continues genomic surveillance activities, tracking different variants of SARS-CoV-2 circulating in Michigan and the populations affected. In addition, our division completed its fourth year of participating in the CDC-sponsored Influenza and Other Viruses in the Acutely Ill (IVY) Network, which assesses clinical outcomes of individuals hospitalized with COVID-19, influenza, and respiratory syncytial virus (RSV) infection.

Powel Kazanjian, MD, explores how COVID-19 mirrors past epidemics in demonstrating that scientific advances alone are insufficient to eradicate disease. His analysis underscored the critical role of socioeconomic and political forces in shaping public health responses and outcomes. The evolution of the COVID-19 pandemic – from devastation to optimism for eradication, to persistent, uneven spread of disease – may seem unprecedented. As an infectious disease doctor and medical historian, however, I see similarities to other epidemics, including syphilis, AIDS and tuberculosis. Vaccines, medications and other biomedical breakthroughs are necessary to eliminate epidemic diseases.

Krishna Rao, MD, co-authored a study on artificial intelligence (AI) guidance for clinicians aimed at reducing the spread of Clostridioides difficile, a deadly bacterium. The protocol significantly reduced antibiotic prescriptions, a factor that increases infection risk for vulnerable patients, with 10-15% fewer days on antimicrobials, and did not increase length of stay, readmission rate, or mortality. Applied to never-before-seen patients, predictions aligned with true risk, showing the model worked. When trained specifically for Michigan Medicine, comparing the year-long intervention with the pre-AI period, Clostridioides difficile trended downward from 5.76 to 5.65 per 10,000 patient days.

The current guideline-recommended antibiotic treatment durations for ventilator-associated pneumonia have posed risks of overtreatment-promoting antimicrobial resistance and adverse drug events, as well as undertreatment, and have increased the likelihood of pneumonia recurrence and sepsis-related complications. The Ventilator-associated pneumonia Biomarker Evaluation (or VIBE) study, led by Owen Albin, MD, and other University of Michigan researchers, aimed to identify an alveolar biomarker signature associated with treatment response and informing antibiotic duration in future clinical trials.

Faculty Lab Websites