Pediatric Infectious Disease
The section of Pediatric Infectious Disease offers complete services for both common and uncommon infectious diseases in children and adolescents, such as pneumonia, osteomyelitis, MRSA and HIV. Through its multi-disciplinary team approach with the physician, nurse practitioner, social worker, dietitian and clinical pharmacist, patients receive the full spectrum of care throughout the diagnosis and treatment process.
Our clinical program is very robust and includes both inpatient and outpatient services. The children’s HIV clinic is recognized by the state of California as a provider of diagnostic, therapeutic and support services for infants and children with or at risk of HIV infection or AIDS and is the only pediatric HIV provider in Sacramento County. We also have a new young adult HIV clinic, which helps our pediatric patients transition to the HIV adult clinic for their care. We are part of California’s Severe Combined Immunodeficiency (SCID) newborn screening pilot program, where we perform the initial evaluation of infants who test positive for SCID. Our clinic also participates in the Ryan White Comprehensive AIDS Resources Emergency Act Program, established by the federal government to help underwrite care for people with HIV or AIDS who lack adequate health insurance. In addition to inpatient services at the UC Davis Medical Center, our specialists also provide clinical services to the local community hospitals of Sutter Health.
Our infectious disease team has developed a Telemedicine program to provide outreach specialty care to children all over California. We see non-acute cases in this clinic such as MRSA colonization and disease, osteomyelitis, rheumatic fever, HIV, tuberculosis. This helps reduce the number of face-to-face visits for chronically ill patients who live far from the medical center.
Research within the section ranges from bench research to clinical vaccine studies. Our bench research involves the evaluation of Chlamydia pneumoniae, a ubiquitous organism that causes pneumonia, in conjunction with secondhand tobacco smoke exposure and their combined role in progression of atherosclerosis. In combination, these 2 factors significantly promote disease in our apo-E knockout mouse model by enhancing infectious burden, driving more robust inflammatory response, blocking the ability of phagocytes to clear apoptotic cells and enhancing the development of necrotic cores within atherosclerotic lesions. These data strongly support avoidance of smoke exposure.
Currently, the Pediatric Infectious Disease team is working on a Centers for Disease Control and Prevention (CDC)-sponsored study, LEGACY (Longitudinal Epidemiologic Study to Gain Insight into HIV and AIDS in Children and Youth). This is a national study which aims to look at HIV-infected children and adolescents from birth to 24-years and are receiving care from a pediatrician or adolescent medicine specialist. It will monitor trends in illness and death in HIV-infected children and adolescents, disease progression, long-term complications from the disease or treatment, life span, use of antiretroviral drugs and their side effects or resistance, as well as factors related to the risk for secondary HIV transmission. We are one of approximately 20 sites participating throughout the United States. The study is in its final stages and data is currently being evaluated and analyzed.
The Pediatric Infectious Disease group also participates in a variety of vaccine studies and grants to evaluate new vaccines as well as the safety and efficacy of using existing vaccines at earlier ages to protect children.
The Pediatric Infectious Disease section has a strong commitment to medical student and resident education. The infectious disease rotation focuses on the evaluation of suspected or confirmed infections in children, their diagnosis, treatment and follow-up. Topics covered include anti-infective therapies, use of the microbiology laboratory, and immunizations. Teaching occurs in both inpatient and outpatient settings, and the student is encouraged to play an active role in the infectious diseases patient care team. Students learn the principles of diagnosis and the management of common infectious conditions; infectious complications in the immunocompromised host; neonatal infections; interpretation of microbiological data; indications and interpretations of special studies; and utilization of the microbiology laboratory. Most of the clinical time is dedicated to inpatient consultation although some clinic patients are seen.
Resident education includes both ambulatory and inpatient training and teaching is held formally at lectures or noon conferences, as well as informally on the ward, intensive care units, or specialty clinic. In addition, the section actively participates on a CDC-sponsored project in conjunction with the California American Academy of Pediatrics on a program to educate residents on best communication practices with parents on vaccine safety concerns.
Our infectious diseases team also runs a prospective antibiotic stewardship program with feedback to physicians and resident/student teams to educate as well as improve quality of care, safety and impact the incidence of resistant organisms.
The Pediatric Infectious Disease team also works regularly with the adult allergy and immunology fellows who rotate through on a part-time basis to evaluate patients with known or suspected immunologic deficiencies.
On an advocacy level, the section works with the California Medical Association (CMA) Foundation on the Alliance Working for Antibiotic Resistance Education (AWARE), which is a long-term statewide effort to promote and educate healthcare providers and public about the appropriate use of antibiotics in order to reduce antibiotic resistant bacteria. We also participate on the Human Papillomavirus (HPV) project, which aims to educate patients and healthcare providers about the connection between the HPV virus and cervical cancer in order to promote strategies to prevent both of these diseases.