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Kassis G, Palshikar MG, Hilchey SP, Zand MS, Thakar J. Discrete-state models identify pathway specific B cell states across diseases and infections at single-cell resolution. J Theor Biol 2024; 583:111769. [PMID: 38423206 PMCID: PMC11046450 DOI: 10.1016/j.jtbi.2024.111769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 02/10/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024]
Abstract
Oxygen (O2) regulated pathways modulate B cell activation, migration and proliferation during infection, vaccination, and other diseases. Modeling these pathways in health and disease is critical to understand B cell states and ways to mediate them. To characterize B cells by their activation of O2 regulated pathways we develop pathway specific discrete state models using previously published single-cell RNA-sequencing (scRNA-seq) datasets from isolated B cells. Specifically, Single Cell Boolean Omics Network Invariant-Time Analysis (scBONITA) was used to infer logic gates for known pathway topologies. The simplest inferred set of logic gates that maximized the number of "OR" interactions between genes was used to simulate B cell networks involved in oxygen sensing until they reached steady network states (attractors). By focusing on the attractors that best represented sequenced cells, we identified genes critical in determining pathway specific cellular states that corresponded to diseased and healthy B cell phenotypes. Specifically, we investigate the transendothelial migration, regulation of actin cytoskeleton, HIF1A, and Citrate Cycle pathways. Our analysis revealed attractors that resembled the state of B cell exhaustion in HIV+ patients as well as attractors that promoted anerobic metabolism, angiogenesis, and tumorigenesis in breast cancer patients, which were eliminated after neoadjuvant chemotherapy (NACT). Finally, we investigated the attractors to which the Azimuth-annotated B cells mapped and found that attractors resembling B cells from HIV+ patients encompassed a significantly larger number of atypical memory B cells than HIV- attractors. Meanwhile, attractors resembling B cells from breast cancer patients post NACT encompassed a reduced number of atypical memory B cells compared to pre-NACT attractors.
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Affiliation(s)
- George Kassis
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, USA
| | - Mukta G Palshikar
- Biophysics, Structural, and Computational Biology Program, University of Rochester School of Medicine and Dentistry, Rochester, USA
| | - Shannon P Hilchey
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Martin S Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Juilee Thakar
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, USA; Biophysics, Structural, and Computational Biology Program, University of Rochester School of Medicine and Dentistry, Rochester, USA; Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, USA; Department of Biomedical Genetics, University of Rochester School of Medicine and Dentistry, Rochester, USA.
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Zand MS, Spallina S, Ross A, Zandi K, Pawlowski A, Seplaki CL, Herington J, Corbett AM, Kaukeinen K, Holden-Wiltse J, Freedman EG, Alcantara L, Li D, Cameron A, Beaumont N, Dozier A, Dewhurst S, Foxe JJ. Ventilation during COVID-19 in a school for students with intellectual and developmental disabilities (IDD). PLoS One 2024; 19:e0291840. [PMID: 38568915 PMCID: PMC10990219 DOI: 10.1371/journal.pone.0291840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/21/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND This study examined the correlation of classroom ventilation (air exchanges per hour (ACH)) and exposure to CO2 ≥1,000 ppm with the incidence of SARS-CoV-2 over a 20-month period in a specialized school for students with intellectual and developmental disabilities (IDD). These students were at a higher risk of respiratory infection from SARS-CoV-2 due to challenges in tolerating mitigation measures (e.g. masking). One in-school measure proposed to help mitigate the risk of SARS-CoV-2 infection in schools is increased ventilation. METHODS We established a community-engaged research partnership between the University of Rochester and the Mary Cariola Center school for students with IDD. Ambient CO2 levels were measured in 100 school rooms, and air changes per hour (ACH) were calculated. The number of SARS-CoV-2 cases for each room was collected over 20 months. RESULTS 97% of rooms had an estimated ACH ≤4.0, with 7% having CO2 levels ≥2,000 ppm for up to 3 hours per school day. A statistically significant correlation was found between the time that a room had CO2 levels ≥1,000 ppm and SARS-CoV-2 PCR tests normalized to room occupancy, accounting for 43% of the variance. No statistically significant correlation was found for room ACH and per-room SARS-CoV-2 cases. Rooms with ventilation systems using MERV-13 filters had lower SARS-CoV-2-positive PCR counts. These findings led to ongoing efforts to upgrade the ventilation systems in this community-engaged research project. CONCLUSIONS There was a statistically significant correlation between the total time of room CO2 concentrations ≥1,000 and SARS-CoV-2 cases in an IDD school. Merv-13 filters appear to decrease the incidence of SARS-CoV-2 infection. This research partnership identified areas for improving in-school ventilation.
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Affiliation(s)
- Martin S. Zand
- Department of Medicine, Division of Nephrology, University of Rochester, Rochester, NY, United States of America
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, United States of America
- Department of Public Health Sciences, University of Rochester, Rochester, NY, United States of America
| | - Samantha Spallina
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America
| | - Alexis Ross
- The Mary Cariola Center, Rochester, NY, United States of America
| | - Karen Zandi
- The Mary Cariola Center, Rochester, NY, United States of America
| | - Anne Pawlowski
- The Mary Cariola Center, Rochester, NY, United States of America
| | - Christopher L. Seplaki
- Department of Public Health Sciences, University of Rochester, Rochester, NY, United States of America
- Department of Psychiatry, University of Rochester, Rochester, NY, United States of America
| | - Jonathan Herington
- Department of Health Humanities and Bioethics, University of Rochester, Rochester, NY, United States of America
| | - Anthony M. Corbett
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, United States of America
| | - Kimberly Kaukeinen
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, United States of America
| | - Jeanne Holden-Wiltse
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, United States of America
| | - Edward G. Freedman
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America
| | - Lisette Alcantara
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, United States of America
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, United States of America
| | - Andrew Cameron
- Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, United States of America
| | - Nicole Beaumont
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America
| | - Ann Dozier
- Department of Public Health Sciences, University of Rochester, Rochester, NY, United States of America
| | - Stephen Dewhurst
- Department of Microbiology and Immunology, University of Rochester, Rochester, NY, United States of America
| | - John J. Foxe
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America
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Park HS, Yin A, Barranta C, Lee JS, Caputo CA, Sachithanandham J, Li M, Yoon S, Sitaras I, Jedlicka A, Eby Y, Ram M, Fernandez RE, Baker OR, Shenoy AG, Mosnaim GS, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Lau B, Ehrhardt S, Baksh SN, Shapiro JR, Ou J, Na YB, Knoll MD, Ornelas-Gatdula E, Arroyo-Curras N, Gniadek TJ, Caturegli P, Wu J, Ndahiro N, Betenbaugh MJ, Ziman A, Hanley DF, Casadevall A, Shoham S, Bloch EM, Gebo KA, Tobian AA, Laeyendecker O, Pekosz A, Klein SL, Sullivan DJ. Outpatient COVID-19 convalescent plasma recipient antibody thresholds correlated to reduced hospitalizations within a randomized trial. JCI Insight 2024; 9:e178460. [PMID: 38483534 DOI: 10.1172/jci.insight.178460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUNDCOVID-19 convalescent plasma (CCP) virus-specific antibody levels that translate into recipient posttransfusion antibody levels sufficient to prevent disease progression are not defined.METHODSThis secondary analysis correlated donor and recipient antibody levels to hospitalization risk among unvaccinated, seronegative CCP recipients within the outpatient, double-blind, randomized clinical trial that compared CCP to control plasma. The majority of COVID-19 CCP arm hospitalizations (15/17, 88%) occurred in this unvaccinated, seronegative subgroup. A functional cutoff to delineate recipient high versus low posttransfusion antibody levels was established by 2 methods: (i) analyzing virus neutralization-equivalent anti-Spike receptor-binding domain immunoglobulin G (anti-S-RBD IgG) responses in donors or (ii) receiver operating characteristic (ROC) curve analysis.RESULTSSARS-CoV-2 anti-S-RBD IgG antibody was volume diluted 21.3-fold into posttransfusion seronegative recipients from matched donor units. Virus-specific antibody delivered was approximately 1.2 mg. The high-antibody recipients transfused early (symptom onset within 5 days) had no hospitalizations. A CCP-recipient analysis for antibody thresholds correlated to reduced hospitalizations found a statistical significant association between early transfusion and high antibodies versus all other CCP recipients (or control plasma), with antibody cutoffs established by both methods-donor-based virus neutralization cutoffs in posttransfusion recipients (0/85 [0%] versus 15/276 [5.6%]; P = 0.03) or ROC-based cutoff (0/94 [0%] versus 15/267 [5.4%]; P = 0.01).CONCLUSIONIn unvaccinated, seronegative CCP recipients, early transfusion of plasma units in the upper 30% of study donors' antibody levels reduced outpatient hospitalizations. High antibody level plasma units, given early, should be reserved for therapeutic use.TRIAL REGISTRATIONClinicalTrials.gov NCT04373460.FUNDINGDepartment of Defense (W911QY2090012); Defense Health Agency; Bloomberg Philanthropies; the State of Maryland; NIH (3R01AI152078-01S1, U24TR001609-S3, 1K23HL151826NIH); the Mental Wellness Foundation; the Moriah Fund; Octapharma; the Healthnetwork Foundation; the Shear Family Foundation; the NorthShore Research Institute; and the Rice Foundation.
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Affiliation(s)
- Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anna Yin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caelan Barranta
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - John S Lee
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Christopher A Caputo
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jaiprasath Sachithanandham
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Steve Yoon
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ioannis Sitaras
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anne Jedlicka
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yolanda Eby
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Reinaldo E Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Owen R Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aarthi G Shenoy
- Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center, Washington DC, USA
| | - Giselle S Mosnaim
- Division of Allergy and Immunology, Department of Medicine, NorthShore University Health System, Evanston, Illinois, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adam C Levine
- Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA
| | | | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio, USA
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, UCLA, Los Angeles, California, USA
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | | | | | | | - Jean Hammel
- Nuvance Health Norwalk Hospital, Norwalk, Connecticut, USA
| | | | - Valerie C Cluzet
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Daniel Cruser
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Kevin Oei
- Ascada Research, Fullerton, California, USA
| | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, California, USA
| | - Martin S Zand
- Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, UCSD, San Diego, California, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington DC, USA
| | - Christi E Marshall
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Karen Lane
- Department of Neurology, Brain Injury Outcomes
| | | | - Amy L Gawad
- Department of Neurology, Brain Injury Outcomes
| | | | - Atika Singh
- Department of Neurology, Brain Injury Outcomes
| | - Daniel E Ford
- Institute for Clinical and Translational Research, and
| | - Douglas A Jabs
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David M Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sheriza N Baksh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Janna R Shapiro
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jiangda Ou
- Department of Neurology, Brain Injury Outcomes
| | - Yu Bin Na
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maria D Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elysse Ornelas-Gatdula
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Netzahualcoyotl Arroyo-Curras
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, Illinois, USA
| | - Patrizio Caturegli
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jinke Wu
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nelson Ndahiro
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michael J Betenbaugh
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | | | - Arturo Casadevall
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron Ar Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), Baltimore, Maryland, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David J Sullivan
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Park HS, Yin A, Barranta C, Lee JS, Caputo CA, Sachithanandham J, Li M, Yoon S, Sitaras I, Jedlicka A, Eby Y, Ram M, Fernandez RE, Baker OR, Shenoy AG, Mosnaim GS, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Lau B, Ehrhardt S, Baksh SN, Shapiro JR, Ou J, Na YB, Knoll MD, Ornelas-Gatdula E, Arroyo-Curras N, Gniadek TJ, Caturegli P, Wu J, Ndahiro N, Betenbaugh MJ, Ziman A, Hanley DF, Casadevall A, Shoham S, Bloch EM, Gebo KA, Tobian AAR, Laeyendecker O, Pekosz A, Klein SL, Sullivan DJ. Outpatient COVID-19 convalescent plasma recipient antibody thresholds correlated to reduced hospitalizations within a randomized trial. medRxiv 2023:2023.04.13.23288353. [PMID: 37131659 PMCID: PMC10153328 DOI: 10.1101/2023.04.13.23288353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND The COVID-19 convalescent plasma (CCP) viral specific antibody levels that translate into recipient post-transfusion antibody levels sufficient to prevent disease progression is not defined. METHODS This secondary analysis correlated donor and recipient antibody levels to hospitalization risk among unvaccinated, seronegative CCP recipients within the outpatient, double blind, randomized clinical trial that compared CCP to control plasma. The majority of COVID-19 CCP arm hospitalizations (15/17, 88%) occurred in this unvaccinated, seronegative subgroup. A functional cutoff to delineate recipient high versus low post-transfusion antibody levels was established by two methods: 1) analyzing virus neutralization-equivalent anti-S-RBD IgG responses in donors or 2) receiver operating characteristic (ROC) analysis. RESULTS SARS-CoV-2 anti-S-RBD IgG antibody was diluted by a factor of 21.3 into post-transfusion seronegative recipients from matched donor units. Viral specific antibody delivered approximated 1.2 mg. The high antibody recipients transfused early (symptom onset within 5 days) had no hospitalizations. A CCP recipient analysis for antibody thresholds correlated to reduced hospitalizations found a significant association with Fisher's exact test between early and high antibodies versus all other CCP recipients (or control plasma) with antibody cutoffs established by both methods-donor virus neutralization-based cutoff: (0/85; 0% versus 15/276; 5.6%) p=0.03 or ROC based cutoff: (0/94; 0% versus 15/267; 5.4%) p=0.01. CONCLUSION In unvaccinated, seronegative CCP recipients, early transfusion of plasma units corresponding to the upper 30% of all study donors reduced outpatient hospitalizations. These high antibody level plasma units, given early, should be reserved for therapeutic use.Trial registration: NCT04373460. FUNDING Defense Health Agency and others.
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Affiliation(s)
- Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anna Yin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Caelan Barranta
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John S Lee
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christopher A Caputo
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jaiprasath Sachithanandham
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Steve Yoon
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ioannis Sitaras
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anne Jedlicka
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yolanda Eby
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Reinaldo E Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Owen R Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aarthi G Shenoy
- Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center, Washington DC, USA
| | - Giselle S Mosnaim
- Division of Allergy and Immunology, Department of Medicine, NorthShore University Health System, Evanston, IL, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
| | - Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX, USA
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adam C Levine
- Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI, USA
| | | | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, OH, USA
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, CA, USA
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | | | | | | | - Jean Hammel
- Nuvance Health Norwalk Hospital, Norwalk, CT, USA
| | | | - Valerie C Cluzet
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA
| | - Daniel Cruser
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA
| | | | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine G Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, CA, USA
| | - Martin S Zand
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, CA, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center Washington DC, USA
| | - Christi E Marshall
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anusha Yarava
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen Lane
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nichol A McBee
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amy L Gawad
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicky Karlen
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Atika Singh
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel E Ford
- Institute for Clinical and Translational Research Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Douglas A Jabs
- Department of Ophthalmology Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David M Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sheriza N Baksh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janna R Shapiro
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jiangda Ou
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu Bin Na
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria D Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elysse Ornelas-Gatdula
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore MD, USA
| | - Netzahualcoyotl Arroyo-Curras
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore MD, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, IL
| | - Patrizio Caturegli
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jinke Wu
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Nelson Ndahiro
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Michael J Betenbaugh
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Daniel F Hanley
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Arturo Casadevall
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Baltimore, MD, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David J Sullivan
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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5
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Dziorny A, Jones C, Salant J, Kubis S, Zand MS, Wolfe H, Srinivasan V. Clinical and Analytic Accuracy of Simultaneously Acquired Hemoglobin Measurements: A Multi-Institution Cohort Study to Minimize Redundant Laboratory Usage. Pediatr Crit Care Med 2023; 24:e520-e530. [PMID: 37219964 PMCID: PMC10665541 DOI: 10.1097/pcc.0000000000003287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Frequent diagnostic blood sampling contributes to anemia among critically ill children. Reducing duplicative hemoglobin testing while maintaining clinical accuracy can improve patient care efficacy. The objective of this study was to determine the analytical and clinical accuracy of simultaneously acquired hemoglobin measurements with different methods. DESIGN Retrospective cohort study. SETTING Two U.S. children's hospitals. PATIENTS Children (< 18 yr old) admitted to the PICU. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We identified hemoglobin results from complete blood count (CBC) panels paired with blood gas (BG) panels and point-of-care (POC) devices. We estimated analytic accuracy by comparing hemoglobin distributions, correlation coefficients, and Bland-Altman bias. We measured clinical accuracy with error grid analysis and defined mismatch zones as low, medium, or high risk-based on deviance from unity and risk of therapeutic error. We calculated pairwise agreement to a binary decision to transfuse based on a hemoglobin value. Our cohort includes 49,004 ICU admissions from 29,926 patients, resulting in 85,757 CBC-BG hemoglobin pairs. BG hemoglobin was significantly higher (mean bias, 0.43-0.58 g/dL) than CBC hemoglobin with similar Pearson correlation ( R2 ) (0.90-0.91). POC hemoglobin was also significantly higher, but of lower magnitude (mean bias, 0.14 g/dL). Error grid analysis revealed only 78 (< 0.1%) CBC-BG hemoglobin pairs in the high-risk zone. For CBC-BG hemoglobin pairs, at a BG hemoglobin cutoff of greater than 8.0 g/dL, the "number needed to miss" a CBC hemoglobin less than 7 g/dL was 275 and 474 at each institution, respectively. CONCLUSIONS In this pragmatic two-institution cohort of greater than 29,000 patients, we show similar clinical and analytic accuracy of CBC and BG hemoglobin. Although BG hemoglobin values are higher than CBC hemoglobin values, the small magnitude is unlikely to be clinically significant. Application of these findings may reduce duplicative testing and decrease anemia among critically ill children.
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Affiliation(s)
- Adam Dziorny
- Department of Pediatrics, University of Rochester School of
Medicine, Rochester, NY
- Department of Biomedical Engineering, University of
Rochester, Rochester, NY
| | - Chloe Jones
- Department of Biomedical Engineering, University of
Rochester, Rochester, NY
| | - Jennifer Salant
- Department of Pediatrics, Weill Cornell Medicine, New York,
NY
| | - Sherri Kubis
- Department of Anesthesiology & Critical Care Medicine,
Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Martin S. Zand
- Department of Internal Medicine, University of Rochester
School of Medicine, Rochester NY
| | - Heather Wolfe
- Department of Anesthesiology & Critical Care Medicine,
Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Anesthesiology, Critical Care and Pediatrics,
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Vijay Srinivasan
- Department of Anesthesiology & Critical Care Medicine,
Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Anesthesiology, Critical Care and Pediatrics,
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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6
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Zand MS, Spallina S, Ross A, Zandi K, Pawlowski A, Seplaki CL, Herington J, Corbett AM, Kaukeinen K, Holden-Wiltse J, Freedman EG, Alcantara L, Li D, Cameron A, Beaumont N, Dozier A, Dewhurst S, Foxe JJ. Ventilation during COVID-19 in a school for students with intellectual and developmental disabilities (IDD). medRxiv 2023:2023.09.08.23295268. [PMID: 37732178 PMCID: PMC10508805 DOI: 10.1101/2023.09.08.23295268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Background This study examined the correlation of classroom ventilation (air exchanges per hour (ACH)) and exposure to CO2 ≥1,000 ppm with the incidence of SARS-CoV-2 over a 20-month period in a specialized school for students with intellectual and developmental disabilities (IDD). These students were at a higher risk of respiratory infection from SARS-CoV-2 due to challenges in tolerating mitigation measures (e.g. masking). One in-school measure proposed to help mitigate the risk of SARS-CoV-2 infection in schools is increased ventilation. Methods We established a community-engaged research partnership between the University of Rochester and the Mary Cariola Center school for students with IDD. Ambient CO2 levels were measured in 100 school rooms, and air changes per hour (ACH) were calculated. The number of SARS-CoV-2 cases for each room was collected over 20 months. Results 97% of rooms had an estimated ACH ≤4.0, with 7% having CO2 levels ≥2,000 ppm for up to 3 hours per school day. A statistically significant correlation was found between the time that a room had CO2 levels ≥1,000 ppm and SARS-CoV-2 PCR tests normalized to room occupancy, accounting for 43% of the variance. No statistically significant correlation was found for room ACH and per-room SARS-CoV-2 cases. Rooms with ventilation systems using MERV-13 filters had lower SARS-CoV-2-positive PCR counts. These findings led to ongoing efforts to upgrade the ventilation systems in this community-engaged research project. Conclusions There was a statistically significant correlation between the total time of room CO2 concentrations ≥1,000 and SARS-CoV-2 cases in an IDD school. Merv-13 filters appear to decrease the incidence of SARS-CoV-2 infection. This research partnership identified areas for improving in-school ventilation.
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Affiliation(s)
- Martin S. Zand
- Department of Medicine, Division of Nephrology, University of Rochester, Rochester, NY, USA
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Samantha Spallina
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Alexis Ross
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | | | - Christopher L. Seplaki
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Jonathan Herington
- Department of Health Humanities and Bioethics, University of Rochester, Rochester, NY, USA
| | - Anthony M. Corbett
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, USA
| | - Kimberly Kaukeinen
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, USA
| | - Jeanne Holden-Wiltse
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, USA
| | - Edward G. Freedman
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Lisette Alcantara
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, USA
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, USA
| | - Andrew Cameron
- Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA
| | - Nicole Beaumont
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Ann Dozier
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Stephen Dewhurst
- Department of Microbiology and Immunology, University of Rochester, Rochester, NY, USA
| | - John J. Foxe
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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7
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Cure P, ElShourbagy Ferreira S, Fessel JP, Ossip D, Zand MS, Steele SJ, Gersing K, Hartshorn CM. Real-world data for 21 st-century medicine: The clinical and translational science awards program perspective. J Clin Transl Sci 2023; 7:e201. [PMID: 37830007 PMCID: PMC10565194 DOI: 10.1017/cts.2023.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 10/14/2023] Open
Affiliation(s)
- Pablo Cure
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | | | - Joshua P. Fessel
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Deborah Ossip
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Martin S. Zand
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Scott J. Steele
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Kenneth Gersing
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Christopher M. Hartshorn
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
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8
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Huaman MA, Raval JS, Paxton JH, Mosnaim GS, Patel B, Anjan S, Meisenberg BR, Levine AC, Marshall CE, Yarava A, Shenoy AG, Heath SL, Currier JS, Fukuta Y, Blair JE, Spivak ES, Petrini JR, Broderick PB, Rausch W, Cordisco M, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Kassaye SG, Ram M, Wang Y, Das P, Lane K, McBee NA, Gawad AL, Karlen N, Ford DE, Laeyendecker O, Pekosz A, Klein SL, Ehrhardt S, Lau B, Baksh SN, Shade DM, Casadevall A, Hanley DF, Ou J, Gniadek TJ, Ziman A, Shoham S, Gebo KA, Bloch EM, Tobian AAR, Sullivan DJ, Gerber JM. Transfusion reactions associated with COVID-19 convalescent plasma in outpatient clinical trials. Transfusion 2023; 63:1639-1648. [PMID: 37534607 PMCID: PMC10720768 DOI: 10.1111/trf.17485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND COVID-19 convalescent plasma (CCP) is an important therapeutic option for outpatients at high risk of hospitalization from SARS-CoV-2 infection. We assessed the safety of outpatient CCP transfusions administered during clinical trials. STUDY DESIGN AND METHODS We analyzed data pertaining to transfusion-related reactions from two randomized controlled trials in the U.S. that evaluated the efficacy of CCP versus control plasma in various ambulatory settings. Multivariable logistic regression was used to assess whether CCP was associated with transfusion reactions, after adjusting for potential confounders. RESULTS The combined study reported 79/1351 (5.9%) adverse events during the transfusion visit, with the majority 62/1351 (4.6%) characterized by mild, allergic-type findings of urticaria, and/or pruritus consistent with minor allergic transfusion reactions; the other reported events were attributed to the patients' underlying disease, COVID-19, or vasovagal in nature. We found no difference in the likelihood of allergic transfusion reactions between those receiving CCP versus control plasma (adjusted odds ratio [AOR], 0.75; 95% CI, 0.43-1.31). Risk of urticaria and/or pruritus increased with a pre-existing diagnosis of asthma (AOR, 2.33; 95% CI, 1.16-4.67). We did not observe any CCP-attributed antibody disease enhancement in participants with COVID-19 or increased risk of infection. There were no life-threatening severe transfusion reactions and no patients required hospitalization related to transfusion-associated complications. DISCUSSION Outpatient plasma administration was safely performed for nearly 1400 participants. CCP is a safe therapeutic option for outpatients at risk of hospitalization from COVID-19.
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Affiliation(s)
- Moises A Huaman
- Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA
| | - Giselle S Mosnaim
- Department of Medicine, Division of Allergy and Immunology, NorthShore University Health System, Evanston, Illinois, USA
| | - Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Adam C Levine
- Department of Emergency Medicine, Rhode Island Hospital & Brown University, Providence, Rhode Island, USA
| | - Christi E Marshall
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anusha Yarava
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aarthi G Shenoy
- Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center, DC, USA
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | | | | | | | - Jean Hammel
- Nuvance Health Norwalk Hospital, Norwalk, Connecticut, USA
| | | | - Valerie C Cluzet
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Daniel Cruser
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Kevin Oei
- Ascada Research, Fullerton, California, USA
| | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, California, USA
| | - Martin S Zand
- Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, California, USA
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, DC, USA
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ying Wang
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Piyali Das
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Karen Lane
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nichol A McBee
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amy L Gawad
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicky Karlen
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel E Ford
- Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- The Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sabra L Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sheriza N Baksh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - David M Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniel F Hanley
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiangda Ou
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, NorthShore University Health System, Evanston, Illinois, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David J Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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9
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Augustine EF, Steele SJ, McIntosh S, Sugarwala L, White RJ, Yousefi-Nooraie R, Zand MS, Ossip DJ. Utilizing the Un-Meeting model to advance innovative translational and team science. J Clin Transl Sci 2023; 7:e176. [PMID: 37745928 PMCID: PMC10514683 DOI: 10.1017/cts.2023.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 09/26/2023] Open
Abstract
Advances in translational science require innovative solutions, and engagement of productive transdisciplinary teams play a critical role. While various forms of scientific meetings have long provided venues for sharing scientific findings and generating new collaborations, many conferences lack opportunities for active discussions. We describe the use of an Un-Meeting to foster innovative translational science teams through engaged discussions across multidisciplinary groups addressing a shared theme. The Un-Meeting was delivered by the University of Rochester Center for Leading Innovation and Collaboration, the national coordinating center for the National Institutes of Health Clinical and Translational Science Awards (CTSA) program. This pilot CTSA program Un-Meeting focused on engaging translational scientists, policy-makers, community members, advocates, and public health professionals to address the opioid crisis. The participant-driven format leveraged lightning talks, attendee-led idea generation, and extensive breakout discussions to foster multidisciplinary networking. Results indicated participation by a broad set of attendees and a high level of networking during the meeting. These results, coupled with the growth of the Un-Meeting across the CTSA Consortium, provide practices and models to potentially advance team and translational science. While future work will further assess the impact of Un-Meetings, this format presents a promising approach to enhance translational science.
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Affiliation(s)
- Erika F. Augustine
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- University of Rochester Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
- Kennedy Krieger Institute, Baltimore, MD, USA
| | - Scott J. Steele
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- University of Rochester Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Currently with the Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Scott McIntosh
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Laura Sugarwala
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Robert J. White
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- University of Rochester Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Reza Yousefi-Nooraie
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- University of Rochester Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Martin S. Zand
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- University of Rochester Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Department of Medicine – Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Deborah J. Ossip
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Award Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- University of Rochester Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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10
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Palshikar MG, Min X, Crystal A, Meng J, Hilchey SP, Zand MS, Thakar J. Executable Network Models of Integrated Multiomics Data. J Proteome Res 2023; 22:1546-1556. [PMID: 37000949 PMCID: PMC10167691 DOI: 10.1021/acs.jproteome.2c00730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Multiomics profiling provides a holistic picture of a condition being examined and captures the complexity of signaling events, beginning from the original cause (environmental or genetic), to downstream functional changes at multiple molecular layers. Pathway enrichment analysis has been used with multiomics data sets to characterize signaling mechanisms. However, technical and biological variability between these layered data limit an integrative computational analyses. We present a Boolean network-based method, multiomics Boolean Omics Network Invariant-Time Analysis (mBONITA), to integrate omics data sets that quantify multiple molecular layers. mBONITA utilizes prior knowledge networks to perform topology-based pathway analysis. In addition, mBONITA identifies genes that are consistently modulated across molecular measurements by combining observed fold-changes and variance, with a measure of node (i.e., gene or protein) influence over signaling, and a measure of the strength of evidence for that gene across data sets. We used mBONITA to integrate multiomics data sets from RAMOS B cells treated with the immunosuppressant drug cyclosporine A under varying O2 tensions to identify pathways involved in hypoxia-mediated chemotaxis. We compare mBONITA's performance with 6 other pathway analysis methods designed for multiomics data and show that mBONITA identifies a set of pathways with evidence of modulation across all omics layers. mBONITA is freely available at https://github.com/Thakar-Lab/mBONITA.
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11
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King SM, Bryan SP, Hilchey SP, Wang J, Zand MS. First Impressions Matter: Immune Imprinting and Antibody Cross-Reactivity in Influenza and SARS-CoV-2. Pathogens 2023; 12:169. [PMID: 36839441 PMCID: PMC9967769 DOI: 10.3390/pathogens12020169] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/24/2023] Open
Abstract
Many rigorous studies have shown that early childhood infections leave a lasting imprint on the immune system. The understanding of this phenomenon has expanded significantly since 1960, when Dr. Thomas Francis Jr first coined the term "original antigenic sin", to account for all previous pathogen exposures, rather than only the first. Now more commonly referred to as "immune imprinting", this effect most often focuses on how memory B-cell responses are shaped by prior antigen exposure, and the resultant antibodies produced after subsequent exposure to antigenically similar pathogens. Although imprinting was originally observed within the context of influenza viral infection, it has since been applied to the pandemic coronavirus SARS-CoV-2. To fully comprehend how imprinting affects the evolution of antibody responses, it is necessary to compare responses elicited by pathogenic strains that are both antigenically similar and dissimilar to strains encountered previously. To accomplish this, we must be able to measure the antigenic distance between strains, which can be easily accomplished using data from multidimensional immunological assays. The knowledge of imprinting, combined with antigenic distance measures, may allow for improvements in vaccine design and development for both influenza and SARS-CoV-2 viruses.
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Affiliation(s)
- Samantha M. King
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Shane P. Bryan
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Shannon P. Hilchey
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jiong Wang
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Martin S. Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY 14618, USA
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12
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Chen Y, Hilchey SP, Wang J, Garigen J, Zand MS, Huang J. Anamnestic broadly reactive antibodies induced by H7N9 virus more efficiently bind to seasonal H3N2 strains. Hum Vaccin Immunother 2022; 18:2128014. [PMID: 36197079 DOI: 10.1080/21645515.2022.2128014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The very first influenza virus exposure in a human during infancy is known to imprint the host immune system. However, it is unclear how the memory B cells that first target virus epitopes affect antibody response to the stalk of hemagglutinin (HA) domain of influenza virus. Our study is designed to measure the cross-reactivity of antibodies induced by inactivated H7N9 virus using isolated human peripheral blood B cells. Most of the participants displayed higher levels of plasma IgG against the seasonal strains A/Vic11 and A/Cali09 than those binding to historical outbreak A/HK68 and A/PR8. H3 stalk-binding antibodies were detected in plasma at a 1:5000 dilution in 12 of 13 donors, H1 stalk-binding antibodies in all donors, indicating the existence of H3 and H1 stalk-reactive memory B cells. A moderate to high level of broadly cross-reactive antibodies was induced in memory B cells from all donors after in vitro stimulation of B cells with H7N9 virus. H3 stalk-binding antibodies were also detected in most subjects, with cross-reactivity to H1 and H7 stalk domains. The stalk-reactive antibodies bound to five H3 strains spanning 45 years and different H1, H2, H3, H5, H6, H7, H9 and B strains. Interestingly, H1- and H3-reactive IgG were much higher than H7-binding antibodies after 6 days of H7N9 stimulation. Our results demonstrate that HA stalk-reactive antibodies induced by H7N9 viruses more efficiently bound to yearly circulating both H3N2 and H1N1 strains than the boosting strain, indicating that HA stalk immunological imprint can be extended across currently circulating strains or vaccines.
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Affiliation(s)
- Yao Chen
- Department of Blood Transfusion, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Shannon P Hilchey
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Jiong Wang
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Jessica Garigen
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Martin S Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Junqiong Huang
- Department of Blood Transfusion, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
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13
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Yousefi Nooraie R, White RJ, Steele S, Augustine EF, Ossip DJ, Zand MS. Un-Meetings as tools for translational idea generation: A semantic content analysis of an Opioid Crisis Un-Meeting. J Clin Transl Sci 2022; 6:e124. [PMID: 36590361 PMCID: PMC9794961 DOI: 10.1017/cts.2022.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/10/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Background Team development and idea generation are key intertwined steps in translational science that need a framework to accommodate unstructured, participatory interactions. To this end, we introduced Un-Meetings to the Clinical and Translational Science Awards (CTSA) Program, innovative events that facilitate cross-disciplinary idea generation and informal discussions between translational scientists, policy makers, community members, advocates, and public health professionals. Here we describe a mixed methods study to characterize the conceptual diversity and clusterization of ideas generated through an Opioid Crisis Un-Meeting. Methods An Un-Meeting targeting translation science approaches to the opioid crisis were hosted at the University of Rochester Center for Leading Innovation and Collaboration (CLIC). We used semantic analysis and conceptual mapping of keywords to analyze how attendee-led idea generation sessions identified topics for breakout discussions. Results One hundred and two individuals from 40 institutions proposed 150 unique ideas that were grouped into 23 breakout sessions. Network analysis showed that diverse pools of experts were bridged by topics addressing the complexities of the opioid crisis. Two clusters emerged: (1) systems, contexts, and community engagement, and (2) technologies, innovations, and treatment advancements. Conclusions The cross-disciplinary nature of topic areas that bridge across thematic communities provide opportunities for CTSA programs to engage and support development of diverse translational teams. Potential opportunities for team building include technological advancements of opioid prevention, treatment, surveillance, systems approaches, and studies focusing on special populations and health disparities. The analysis method here may be useful in identifying naturally emerging teams of experts and community gaps when addressing large problems.
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Affiliation(s)
- Reza Yousefi Nooraie
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Robert J. White
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Scott Steele
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Martin S. Zand
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), Clinical and Translational Science Program National Coordinating Center, University of Rochester Medical Center, Rochester, NY, USA
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Abstract
RNA-seq is a high-throughput sequencing technology widely used for gene transcript discovery and quantification under different biological or biomedical conditions. A fundamental research question in most RNA-seq experiments is the identification of differentially expressed genes among experimental conditions or sample groups. Numerous statistical methods for RNA-seq differential analysis have been proposed since the emergence of the RNA-seq assay. To evaluate popular differential analysis methods used in the open source R and Bioconductor packages, we conducted multiple simulation studies to compare the performance of eight RNA-seq differential analysis methods used in RNA-seq data analysis (edgeR, DESeq, DESeq2, baySeq, EBSeq, NOISeq, SAMSeq, Voom). The comparisons were across different scenarios with either equal or unequal library sizes, different distribution assumptions and sample sizes. We measured performance using false discovery rate (FDR) control, power, and stability. No significant differences were observed for FDR control, power, or stability across methods, whether with equal or unequal library sizes. For RNA-seq count data with negative binomial distribution, when sample size is 3 in each group, EBSeq performed better than the other methods as indicated by FDR control, power, and stability. When sample sizes increase to 6 or 12 in each group, DESeq2 performed slightly better than other methods. All methods have improved performance when sample size increases to 12 in each group except DESeq. For RNA-seq count data with log-normal distribution, both DESeq and DESeq2 methods performed better than other methods in terms of FDR control, power, and stability across all sample sizes. Real RNA-seq experimental data were also used to compare the total number of discoveries and stability of discoveries for each method. For RNA-seq data analysis, the EBSeq method is recommended for studies with sample size as small as 3 in each group, and the DESeq2 method is recommended for sample size of 6 or higher in each group when the data follow the negative binomial distribution. Both DESeq and DESeq2 methods are recommended when the data follow the log-normal distribution.
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Affiliation(s)
- Dongmei Li
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
- * E-mail:
| | - Martin S. Zand
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
- Department of Medicine, Division of Nephrology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
| | - Timothy D. Dye
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Irfan Rahman
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
| | - Zidian Xie
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
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Hilchey SP, Palshikar MG, Mendelson ES, Shen S, Rasam S, Emo JA, Qu J, Thakar J, Zand MS. Cyclosporine A Modulates LSP1 Protein Levels in Human B Cells to Attenuate B Cell Migration at Low O 2 Levels. Life (Basel) 2022; 12:life12081284. [PMID: 36013463 PMCID: PMC9410508 DOI: 10.3390/life12081284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 12/20/2022]
Abstract
Coordinated migration of B cells within and between secondary lymphoid tissues is required for robust antibody responses to infection or vaccination. Secondary lymphoid tissues normally expose B cells to a low O2 (hypoxic) environment. Recently, we have shown that human B cell migration is modulated by an O2-dependent molecular switch, centrally controlled by the hypoxia-induced (transcription) factor-1α (HIF1A), which can be disrupted by the immunosuppressive calcineurin inhibitor, cyclosporine A (CyA). However, the mechanisms by which low O2 environments attenuate B cell migration remain poorly defined. Proteomics analysis has linked CXCR4 chemokine receptor signaling to cytoskeletal rearrangement. We now hypothesize that the pathways linking the O2 sensing molecular switch to chemokine receptor signaling and cytoskeletal rearrangement would likely contain phosphorylation events, which are typically missed in traditional transcriptomic and/or proteomic analyses. Hence, we have performed a comprehensive phosphoproteomics analysis of human B cells treated with CyA after engagement of the chemokine receptor CXCR4 with CXCL12. Statistical analysis of the separate and synergistic effects of CyA and CXCL12 revealed 116 proteins whose abundance is driven by a synergistic interaction between CyA and CXCL12. Further, we used our previously described algorithm BONITA to reveal a critical role for Lymphocyte Specific Protein 1 (LSP1) in cytoskeletal rearrangement. LSP1 is known to modulate neutrophil migration. Validating these modeling results, we show experimentally that LSP1 levels in B cells increase with low O2 exposure, and CyA treatment results in decreased LSP1 protein levels. This correlates with the increased chemotactic activity observed after CyA treatment. Lastly, we directly link LSP1 levels to chemotactic capacity, as shRNA knock-down of LSP1 results in significantly increased B cell chemotaxis at low O2 levels. These results directly link CyA to LSP1-dependent cytoskeletal regulation, demonstrating a previously unrecognized mechanism by which CyA modulates human B cell migration. Data are available via ProteomeXchange with identifier PXD036167.
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Affiliation(s)
- Shannon P. Hilchey
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Mukta G. Palshikar
- Biophysics, Structural, and Computational Biology Program, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Eric S. Mendelson
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Shichen Shen
- Department of Pharmaceutical Sciences, State University of New York (SUNY) at Buffalo, Buffalo, NY 14203, USA
- New York State Center of Excellence in Bioinformatics & Life Sciences, State University of New York (SUNY) at Buffalo, Buffalo, NY 14203, USA
| | - Sailee Rasam
- Department of Pharmaceutical Sciences, State University of New York (SUNY) at Buffalo, Buffalo, NY 14203, USA
- New York State Center of Excellence in Bioinformatics & Life Sciences, State University of New York (SUNY) at Buffalo, Buffalo, NY 14203, USA
| | - Jason A. Emo
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jun Qu
- Department of Pharmaceutical Sciences, State University of New York (SUNY) at Buffalo, Buffalo, NY 14203, USA
- New York State Center of Excellence in Bioinformatics & Life Sciences, State University of New York (SUNY) at Buffalo, Buffalo, NY 14203, USA
| | - Juilee Thakar
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Martin S. Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
- Correspondence:
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16
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Ruiz R, Vitale A, Schwartz A, Ossip D, Zand MS, Dozier A, Egede LE. From insights to action: Enriching the clinical and translational research workforce by developing diverse and inclusive career programs. J Clin Transl Sci 2022; 6:e104. [PMID: 36128340 PMCID: PMC9453576 DOI: 10.1017/cts.2022.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/06/2022] Open
Abstract
Diversification of the Translational Science workforce is a strategic goal for the National Center for the Advancement of Translational Science (NCATS) program. NCATS has identified the development of translational science education, training, and support for a diverse translational science workforce as key to advancing the growing field of translational science. An annual mixed-methods assessment has been conducted on Common Metrics data submitted by over 60 Clinical & Translational Science Awards (CTSA) programs nationwide and includes metrics addressing recruitment and retention of scientists with particular attention to underrepresented persons and women. This article describes a methodology for the development of From Insights to Action, a resource for guiding program implementation and strategic planning to develop a diverse clinical and translational science workforce. This was informed by the Common Metrics Initiative process and constituted of findings from qualitative interviews of a subset of CTSAs that participated. The dissemination of this guide had several impacts, including providing structural foci for the CTSA Fall 2020 program meeting centered on Diversity, Equity, and Inclusion in translational science; addressing NCATS' goal of workforce diversity; and understanding the number of diverse graduates still engaged in research.
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Affiliation(s)
- Raquel Ruiz
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Alfred Vitale
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Ann Schwartz
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Deborah Ossip
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Martin S. Zand
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
- Department of Medicine, Division of Nephrology, University of Rochester, Rochester, NY, USA
| | - Ann Dozier
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Leonard E. Egede
- Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
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17
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Ruiz R, Schwartz A, Orlando E, Ossip D, Zand MS, Dozier A. Moving beyond annual data reports: A blueprint for communicating and disseminating actionable intelligence. J Clin Transl Sci 2022; 6:e70. [PMID: 35836791 PMCID: PMC9257770 DOI: 10.1017/cts.2022.399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
Identifying and disseminating actionable intelligence is a challenging task that requires thoughtful planning. The National Center for Advancing Translational Sciences instituted the Common Metrics Initiative with the goal of evaluating the Clinical and Translational Science Awards (CTSA) Programs using a standard set of metrics. Initially managed by Tufts University, the Center for Leading Innovation and Collaboration (CLIC) at the University of Rochester began leading this initiative in 2017. In directing this work, CLIC created a framework for communicating and disseminating data insights. Insights to Inspire emerged from the need to share strategies and lessons learned to improve metric performance at the local level to a network of 60+ academic research institutions. Insights to Inspire employs a mixed methods approach for translating data into actionable intelligence. A series of blogs, webinars, and webcasts were designed to communicate metric-specific strategies used by individual sites to the broader CTSA consortium. A dissemination plan to expand the reach beyond metric stakeholders utilized focused communications including social media channels, network newsletters, and presentations at national meetings. This framework serves as a blueprint for other national evaluation programs interested in a systematic approach to using data insights for continuous improvement.
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Affiliation(s)
- Raquel Ruiz
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Ann Schwartz
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Elissa Orlando
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Deborah Ossip
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Martin S. Zand
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
- Department of Medicine, Division of Nephrology, University of Rochester, Rochester, NY, USA
| | - Ann Dozier
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
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18
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Sullivan DJ, Gebo KA, Shoham S, Bloch EM, Lau B, Shenoy AG, Mosnaim GS, Gniadek TJ, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Foster EC, Roth M, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Ehrhardt S, Baksh SN, Laeyendecker O, Pekosz A, Klein SL, Casadevall A, Tobian AAR, Hanley DF. Early Outpatient Treatment for Covid-19 with Convalescent Plasma. N Engl J Med 2022; 386:1700-1711. [PMID: 35353960 PMCID: PMC9006786 DOI: 10.1056/nejmoa2119657] [Citation(s) in RCA: 159] [Impact Index Per Article: 79.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Polyclonal convalescent plasma may be obtained from donors who have recovered from coronavirus disease 2019 (Covid-19). The efficacy of this plasma in preventing serious complications in outpatients with recent-onset Covid-19 is uncertain. METHODS In this multicenter, double-blind, randomized, controlled trial, we evaluated the efficacy and safety of Covid-19 convalescent plasma, as compared with control plasma, in symptomatic adults (≥18 years of age) who had tested positive for severe acute respiratory syndrome coronavirus 2, regardless of their risk factors for disease progression or vaccination status. Participants were enrolled within 8 days after symptom onset and received a transfusion within 1 day after randomization. The primary outcome was Covid-19-related hospitalization within 28 days after transfusion. RESULTS Participants were enrolled from June 3, 2020, through October 1, 2021. A total of 1225 participants underwent randomization, and 1181 received a transfusion. In the prespecified modified intention-to-treat analysis that included only participants who received a transfusion, the primary outcome occurred in 17 of 592 participants (2.9%) who received convalescent plasma and 37 of 589 participants (6.3%) who received control plasma (absolute risk reduction, 3.4 percentage points; 95% confidence interval, 1.0 to 5.8; P = 0.005), which corresponded to a relative risk reduction of 54%. Evidence of efficacy in vaccinated participants cannot be inferred from these data because 53 of the 54 participants with Covid-19 who were hospitalized were unvaccinated and 1 participant was partially vaccinated. A total of 16 grade 3 or 4 adverse events (7 in the convalescent-plasma group and 9 in the control-plasma group) occurred in participants who were not hospitalized. CONCLUSIONS In participants with Covid-19, most of whom were unvaccinated, the administration of convalescent plasma within 9 days after the onset of symptoms reduced the risk of disease progression leading to hospitalization. (Funded by the Department of Defense and others; CSSC-004 ClinicalTrials.gov number, NCT04373460.).
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Affiliation(s)
- David J Sullivan
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Kelly A Gebo
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Shmuel Shoham
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Evan M Bloch
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Bryan Lau
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Aarthi G Shenoy
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Giselle S Mosnaim
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Thomas J Gniadek
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Yuriko Fukuta
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Bela Patel
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Sonya L Heath
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Adam C Levine
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Barry R Meisenberg
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Emily S Spivak
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Shweta Anjan
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Moises A Huaman
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Janis E Blair
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Judith S Currier
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - James H Paxton
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Jonathan M Gerber
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Joann R Petrini
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Patrick B Broderick
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - William Rausch
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Marie-Elena Cordisco
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Jean Hammel
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Benjamin Greenblatt
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Valerie C Cluzet
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Daniel Cruser
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Kevin Oei
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Matthew Abinante
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Laura L Hammitt
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Catherine G Sutcliffe
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Donald N Forthal
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Martin S Zand
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Edward R Cachay
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Jay S Raval
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Seble G Kassaye
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - E Colin Foster
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Michael Roth
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Christi E Marshall
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Anusha Yarava
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Karen Lane
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Nichol A McBee
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Amy L Gawad
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Nicky Karlen
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Atika Singh
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Daniel E Ford
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Douglas A Jabs
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Lawrence J Appel
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - David M Shade
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Stephan Ehrhardt
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Sheriza N Baksh
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Oliver Laeyendecker
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Andrew Pekosz
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Sabra L Klein
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Arturo Casadevall
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Aaron A R Tobian
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Daniel F Hanley
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
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Wang J, Young BE, Li D, Seppo AE, Zhou Q, Wiltse A, Nowak-Wegrzyn A, Murphy K, Widrick K, Diaz N, Cruz-Vasquez J, Järvinen KM, Zand MS. Broad Cross-reactive IgA and IgG Against Human Coronaviruses in Milk Induced by COVID-19 Vaccination and Infection. medRxiv 2022:2022.03.13.22272281. [PMID: 35313594 PMCID: PMC8936120 DOI: 10.1101/2022.03.13.22272281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
UNLABELLED It is currently unclear if SARS-CoV-2 infection or mRNA vaccination can also induce IgG and IgA against common human coronaviruses (HCoVs) in lactating parents. Here we prospectively analyzed human milk (HM) and blood samples from lactating parents to measure the temporal patterns of anti-SARS-CoV-2 specific and anti-HCoV cross-reactive IgA and IgG responses. Two cohorts were analyzed: a vaccination cohort (n=30) who received mRNA-based vaccines for COVID-19 (mRNA-1273 or BNT162b2), and an infection cohort (n=45) with COVID-19 disease. Longitudinal HM and fingerstick blood samples were collected pre- and post-vaccination or, for infected subjects, at 5 time-points 14 - 28 days after confirmed diagnosis. The anti-spike(S) and antinucleocapsid(N) IgA and IgG antibody levels against SARS-CoV-2 and HCoVs were measured by multiplex immunoassay (mPlex-CoV). We found that vaccination significantly increased the anti-S IgA and IgG levels in HM. In contrast, while IgG levels increased after a second vaccine dose, blood and HM IgA started to decrease. Moreover, HM and blood anti-S IgG levels were significantly correlated, but anti-S IgA levels were not. SARS2 acute infection elicited anti-S IgG and IgA that showed much higher correlations between HM and blood compared to vaccination. Vaccination and infection were able to significantly increase the broadly cross-reactive IgG recognizing HCoVs in HM and blood than the IgA antibodies in HM and blood. In addition, the broader cross-reactivity of IgG in HM versus blood indicates that COVID-19 vaccination and infection might provide passive immunity through HM for the breastfed infants not only against SARS-CoV-2 but also against common cold coronaviruses. IMPORTANCE It is unknown if COVID-19 mRNA vaccination and infection in lactating mothers results in cross-reactive antibodies against other common human coronaviruses. Our study demonstrates that mRNA vaccination and COVID-19 infection increase anti-spike SARS-CoV-2 IgA and IgG in both blood and milk. IgA and IgG antibody concentrations in milk were more tightly correlated with concentrations in blood after infection compared to mRNA vaccination. Notably, both infection and vaccination resulted in increased IgG against common seasonal β -coronaviruses. This suggests that SARS-CoV-2 vaccination or infection in a lactating parent may result in passive immunity against SARS-CoV-2 and seasonal coronaviruses for the recipient infant.
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20
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Sherby MR, Kalb LG, Coller RJ, DeMuri GP, Butteris S, Foxe JJ, Zand MS, Freedman EG, Dewhurst S, Newland JG, Gurnett CA. Supporting COVID-19 School Safety for Children With Disabilities and Medical Complexity. Pediatrics 2022; 149:e2021054268H. [PMID: 34737172 PMCID: PMC8926067 DOI: 10.1542/peds.2021-054268h] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
Children with intellectual and developmental disabilities (IDDs) and children with medical complexity (CMC) have been disproportionally impacted by the coronavirus disease 2019 pandemic, including school closures. Children with IDDs and CMC rely on schools for a vast array of educational, therapeutic, medical, and social needs. However, maintaining safe schools for children with IDDs and CMC during the coronavirus disease 2019 pandemic may be difficult because of the unique challenges of implementing prevention strategies, such as masking, social distancing, and hand hygiene in this high-risk environment. Furthermore, children with IDDs and CMC are at a higher risk of infectious complications and mortality, underscoring the need for effective mitigation strategies. The goal of this report is to describe the implementation of several screening testing models for severe acute respiratory syndrome coronavirus 2 in this high-risk population. By describing these models, we hope to identify generalizable and scalable approaches to facilitate safe school operations for children with IDDs and CMC during the current and future pandemics.
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Affiliation(s)
| | - Luther G. Kalb
- Kennedy Krieger Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - John J. Foxe
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Martin S. Zand
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Edward G. Freedman
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Stephen Dewhurst
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
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21
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Embong AK, Nguyen-Contant P, Wang J, Kanagaiah P, Chaves FA, Fitzgerald TF, Zhou Q, Kosoy G, Branche AR, Miller BL, Zand MS, Sangster MY, Topham DJ. Formation and Expansion of Memory B Cells against Coronavirus in Acutely Infected COVID-19 Individuals. Pathogens 2022; 11:186. [PMID: 35215130 PMCID: PMC8876169 DOI: 10.3390/pathogens11020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Infection with the β-coronavirus SARS-CoV-2 typically generates strong virus-specific antibody production. Antibody responses against novel features of SARS-CoV-2 proteins require naïve B cell activation, but there is a growing appreciation that conserved regions are recognized by pre-existing memory B cells (MBCs) generated by endemic coronaviruses. The current study investigated the role of pre-existing cross-reactive coronavirus memory in the antibody response to the viral spike (S) and nucleocapsid (N) proteins following SARS-CoV-2 infection. The breadth of reactivity of circulating antibodies, plasmablasts, and MBCs was analyzed. Acutely infected subjects generated strong IgG responses to the S protein, including the novel receptor binding domain, the conserved S2 region, and to the N protein. The response included reactivity to the S of endemic β-coronaviruses and, interestingly, to the N of an endemic α-coronavirus. Both mild and severe infection expanded IgG MBC populations reactive to the S of SARS-CoV-2 and endemic β-coronaviruses. Avidity of S-reactive IgG antibodies and MBCs increased after infection. Overall, findings indicate that the response to the S and N of SARS-CoV-2 involves pre-existing MBC activation and adaptation to novel features of the proteins, along with the potential of imprinting to shape the response to SARS-CoV-2 infection.
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Affiliation(s)
- A. Karim Embong
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14620, USA; (A.K.E.); (P.K.); (F.A.C.); (T.F.F.); (M.Y.S.)
| | | | - Jiong Wang
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14620, USA; (J.W.); (Q.Z.); (M.S.Z.)
| | - Preshetha Kanagaiah
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14620, USA; (A.K.E.); (P.K.); (F.A.C.); (T.F.F.); (M.Y.S.)
| | - Francisco A. Chaves
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14620, USA; (A.K.E.); (P.K.); (F.A.C.); (T.F.F.); (M.Y.S.)
| | - Theresa F. Fitzgerald
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14620, USA; (A.K.E.); (P.K.); (F.A.C.); (T.F.F.); (M.Y.S.)
| | - Qian Zhou
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14620, USA; (J.W.); (Q.Z.); (M.S.Z.)
| | - Gabrielle Kosoy
- Department of Biochemistry and Biophysics, University of Rochester, Rochester, NY 14620, USA; (G.K.); (B.L.M.)
| | - Angela R. Branche
- Department of Medicine, University of Rochester Medical Center, Rochester, NY 14620, USA;
| | - Benjamin L. Miller
- Department of Biochemistry and Biophysics, University of Rochester, Rochester, NY 14620, USA; (G.K.); (B.L.M.)
| | - Martin S. Zand
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14620, USA; (J.W.); (Q.Z.); (M.S.Z.)
| | - Mark Y. Sangster
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14620, USA; (A.K.E.); (P.K.); (F.A.C.); (T.F.F.); (M.Y.S.)
| | - David J. Topham
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14620, USA; (A.K.E.); (P.K.); (F.A.C.); (T.F.F.); (M.Y.S.)
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22
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Abstract
BACKGROUND A protective antibody response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial to decrease morbidity and mortality from severe coronavirus disease 2019 (COVID-19) disease. The effects of preexisting anti-human coronavirus (HCoV) antibodies on the SARS-CoV-2-specific immunoglobulin G (IgG) responses and severity of disease are currently unclear. METHODS We profiled anti-spike (S), S1, S2, and receptor-binding domain IgG antibodies against SARS-CoV-2 and 6 HCoVs using a multiplex assay (mPLEX-CoV) with serum samples from SARS-CoV-2 infected (n = 155) and pre-COVID-19 (n = 188) cohorts. RESULTS COVID-19 subjects showed significantly increased anti-S SARS-CoV-2 IgG levels that were highly correlated with IgG antibodies against OC43 and HKU1 S proteins. However, OC43 and HKU1 anti-S antibodies in pre-COVID-19 era sera did not cross-react with SARS-CoV-2. Unidirectional cross-reactive antibodies elicited by SARS-CoV-2 infection were distinct from the bidirectional cross-reactive antibodies recognizing homologous strains RaTG13 and SARS-CoV-1. High anti-OC43 and anti-S2 antibody levels were associated with both a rapid anti-SARS-CoV-2 antibody response and increased disease severity. Subjects with increased sequential organ failure assessment (SOFA) scores developed a higher ratio of S2- to S1-reactive antibodies. CONCLUSIONS Early and rapid emergence of OC43 S- and S2-reactive IgG after SARS-CoV-2 infection correlates with COVID-19 disease severity.
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Affiliation(s)
- Jiong Wang
- Department of Medicine, Division of Nephrology, University of Rochester, Rochester, New York, USA
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester, Rochester, New York, USA
| | - Andrew Cameron
- Clinical Microbiology, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, New York, USA
| | - Qian Zhou
- Department of Medicine, Division of Nephrology, University of Rochester, Rochester, New York, USA
| | - Alexander Wiltse
- Present affiliation: University of Maryland Medical Center, Baltimore, MD
| | - Jennifer Nayak
- Department of Pediatrics, Division of Infectious Diseases, University of Rochester, Rochester, New York, USA
| | - Nicole D Pecora
- Present affiliation: Brigham and Women’s Hospital, Harvard University, Boston, MA
| | - Martin S Zand
- Correspondence: Martin S. Zand, MD, PhD, University of Rochester Medical Center, Clinical and Translational Science Institute, Room 1.207, 265 Crittendon Boulevard, Rochester, NY 14642 ()
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23
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Sullivan DJ, Gebo KA, Shoham S, Bloch EM, Lau B, Shenoy AG, Mosnaim GS, Gniadek TJ, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Foster EC, Roth M, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Ehrhardt S, Baksh SN, Laeyendecker O, Pekosz A, Klein SL, Casadevall A, Tobian AAR, Hanley DF. Randomized Controlled Trial of Early Outpatient COVID-19 Treatment with High-Titer Convalescent Plasma. medRxiv 2021:2021.12.10.21267485. [PMID: 34981068 PMCID: PMC8722611 DOI: 10.1101/2021.12.10.21267485] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The efficacy of polyclonal high titer convalescent plasma to prevent serious complications of COVID-19 in outpatients with recent onset of illness is uncertain. METHODS This multicenter, double-blind randomized controlled trial compared the efficacy and safety of SARS-CoV-2 high titer convalescent plasma to placebo control plasma in symptomatic adults ≥18 years positive for SARS-CoV-2 regardless of risk factors for disease progression or vaccine status. Participants with symptom onset within 8 days were enrolled, then transfused within the subsequent day. The measured primary outcome was COVID-19-related hospitalization within 28 days of plasma transfusion. The enrollment period was June 3, 2020 to October 1, 2021. RESULTS A total of 1225 participants were randomized and 1181 transfused. In the pre-specified modified intention-to-treat analysis that excluded those not transfused, the primary endpoint occurred in 37 of 589 (6.3%) who received placebo control plasma and in 17 of 592 (2.9%) participants who received convalescent plasma (relative risk, 0.46; one-sided 95% upper bound confidence interval 0.733; P=0.004) corresponding to a 54% risk reduction. Examination with a model adjusting for covariates related to the outcome did not change the conclusions. CONCLUSION Early administration of high titer SARS-CoV-2 convalescent plasma reduced outpatient hospitalizations by more than 50%. High titer convalescent plasma is an effective early outpatient COVID-19 treatment with the advantages of low cost, wide availability, and rapid resilience to variant emergence from viral genetic drift in the face of a changing pandemic. Trial Registration ClinicalTrials.gov number, NCT04373460.
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Affiliation(s)
- David J Sullivan
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Evan M Bloch
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Bryan Lau
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Aarthi G Shenoy
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Giselle S Mosnaim
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Thomas J Gniadek
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Yuriko Fukuta
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Bela Patel
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Adam C Levine
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Barry R Meisenberg
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - James H Paxton
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Jonathan M Gerber
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Joann R Petrini
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Patrick B Broderick
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - William Rausch
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Marie Elena Cordisco
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Jean Hammel
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Benjamin Greenblatt
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Valerie C Cluzet
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Daniel Cruser
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Kevin Oei
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Matthew Abinante
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Laura L Hammitt
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Catherine G Sutcliffe
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Martin S Zand
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Jay S Raval
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - E Colin Foster
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Michael Roth
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Christi E Marshall
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Anusha Yarava
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Karen Lane
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Nichol A McBee
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Amy L Gawad
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Nicky Karlen
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Atika Singh
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Daniel E Ford
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Douglas A Jabs
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Lawrence J Appel
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - David M Shade
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Stephan Ehrhardt
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Sheriza N Baksh
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Oliver Laeyendecker
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Andrew Pekosz
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Sabra L Klein
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Arturo Casadevall
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Aaron A R Tobian
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Daniel F Hanley
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
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24
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Hill DL, Whyte CE, Innocentin S, Lee JL, Dooley J, Wang J, James EA, Lee JC, Kwok WW, Zand MS, Liston A, Carr EJ, Linterman MA. Impaired HA-specific T follicular helper cell and antibody responses to influenza vaccination are linked to inflammation in humans. eLife 2021; 10:e70554. [PMID: 34726156 PMCID: PMC8562996 DOI: 10.7554/elife.70554] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/08/2021] [Indexed: 12/12/2022] Open
Abstract
Antibody production following vaccination can provide protective immunity to subsequent infection by pathogens such as influenza viruses. However, circumstances where antibody formation is impaired after vaccination, such as in older people, require us to better understand the cellular and molecular mechanisms that underpin successful vaccination in order to improve vaccine design for at-risk groups. Here, by studying the breadth of anti-haemagglutinin (HA) IgG, serum cytokines, and B and T cell responses by flow cytometry before and after influenza vaccination, we show that formation of circulating T follicular helper (cTfh) cells was associated with high-titre antibody responses. Using Major Histocompatability Complex (MHC) class II tetramers, we demonstrate that HA-specific cTfh cells can derive from pre-existing memory CD4+ T cells and have a diverse T cell receptor (TCR) repertoire. In older people, the differentiation of HA-specific cells into cTfh cells was impaired. This age-dependent defect in cTfh cell formation was not due to a contraction of the TCR repertoire, but rather was linked with an increased inflammatory gene signature in cTfh cells. Together, this suggests that strategies that temporarily dampen inflammation at the time of vaccination may be a viable strategy to boost optimal antibody generation upon immunisation of older people.
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Affiliation(s)
- Danika L Hill
- Department of Immunology and Pathology, Monash UniversityMelbourneAustralia
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
| | - Carly E Whyte
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
| | - Silvia Innocentin
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
| | - Jia Le Lee
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
| | - James Dooley
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
| | - Jiong Wang
- Division of Nephrology, Department of Medicine and Clinical and Translational Science Institute, University of Rochester Medical CenterRochesterUnited States
| | - Eddie A James
- Benaroya Research Institute at Virginia Mason, Translational Research Program and Tetramer Core LaboratorySeattleUnited States
| | - James C Lee
- Department of Medicine, Cambridge Biomedical Campus, University of CambridgeCambridgeUnited Kingdom
- Cambridge Institute of Therapeutic Immunology & Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, University of CambridgeCambridgeUnited Kingdom
| | - William W Kwok
- Benaroya Research Institute at Virginia Mason, Diabetes ProgramSeattleUnited States
- Department of Medicine, University of WashingtonSeattleUnited States
| | - Martin S Zand
- Division of Nephrology, Department of Medicine and Clinical and Translational Science Institute, University of Rochester Medical CenterRochesterUnited States
| | - Adrian Liston
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
| | - Edward J Carr
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
- Department of Medicine, Cambridge Biomedical Campus, University of CambridgeCambridgeUnited Kingdom
| | - Michelle A Linterman
- Immunology Program, The Babraham Institute, Babraham Research CampusCambridgeUnited Kingdom
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25
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Palshikar MG, Hilchey SP, Zand MS, Thakar J. WikiNetworks: translating manually created biological pathways for topological analysis. Bioinformatics 2021; 38:869-871. [PMID: 34636843 PMCID: PMC8756176 DOI: 10.1093/bioinformatics/btab699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 02/03/2023] Open
Abstract
SUMMARY WikiPathways is a database of 2979 biological pathways across 31 species created using the drawing software PathVisio. Many of these pathways are not directly usable for network-based topological analyses due to differences in curation styles and drawings. We developed the WikiNetworks package to standardize and construct directed networks by combining geometric information and manual annotations from WikiPathways. WikiNetworks performs significantly better than existing tools. This enables the use of high-quality WikiPathways resource for network-based topological analysis of high-throughput data. AVAILABILITY AND IMPLEMENTATION WikiNetworks is written in Python3 and is available on github.com/Thakar-Lab/wikinetworks and on PyPI. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Mukta G Palshikar
- Biophysics, Structural, and Computational Biology Program, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Shannon P Hilchey
- Division of Nephrology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Martin S Zand
- Division of Nephrology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA,Clinical and Translational Science Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
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26
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Wang J, Li D, Zhou Q, Wiltse A, Zand MS. Antibody Mediated Immunity to SARS-CoV-2 and Human Coronaviruses: Multiplex Beads Assay and Volumetric Absorptive Microsampling to Generate Immune Repertoire Cartography. Front Immunol 2021; 12:696370. [PMID: 34386006 PMCID: PMC8353270 DOI: 10.3389/fimmu.2021.696370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/21/2021] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic is caused by SARS-CoV-2, a novel zoonotic coronavirus. Emerging evidence indicates that preexisting humoral immunity against other seasonal human coronaviruses (HCoVs) plays a critical role in the specific antibody response to SARS-CoV-2. However, current work to assess the effects of preexisting and cross-reactive anti-HCoVs antibodies has been limited. To address this issue, we have adapted our previously reported multiplex assay to simultaneously and quantitatively measure anti-HCoV antibodies. The full mPlex-CoV panel covers the spike (S) and nucleocapsid (N) proteins of three highly pathogenic HCoVs (SARS-CoV-1, SARS-CoV-2, MERS) and four human seasonal strains (OC43, HKU1, NL63, 229E). Combining this assay with volumetric absorptive microsampling (VAMS), we measured the anti-HCoV IgG, IgA, and IgM antibodies in fingerstick blood samples. The results demonstrate that the mPlex-CoV assay has high specificity and sensitivity. It can detect strain-specific anti-HCoV antibodies down to 0.1 ng/ml with 4 log assay range and with low intra- and inter-assay coefficients of variation (%CV). We also estimate multiple strain HCoVs IgG, IgA and IgM concentration in VAMS samples in three categories of subjects: pre-COVID-19 (n=21), post-COVID-19 convalescents (n=19), and COVID-19 vaccine recipients (n=14). Using metric multidimensional scaling (MDS) analysis, HCoVs IgG concentrations in fingerstick blood samples were well separated between the pre-COVID-19, post-COVID-19 convalescents, and COVID-19 vaccine recipients. In addition, we demonstrate how multi-dimensional scaling analysis can be used to visualize IgG mediated antibody immunity against multiple human coronaviruses. We conclude that the combination of VAMS and the mPlex-Cov assay is well suited to performing remote study sample collection under pandemic conditions to monitor HCoVs antibody responses in population studies.
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Affiliation(s)
- Jiong Wang
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Qian Zhou
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States
| | - Alexander Wiltse
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States
| | - Martin S Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States.,Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States
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27
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Coller BS, Buse JB, Kimberly RP, Powderly WG, Zand MS. Re-engineering The Clinical Research Enterprise in Response to COVID-19: The Clinical Translational Science Award (CTSA) experience and proposed playbook for future pandemics. J Clin Transl Sci 2021; 5:e96. [PMID: 34192053 PMCID: PMC8137226 DOI: 10.1017/cts.2021.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 12/15/2022] Open
Abstract
The 2020 COVID-19 pandemic has had a profound impact on the clinical research enterprises at the 60 Clinical and Translational Science Award (CTSA) Hubs throughout the nation. There was simultaneously a need to expand research to obtain crucial data about disease prognosis and therapy and enormous limitations on conducting research as localities and institutions limited travel and person-to-person contact. These imperatives resulted in major changes in the way research was conducted, including expediting Institutional Review Board review, shifting to remote interactions with participants, centralizing decision-making in prioritizing research protocols, establishing biobanks, adopting novel informatics platforms, and distributing study drugs in unconventional ways. National CTSA Steering Committee meetings provided an opportunity to share best practices and develop the idea of capturing the CTSA program experiences in a series of papers. Here we bring together the recommendations from those papers in a list of specific actions that research sites can take to strengthen operations and prepare for similar future public health emergencies. Most importantly, creative innovations developed in response to the COVID-19 pandemic deserve serious consideration for adoption as new standards, thus converting the painful trauma of the pandemic into "post-traumatic growth" that makes the clinical research enterprise stronger, more resilient, and more effective.
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Affiliation(s)
- Barry S. Coller
- Allen and Frances Adler Laboratory of Vascular Biology, Rockefeller University, New York, NY, USA
| | - John B. Buse
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Robert P. Kimberly
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William G. Powderly
- Division of Infectious Diseases and Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | - Martin S. Zand
- Department of Medicine, University of Rochester Medical Center, Department of Medicine, Nephrology, Rochester, NY, USA
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28
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Abstract
The entire spectrum of diagnostic testing, from reagent supply to test performance, has been a major focus during the coronavirus disease 2019 (COVID-19) pandemic. The hope for serologic testing is that it will provide both epidemiologic information about seroprevalence as well as individual information about previous infection. This information is particularly helpful for high-risk individuals who may be outside of the viral shedding window, such as children with suspected multisystem inflammatory syndrome. It is not yet understood whether serologic testing can be interpreted in terms of protective immunity. These concerns must be addressed using highly sensitive and specific tests.
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Affiliation(s)
| | - Martin S Zand
- Department of Medicine, Nephrology (SMD), Clinical & Translational Science Institute, Clinical Research University of Rochester Medical Center, School of Medicine and Dentistry, 601 Elmwood Avenue, Box 675, Rochester, NY 14642, USA
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29
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Stebegg M, Bignon A, Hill DL, Silva-Cayetano A, Krueger C, Vanderleyden I, Innocentin S, Boon L, Wang J, Zand MS, Dooley J, Clark J, Liston A, Carr E, Linterman MA. Rejuvenating conventional dendritic cells and T follicular helper cell formation after vaccination. eLife 2020; 9:52473. [PMID: 32204792 PMCID: PMC7093110 DOI: 10.7554/elife.52473] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 03/12/2020] [Indexed: 12/22/2022] Open
Abstract
Germinal centres (GCs) are T follicular helper cell (Tfh)-dependent structures that form in response to vaccination, producing long-lived antibody secreting plasma cells and memory B cells that protect against subsequent infection. With advancing age the GC and Tfh cell response declines, resulting in impaired humoral immunity. We sought to discover what underpins the poor Tfh cell response in ageing and whether it is possible to correct it. Here, we demonstrate that older people and aged mice have impaired Tfh cell differentiation upon vaccination. This deficit is preceded by poor activation of conventional dendritic cells type 2 (cDC2) due to reduced type 1 interferon signalling. Importantly, the Tfh and cDC2 cell response can be boosted in aged mice by treatment with a TLR7 agonist. This demonstrates that age-associated defects in the cDC2 and Tfh cell response are not irreversible and can be enhanced to improve vaccine responses in older individuals.
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Affiliation(s)
- Marisa Stebegg
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | - Alexandre Bignon
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | - Danika Lea Hill
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | - Alyssa Silva-Cayetano
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | - Christel Krueger
- Epigenetics Programme, Babraham Institute, Cambridge, United Kingdom
| | - Ine Vanderleyden
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | - Silvia Innocentin
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | | | - Jiong Wang
- Division of Nephrology, Department of Medicine and Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, United States
| | - Martin S Zand
- Division of Nephrology, Department of Medicine and Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, United States
| | - James Dooley
- Autoimmune Genetics Laboratory, VIB and University of Leuven, Leuven, Belgium
| | - Jonathan Clark
- Biological Chemistry, Babraham Institute, Cambridge, United Kingdom
| | - Adrian Liston
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | - Edward Carr
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom.,Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Michelle A Linterman
- Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
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30
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Hilchey SP, Palshikar MG, Emo JA, Li D, Garigen J, Wang J, Mendelson ES, Cipolla V, Thakar J, Zand MS. Cyclosporine a directly affects human and mouse b cell migration in vitro by disrupting a hIF-1 αdependent, o 2 sensing, molecular switch. BMC Immunol 2020; 21:13. [PMID: 32183695 PMCID: PMC7079363 DOI: 10.1186/s12865-020-0342-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 02/27/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Hypoxia is a potent molecular signal for cellular metabolism, mitochondrial function, and migration. Conditions of low oxygen tension trigger regulatory cascades mediated via the highly conserved HIF-1 α post-translational modification system. In the adaptive immune response, B cells (Bc) are activated and differentiate under hypoxic conditions within lymph node germinal centers, and subsequently migrate to other compartments. During migration, they traverse through changing oxygen levels, ranging from 1-5% in the lymph node to 5-13% in the peripheral blood. Interestingly, the calcineurin inhibitor cyclosporine A is known to stimulate prolyl hydroxylase activity, resulting in HIF-1 α destabilization and may alter Bc responses directly. Over 60% of patients taking calcineurin immunosuppressant medications have hypo-gammaglobulinemia and poor vaccine responses, putting them at high risk of infection with significantly increased morbidity and mortality. RESULTS We demonstrate that O 2 tension is a previously unrecognized Bc regulatory switch, altering CXCR4 and CXCR5 chemokine receptor signaling in activated Bc through HIF-1 α expression, and controlling critical aspects of Bc migration. Our data demonstrate that calcineurin inhibition hinders this O 2 regulatory switch in primary human Bc. CONCLUSION This previously unrecognized effect of calcineurin inhibition directly on human Bc has significant and direct clinical implications.
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Affiliation(s)
- Shannon P Hilchey
- University of Rochester Medical CenterDivision of Nephrology, 601 Elmwood Ave., Rochester, 14642 NY USA
| | - Mukta G Palshikar
- University of RochesterBiophysics, Structural, and Computational Biology Program, 601 Elmwood Ave. - Box 675, Rochester, 14642 NY USA
| | - Jason A Emo
- University of Rochester Medical CenterDivision of Nephrology, 601 Elmwood Ave., Rochester, 14642 NY USA
| | - Dongmei Li
- University of RochesterClinical and Translational Science Institute, 265 Crittenden Blvd., Rochester, 14642 NY USA
| | - Jessica Garigen
- University of RochesterClinical and Translational Science Institute, 265 Crittenden Blvd., Rochester, 14642 NY USA
| | - Jiong Wang
- University of Rochester Medical CenterDivision of Nephrology, 601 Elmwood Ave., Rochester, 14642 NY USA
| | - Eric S Mendelson
- University of Rochester Medical CenterDivision of Nephrology, 601 Elmwood Ave., Rochester, 14642 NY USA
| | - Valentina Cipolla
- University of Rochester Medical CenterDivision of Nephrology, 601 Elmwood Ave., Rochester, 14642 NY USA
| | - Juilee Thakar
- University of RochesterDepartment of Microbiology and Immunology, 601 Elmwood Ave - Box 672, Rochester, 14642 NY USA
- University of RochesterDepartment of Biostatistics and Computational Biology, 265 Crittenden Blvd., Rochester, 14642 NY USA
| | - Martin S Zand
- University of Rochester Medical CenterDivision of Nephrology, 601 Elmwood Ave., Rochester, 14642 NY USA
- University of RochesterClinical and Translational Science Institute, 265 Crittenden Blvd., Rochester, 14642 NY USA
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31
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Wang J, Li D, Wiltse A, Emo J, Hilchey SP, Zand MS. Application of volumetric absorptive microsampling (VAMS) to measure multidimensional anti-influenza IgG antibodies by the mPlex-Flu assay. J Clin Transl Sci 2019; 3:332-343. [PMID: 31827907 PMCID: PMC6885997 DOI: 10.1017/cts.2019.410] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction: Recently, volumetric absorptive microsampling (VAMS) has been used for accurate sampling of a fixed peripheral blood volume (10 µL) on a volumetric swab, and long-term sample storage. The mPlex-Flu assay is a novel, high-throughput assay that simultaneously measures the concentration of antibodies against the hemagglutinin (HA) proteins from multiple influenza virus strains with ≤5 µL of serum. Here we describe combining these two methods to measure multidimensional anti-influenza IgG activity in whole blood samples collected by a finger stick and VAMS, with correction for serum volume based on simultaneous hemoglobin measurement. Methods: We compared capillary blood samples obtained from a finger stick using a VAMS device with serum samples collected by traditional phlebotomy from 20 subjects, with the influenza antibody profiles measured by the mPlex-Flu assay. Results: We found that results with the two sampling methods were highly correlated within subjects and across all influenza strains (mean R 2 = 0.9470). Adjustment for serum volume, based on hemaglobin measurement, was used to estimate serum volume of samples and improved the accuracy. IgG measurements were stable over 3 weeks when VAMS samples were stored at room temperature or transported using a variety of shipping methods. Additionally, when volunteers performed finger-stick VAMS at-home by themselves, the comparison results of anti-HA antibody concentrations were highly consistent with sampling performed by study personnel on-site (R 2 = 0.9496). Conclusions: This novel approach can provide a simple, accurate, and low-cost means for monitoring the IgG anti-influenza HA antibody responses in large population studies and clinical trials.
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Affiliation(s)
- Jiong Wang
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Alexander Wiltse
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Jason Emo
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Shannon P. Hilchey
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
| | - Martin S. Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA
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Abstract
Aims: Neck circumference (NC) was found to be related to the risk factors for coronary heart disease (CHD). However, the effects of NC on CHD are still controversial. To evaluate the relationship between NC and CHD, a meta-analysis of observational studies was performed. Method: Eligible studies on the association between NC and CHD were searched in Medline, Embase, Ovid, and Web of Science databases published in English from January 1980 to December 2016. Moreover, studies published in Chinese in Wanfang and China Hospital Knowledge databases were also searched. Random effects models in the metafor package in statistical analysis software R 3.3.3 were used for the meta-analysis. Heterogeneity was analyzed with Q statistics. Results: Eight studies were selected for the meta-analysis. A larger NC was associated with a higher prevalence of CHD (OR = 1.18, 95% CI 1.04–1.34, p = 0.0108). The eight studies were further divided into three subgroups according to the criteria for diagnosing CHD. In the subgroup of coronary angiography, NC was also found to be associated with the prevalence of CHD with low heterogeneity (OR = 1.17, 95% CI 1.07–1.28, p = 0.0007, I2 = 17.02%). However, in the subgroup of computed tomography or past history, no association between NC and CHD was found. In addition, subgroup analyses were also conducted according to the regions of the study. No association between NC and CHD was identified in either Chinese studies or Brazil studies (OR = 1.20, 95% CI 0.96–1.49; OR = 1.31, 95% CI 0.82–2.09, respectively). Conclusion: Larger NC is associated with increased risk of CHD, especially when coronary angiography was taken to diagnose CHD.
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Affiliation(s)
- Guang-Ran Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Timothy D Dye
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Martin S Zand
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Thomas T Fogg
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Shen-Yuan Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jin-Kui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dongmei Li
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
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Weisenthal SJ, Quill C, Farooq S, Kautz H, Zand MS. Predicting acute kidney injury at hospital re-entry using high-dimensional electronic health record data. PLoS One 2018; 13:e0204920. [PMID: 30458044 PMCID: PMC6245516 DOI: 10.1371/journal.pone.0204920] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 09/17/2018] [Indexed: 01/16/2023] Open
Abstract
Acute Kidney Injury (AKI), a sudden decline in kidney function, is associated with increased mortality, morbidity, length of stay, and hospital cost. Since AKI is sometimes preventable, there is great interest in prediction. Most existing studies consider all patients and therefore restrict to features available in the first hours of hospitalization. Here, the focus is instead on rehospitalized patients, a cohort in which rich longitudinal features from prior hospitalizations can be analyzed. Our objective is to provide a risk score directly at hospital re-entry. Gradient boosting, penalized logistic regression (with and without stability selection), and a recurrent neural network are trained on two years of adult inpatient EHR data (3,387 attributes for 34,505 patients who generated 90,013 training samples with 5,618 cases and 84,395 controls). Predictions are internally evaluated with 50 iterations of 5-fold grouped cross-validation with special emphasis on calibration, an analysis of which is performed at the patient as well as hospitalization level. Error is assessed with respect to diagnosis, race, age, gender, AKI identification method, and hospital utilization. In an additional experiment, the regularization penalty is severely increased to induce parsimony and interpretability. Predictors identified for rehospitalized patients are also reported with a special analysis of medications that might be modifiable risk factors. Insights from this study might be used to construct a predictive tool for AKI in rehospitalized patients. An accurate estimate of AKI risk at hospital entry might serve as a prior for an admitting provider or another predictive algorithm.
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Affiliation(s)
- Samuel J. Weisenthal
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Caroline Quill
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Samir Farooq
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Henry Kautz
- Department of Computer Science, University of Rochester, Rochester, NY, United States of America
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States of America
| | - Martin S. Zand
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States of America
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34
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Rosenberg A, Fucile C, White RJ, Trayhan M, Farooq S, Quill CM, Nelson LA, Weisenthal SJ, Bush K, Zand MS. Visualizing nationwide variation in medicare Part D prescribing patterns. BMC Med Inform Decis Mak 2018; 18:103. [PMID: 30454029 PMCID: PMC6245567 DOI: 10.1186/s12911-018-0670-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background To characterize the regional and national variation in prescribing patterns in the Medicare Part D program using dimensional reduction visualization methods. Methods Using publicly available Medicare Part D claims data, we identified and visualized regional and national provider prescribing profile variation with unsupervised clustering and t-distributed stochastic neighbor embedding (t-SNE) dimensional reduction techniques. Additionally, we examined differences between regionally representative prescribing patterns for major metropolitan areas. Results Distributions of prescribing volume and medication diversity were highly skewed among over 800,000 Medicare Part D providers. Medical specialties had characteristic prescribing patterns. Although the number of Medicare providers in each state was highly correlated with the number of Medicare Part D enrollees, some states were enriched for providers with > 10,000 prescription claims annually. Dimension-reduction, hierarchical clustering and t-SNE visualization of drug- or drug-class prescribing patterns revealed that providers cluster strongly based on specialty and sub-specialty, with large regional variations in prescribing patterns. Major metropolitan areas had distinct prescribing patterns that tended to group by major geographical divisions. Conclusions This work demonstrates that unsupervised clustering, dimension-reduction and t-SNE visualization can be used to analyze and visualize variation in provider prescribing patterns on a national level across thousands of medications, revealing substantial prescribing variation both between and within specialties, regionally, and between major metropolitan areas. These methods offer an alternative system-wide and pattern-centric view of such data for hypothesis generation, visualization, and pattern identification. Electronic supplementary material The online version of this article (10.1186/s12911-018-0670-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander Rosenberg
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,University of Alabama Birmingham, Düsternbrooker Weg 20, Birmingham, 14642, AL, USA
| | - Christopher Fucile
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,University of Alabama Birmingham, Düsternbrooker Weg 20, Birmingham, 14642, AL, USA
| | - Robert J White
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,Clinical and Translational Science Institute, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, 14642, NY, USA
| | - Melissa Trayhan
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,Clinical and Translational Science Institute, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, 14642, NY, USA
| | - Samir Farooq
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,Clinical and Translational Science Institute, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, 14642, NY, USA
| | - Caroline M Quill
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,Department of Medicine, Division of Pulmonary and Critical Care, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, 14642, NY, USA.,Clinical and Translational Science Institute, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, 14642, NY, USA
| | - Lisa A Nelson
- Department Pharmacy, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, 14642, NY, USA
| | - Samuel J Weisenthal
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,Clinical and Translational Science Institute, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, 14642, NY, USA
| | - Kristen Bush
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA.,Clinical and Translational Science Institute, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, 14642, NY, USA
| | - Martin S Zand
- Rochester Center for Health Informatics at the University of Rochester Medical Center, 265 Crittenden Blvd - 1.207, Rochester, 14642, NY, USA. .,Department of Medicine, Division of Nephrology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, 14642, NY, USA. .,Clinical and Translational Science Institute, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, 14642, NY, USA.
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35
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Shen S, An B, Wang X, Hilchey SP, Li J, Cao J, Tian Y, Hu C, Jin L, Ng A, Tu C, Qu M, Zand MS, Qu J. Surfactant Cocktail-Aided Extraction/Precipitation/On-Pellet Digestion Strategy Enables Efficient and Reproducible Sample Preparation for Large-Scale Quantitative Proteomics. Anal Chem 2018; 90:10350-10359. [PMID: 30078316 DOI: 10.1021/acs.analchem.8b02172] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
For quantitative proteomics, efficient, robust, and reproducible sample preparation with high throughput is critical yet challenging, especially when large cohorts are involved, as is often required by clinical/pharmaceutical studies. We describe a rapid and straightforward surfactant cocktail-aided extraction/precipitation/on-pellet digestion (SEPOD) strategy to address this need. Prior to organic solvent precipitation and on-pellet digestion, SEPOD treats samples with a surfactant cocktail (SC) containing multiple nonionic/anionic surfactants, which achieves (i) exhaustive/reproducible protein extraction, including membrane-bound proteins; (ii) effective removal of detrimental nonprotein matrix components (e.g., >94% of phospholipids); (iii) rapid/efficient proteolytic digestion owing to dual (surfactants + precipitation) denaturation. The optimal SC composition and concentrations were determined by Orthogonal-Array-Design investigation of their collective/individuals effects on protein extraction/denaturation. Key parameters for cleanup and digestion were experimentally identified as well. The optimized SEPOD procedures allowed a rapid 6 h digestion providing a clean digest with high peptide yields and excellent quantitative reproducibility (especially low-abundance proteins). Compared with filter-assisted sample preparation (FASP) and in-solution digestion, SEPOD showed superior performance by recovering substantially more peptide/proteins (including integral membrane proteins), yielding significantly higher peptide intensities and improving quantification for peptides with extreme physicochemical properties. SEPOD was further applied in a large-cohort temporal investigation of 44 IAV-infected mouse lungs, providing efficient and reproducible peptide yields (77.9 ± 4.6%) across all samples. With the IonStar pipeline, >6 400 unique protein groups were quantified (≥2 peptide/protein, peptide-FDR < 0.05%), ∼99% without missing data in any sample with <7% technical median-intragroup CV. Altered proteome patterns revealed interesting novel insights into pathophysiological changes by IAV infection. In summary, SEPOD offers a feasible solution for rapid, efficient, and reproducible preparation of biological samples, facilitating high-quality proteomic quantification of large sample cohorts.
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Affiliation(s)
- Shichen Shen
- Department of Pharmaceutical Sciences , SUNY at Buffalo , Buffalo , New York 14214 , United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo , New York 14203 , United States
| | - Bo An
- Department of Pharmaceutical Sciences , SUNY at Buffalo , Buffalo , New York 14214 , United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo , New York 14203 , United States
| | - Xue Wang
- New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo , New York 14203 , United States.,Roswell Park Cancer Institute , Buffalo , New York 14263 , United States
| | - Shannon P Hilchey
- Division of Nephrology , University of Rochester Medical Center , Rochester , New York 14642 , United States
| | - Jun Li
- Department of Pharmaceutical Sciences , SUNY at Buffalo , Buffalo , New York 14214 , United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo , New York 14203 , United States
| | - Jin Cao
- National Institute for Food and Drug Control , Beijing , 100050 , China
| | - Yu Tian
- AbbVie Bioresearch Center Inc. , Worcester , Massachusetts 01605 , United States
| | - Chenqi Hu
- AbbVie Bioresearch Center Inc. , Worcester , Massachusetts 01605 , United States
| | - Liang Jin
- AbbVie Bioresearch Center Inc. , Worcester , Massachusetts 01605 , United States
| | - Andrew Ng
- New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo , New York 14203 , United States.,School of Dental Medicine , SUNY at Buffalo , Buffalo , New York 14214 , United States
| | - Chengjian Tu
- Department of Pharmaceutical Sciences , SUNY at Buffalo , Buffalo , New York 14214 , United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo , New York 14203 , United States
| | - Miao Qu
- Department of Neurology, Xuan Wu Hospital , Capital University of Medicine , Beijing , 100053 , China
| | - Martin S Zand
- Division of Nephrology , University of Rochester Medical Center , Rochester , New York 14642 , United States
| | - Jun Qu
- Department of Pharmaceutical Sciences , SUNY at Buffalo , Buffalo , New York 14214 , United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo , New York 14203 , United States
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36
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Wang J, Hilchey SP, DeDiego M, Perry S, Hyrien O, Nogales A, Garigen J, Amanat F, Huertas N, Krammer F, Martinez-Sobrido L, Topham DJ, Treanor JJ, Sangster MY, Zand MS. Broad cross-reactive IgG responses elicited by adjuvanted vaccination with recombinant influenza hemagglutinin (rHA) in ferrets and mice. PLoS One 2018; 13:e0193680. [PMID: 29641537 PMCID: PMC5894995 DOI: 10.1371/journal.pone.0193680] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/15/2018] [Indexed: 12/17/2022] Open
Abstract
Annual immunization against influenza virus is a large international public health effort. Accumulating evidence suggests that antibody mediated cross-reactive immunity against influenza hemagglutinin (HA) strongly correlates with long-lasting cross-protection against influenza virus strains that differ from the primary infection or vaccination strain. However, the optimal strategies for achieving highly cross-reactive antibodies to the influenza virus HA have not yet to be defined. In the current study, using Luminex-based mPlex-Flu assay, developed by our laboratory, to quantitatively measure influenza specific IgG antibody mediated cross-reactivity, we found that prime-boost-boost vaccination of ferrets with rHA proteins admixed with adjuvant elicited higher magnitude and broader cross-reactive antibody responses than that induced by actual influenza viral infection, and this cross-reactive response likely correlated with increased anti-stalk reactive antibodies. We observed a similar phenomenon in mice receiving three sequential vaccinations with rHA proteins from either A/California/07/2009 (H1N1) or A/Hong Kong/1/1968 (H3N2) viruses admixed with Addavax, an MF59-like adjuvant. Using this same mouse vaccination model, we determined that Addavax plays a more significant role in the initial priming event than in subsequent boosts. We also characterized the generation of cross-reactive antibody secreting cells (ASCs) and memory B cells (MBCs) when comparing vaccination to viral infection. We have also found that adjuvant plays a critical role in the generation of long-lived ASCs and MBCs cross-reactive to influenza viruses as a result of vaccination with rHA of influenza virus, and the observed increase in stalk-reactive antibodies likely contributes to this IgG mediated broad cross-reactivity.
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Affiliation(s)
- Jiong Wang
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Shannon P. Hilchey
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Marta DeDiego
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Sheldon Perry
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Ollivier Hyrien
- Biostatistics, Bioinformatics, and Epidemiology Program, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Aitor Nogales
- Biostatistics, Bioinformatics, and Epidemiology Program, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Jessica Garigen
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Fatima Amanat
- Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Nelson Huertas
- Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Luis Martinez-Sobrido
- Biostatistics, Bioinformatics, and Epidemiology Program, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - David J. Topham
- Biostatistics, Bioinformatics, and Epidemiology Program, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - John J. Treanor
- Division of Infectious Disease, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Mark Y. Sangster
- Biostatistics, Bioinformatics, and Epidemiology Program, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Martin S. Zand
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, New York, United States of America
- * E-mail:
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37
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Nogales A, Piepenbrink MS, Wang J, Ortega S, Basu M, Fucile CF, Treanor JJ, Rosenberg AF, Zand MS, Keefer MC, Martinez-Sobrido L, Kobie JJ. A Highly Potent and Broadly Neutralizing H1 Influenza-Specific Human Monoclonal Antibody. Sci Rep 2018. [PMID: 29531320 PMCID: PMC5847613 DOI: 10.1038/s41598-018-22307-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Influenza’s propensity for antigenic drift and shift, and to elicit predominantly strain specific antibodies (Abs) leaves humanity susceptible to waves of new strains with pandemic potential for which limited or no immunity may exist. Subsequently new clinical interventions are needed. To identify hemagglutinin (HA) epitopes that if targeted may confer universally protective humoral immunity, we examined plasmablasts from a subject that was immunized with the seasonal influenza inactivated vaccine, and isolated a human monoclonal Ab (mAb), KPF1. KPF1 has broad and potent neutralizing activity against H1 influenza viruses, and recognized 83% of all H1 isolates tested, including the pandemic 1918 H1. Prophylactically, KPF1 treatment resulted in 100% survival of mice from lethal challenge with multiple H1 influenza strains and when given as late as 72 h after challenge with A/California/04/2009 H1N1, resulted in 80% survival. KPF1 recognizes a novel epitope in the HA globular head, which includes a highly conserved amino acid, between the Ca and Cb antigenic sites. Although recent HA stalk-specific mAbs have broader reactivity, their potency is substantially limited, suggesting that cocktails of broadly reactive and highly potent HA globular head-specific mAbs, like KPF1, may have greater clinical feasibility for the treatment of influenza infections.
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Affiliation(s)
- Aitor Nogales
- Department of Microbiology & Immunology, University of Rochester, Rochester, NY, USA
| | | | - Jiong Wang
- Division of Nephrology, University of Rochester, Rochester, NY, USA
| | - Sandra Ortega
- Department of Microbiology & Immunology, University of Rochester, Rochester, NY, USA
| | - Madhubanti Basu
- Infectious Diseases Division, University of Rochester, Rochester, NY, USA
| | - Christopher F Fucile
- Department of Microbiology, Informatics Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John J Treanor
- Infectious Diseases Division, University of Rochester, Rochester, NY, USA
| | - Alexander F Rosenberg
- Department of Microbiology, Informatics Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Martin S Zand
- Division of Nephrology, University of Rochester, Rochester, NY, USA
| | - Michael C Keefer
- Infectious Diseases Division, University of Rochester, Rochester, NY, USA
| | - Luis Martinez-Sobrido
- Department of Microbiology & Immunology, University of Rochester, Rochester, NY, USA.
| | - James J Kobie
- Infectious Diseases Division, University of Rochester, Rochester, NY, USA.
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38
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Clark AM, DeDiego ML, Anderson CS, Wang J, Yang H, Nogales A, Martinez-Sobrido L, Zand MS, Sangster MY, Topham DJ. Antigenicity of the 2015-2016 seasonal H1N1 human influenza virus HA and NA proteins. PLoS One 2017; 12:e0188267. [PMID: 29145498 PMCID: PMC5690631 DOI: 10.1371/journal.pone.0188267] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/05/2017] [Indexed: 11/18/2022] Open
Abstract
Antigenic drift of the hemagglutinin (HA) and neuraminidase (NA) influenza virus proteins contributes to reduced vaccine efficacy. To analyze antigenic drift in human seasonal H1N1 viruses derived from the 2009 pandemic H1N1 virus (pH1N1-like viruses) accounts for the limited effectiveness (around 40%) of vaccination against pH1N1-like viruses during the 2015-2016 season, nasal washes/swabs collected from adult subjects in the Rochester, NY area, were used to sequence and isolate the circulating viruses. The HA and NA proteins from viruses circulating during the 2015-2016 season encoded eighteen and fourteen amino acid differences, respectively, when compared to A/California/04/2009, a strain circulating at the origin of the 2009 pandemic. The circulating strains belonged to subclade 6B.1, defined by HA amino acid substitutions S101N, S179N, and I233T. Hemagglutination-inhibiting (HAI) and HA-specific neutralizing serum antibody (Ab) titers from around 50% of pH1N1-like virus-infected subjects and immune ferrets were 2-4 fold lower for the 2015-2016 circulating strains compared to the vaccine strain. In addition, using a luminex-based mPlex HA assay, the binding of human sera from subjects infected with pH1N1-like viruses to the HA proteins from circulating and vaccine strains was not identical, strongly suggesting antigenic differences in the HA protein. Additionally, NA inhibition (NAI) Ab titers in human sera from pH1N1-like virus-infected subjects increased after the infection and there were measurable antigenic differences between the NA protein of circulating strains and the vaccine strain using both ferret and human antisera. Despite having been vaccinated, infected subjects exhibited low HAI Ab titers against the vaccine and circulating strains. This suggests that poor responses to the H1N1 component of the vaccine as well as antigenic differences in the HA and NA proteins of currently circulating pH1N1-like viruses could be contributing to risk of infection even after vaccination.
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Affiliation(s)
- Amelia M. Clark
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Marta L. DeDiego
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
- * E-mail: (DT); (MD)
| | - Christopher S. Anderson
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Jiong Wang
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Hongmei Yang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Aitor Nogales
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Luis Martinez-Sobrido
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Martin S. Zand
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Mark Y. Sangster
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - David J. Topham
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York, United States of America
- * E-mail: (DT); (MD)
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39
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Abstract
Background: Recently, several human monoclonal antibodies that target conserved epitopes on the stalk region of influenza hemagglutinin (HA) have shown broad reactivity to influenza A subtypes. Also, vaccination with recombinant chimeric HA or stem fragments from H3 influenza viruses induce broad immune protection in mice and humans. However, it is unclear whether stalk-binding antibodies can be induced in human memory B cells by seasonal H3N2 viruses. Methods: In this study, we recruited 13 donors previously exposed to H3 viruses, the majority (12 of 13) of which had been immunized with seasonal influenza vaccines. We evaluated plasma baseline strain-specific and stalk-reactive anti-HA antibodies and B cell recall responses to inactivated H3N2 A/Victoria/361/2011 virus
in vitro using a high throughput multiplex (mPlex-Flu) assay. Results: Stalk-reactive IgG was detected in the plasma of 7 of the subjects. Inactivated H3 viral particles rapidly induced clade cross-reactive antibodies in B cell cultures derived from all 13 donors. In addition, H3 stalk-reactive antibodies were detected in culture supernatants from 7 of the 13 donors (53.8%). H3 stalk-reactive antibodies were also induced by H1 and H7 subtypes. Interestingly, broadly cross-reactive antibody recall responses to H3 strains were also enhanced by stimulating B cells
in vitro with CpG
2006 ODN in the presence of IL-15. H3 stalk-reactive antibodies were detected in CpG
2006 ODN + IL-15 stimulated B cell cultures derived from 12 of the 13 donors (92.3%), with high levels detected in cultures from 7 of the 13 donors. Conclusions: Our results demonstrate that stalk-reactive antibody recall responses induced by seasonal H3 viruses and CpG
2006 ODN can be enhanced by IL-15.
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Affiliation(s)
- Junqiong Huang
- School of Laboratory Medicine, Zunyi Medical University, Zunyi Guizhou, 563099, China
| | - Shannon P Hilchey
- Division of Nephrology, University of Rochester Medical Center, Rochester , NY, 14642, USA
| | - Jiong Wang
- Division of Nephrology, University of Rochester Medical Center, Rochester , NY, 14642, USA
| | - Jessica Gerigan
- Division of Nephrology, University of Rochester Medical Center, Rochester , NY, 14642, USA
| | - Martin S Zand
- Division of Nephrology, University of Rochester Medical Center, Rochester , NY, 14642, USA
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40
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Zand MS, Trayhan M, Farooq SA, Fucile C, Ghoshal G, White RJ, Quill CM, Rosenberg A, Barbosa HS, Bush K, Chafi H, Boudreau T. Properties of healthcare teaming networks as a function of network construction algorithms. PLoS One 2017; 12:e0175876. [PMID: 28426795 PMCID: PMC5398561 DOI: 10.1371/journal.pone.0175876] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 03/31/2017] [Indexed: 11/25/2022] Open
Abstract
Network models of healthcare systems can be used to examine how providers collaborate, communicate, refer patients to each other, and to map how patients traverse the network of providers. Most healthcare service network models have been constructed from patient claims data, using billing claims to link a patient with a specific provider in time. The data sets can be quite large (106-108 individual claims per year), making standard methods for network construction computationally challenging and thus requiring the use of alternate construction algorithms. While these alternate methods have seen increasing use in generating healthcare networks, there is little to no literature comparing the differences in the structural properties of the generated networks, which as we demonstrate, can be dramatically different. To address this issue, we compared the properties of healthcare networks constructed using different algorithms from 2013 Medicare Part B outpatient claims data. Three different algorithms were compared: binning, sliding frame, and trace-route. Unipartite networks linking either providers or healthcare organizations by shared patients were built using each method. We find that each algorithm produced networks with substantially different topological properties, as reflected by numbers of edges, network density, assortativity, clustering coefficients and other structural measures. Provider networks adhered to a power law, while organization networks were best fit by a power law with exponential cutoff. Censoring networks to exclude edges with less than 11 shared patients, a common de-identification practice for healthcare network data, markedly reduced edge numbers and network density, and greatly altered measures of vertex prominence such as the betweenness centrality. Data analysis identified patterns in the distance patients travel between network providers, and a striking set of teaming relationships between providers in the Northeast United States and Florida, likely due to seasonal residence patterns of Medicare beneficiaries. We conclude that the choice of network construction algorithm is critical for healthcare network analysis, and discuss the implications of our findings for selecting the algorithm best suited to the type of analysis to be performed.
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Affiliation(s)
- Martin S. Zand
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Melissa Trayhan
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Samir A. Farooq
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Christopher Fucile
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Gourab Ghoshal
- Department of Physics, University of Rochester, Rochester, NY, United States of America
| | - Robert J. White
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Caroline M. Quill
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Alexander Rosenberg
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Hugo Serrano Barbosa
- Department of Physics, University of Rochester, Rochester, NY, United States of America
| | - Kristen Bush
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, NY, United States of America
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Hassan Chafi
- Oracle Labs, Belmont, CA, United States of America
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Shen S, Li J, Hilchey S, Shen X, Tu C, Qiu X, Ng A, Ghaemmaghami S, Wu H, Zand MS, Qu J. Ion-Current-Based Temporal Proteomic Profiling of Influenza-A-Virus-Infected Mouse Lungs Revealed Underlying Mechanisms of Altered Integrity of the Lung Microvascular Barrier. J Proteome Res 2016; 15:540-53. [PMID: 26650791 DOI: 10.1021/acs.jproteome.5b00927] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Investigation of influenza-A-virus (IAV)-infected lung proteomes will greatly promote our understanding on the virus-host crosstalk. Using a detergent-cocktail extraction and digestion procedure and a reproducible ion-current-based method, we performed the first comprehensive temporal analysis of mouse IAV infection. Mouse lung tissues at three time points post-inoculation were compared with controls (n = 4/group), and >1600 proteins were quantified without missing value in any animal. Significantly changed proteins were identified at 4 days (n = 144), 7 days (n = 695), and 10 days (n = 396) after infection, with low false altered protein rates (1.73-8.39%). Functional annotation revealed several key biological processes involved in the systemic host responses. Intriguingly, decreased levels of several cell junction proteins as well as increased levels of tissue metalloproteinase MMP9 were observed, reflecting the IAV-induced structural breakdown of lung epithelial barrier. Supporting evidence of MMP9 activation came from immunoassays examining the abundance and phosphorylation states of all MAPKs and several relevant molecules. Importantly, IAV-induced MMP gelatinase expression was suggested to be specific to MMP9, and p38 MAPK may contribute predominantly to MMP9 elevation. These findings help to resolve the long-lasting debate regarding the signaling pathways of IAV-induced MMP9 expression and shed light on the molecular mechanisms underlying pulmonary capillary-alveolar leak syndrome that can occur during influenza infection.
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Affiliation(s)
- Shichen Shen
- New York State Center of Excellence in Bioinformatics & Life Sciences , 701 Ellicott Street, Buffalo, New York 14203, United States.,Jacobs School of Medicine and Biomedical Sciences, SUNY at Buffalo , South Campus, Buffalo, New York 14214, United States
| | - Jun Li
- Department of Pharmaceutical Sciences, SUNY at Buffalo , South Campus, Buffalo, New York 14214, United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , 701 Ellicott Street, Buffalo, New York 14203, United States
| | - Shannon Hilchey
- Division of Nephrology, University of Rochester Medical Center , 601 Elmwood Avenue, Rochester, New York 14642, United States
| | - Xiaomeng Shen
- New York State Center of Excellence in Bioinformatics & Life Sciences , 701 Ellicott Street, Buffalo, New York 14203, United States.,Jacobs School of Medicine and Biomedical Sciences, SUNY at Buffalo , South Campus, Buffalo, New York 14214, United States
| | - Chengjian Tu
- Department of Pharmaceutical Sciences, SUNY at Buffalo , South Campus, Buffalo, New York 14214, United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , 701 Ellicott Street, Buffalo, New York 14203, United States
| | - Xing Qiu
- Department of Biostatistics and Computational Biology, University of Rochester , 265 Crittenden Boulevard, Rochester, New York 14642, United States
| | - Andrew Ng
- Jacobs School of Medicine and Biomedical Sciences, SUNY at Buffalo , South Campus, Buffalo, New York 14214, United States
| | - Sina Ghaemmaghami
- Department of Biology, University of Rochester , 402 Hutchison Hall, Rochester, New York 14627, United States
| | - Hulin Wu
- Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston , 1200 Pressler Street, Houston, Texas 77030, United States
| | - Martin S Zand
- Division of Nephrology, University of Rochester Medical Center , 601 Elmwood Avenue, Rochester, New York 14642, United States
| | - Jun Qu
- Department of Pharmaceutical Sciences, SUNY at Buffalo , South Campus, Buffalo, New York 14214, United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , 701 Ellicott Street, Buffalo, New York 14203, United States
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Zand MS, Wang J, Hilchey S. Graphical Representation of Proximity Measures for Multidimensional Data: Classical and Metric Multidimensional Scaling. Math J 2015; 17:7. [PMID: 26692757 PMCID: PMC4675631 DOI: 10.3888/tmj.17-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We describe the use of classical and metric multidimensional scaling methods for graphical representation of the proximity between collections of data consisting of cases characterized by multidimensional attributes. These methods can preserve metric differences between cases, while allowing for dimensional reduction and projection to two or three dimensions ideal for data exploration. We demonstrate these methods with three datasets for: (i) the immunological similarity of influenza proteins measured by a multidimensional assay; (ii) influenza protein sequence similarity; and (iii) reconstruction of airport-relative locations from paired proximity measurements. These examples highlight the use of proximity matrices, eigenvalues, eigenvectors, and linear and nonlinear mappings using numerical minimization methods. Some considerations and caveats for each method are also discussed, and compact Mathematica programs are provided.
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Affiliation(s)
- Martin S. Zand
- University of Rochester Medical Center, 601 Elmwood Avenue - Box 675, Rochester, NY 14618
| | - Jiong Wang
- University of Rochester Medical Center, 601 Elmwood Avenue - Box 675, Rochester, NY 14618
| | - Shannon Hilchey
- University of Rochester Medical Center, 601 Elmwood Avenue - Box 675, Rochester, NY 14618
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Qiu X, Wu S, Hilchey SP, Thakar J, Liu ZP, Welle SL, Henn AD, Wu H, Zand MS. Diversity in Compartmental Dynamics of Gene Regulatory Networks: The Immune Response in Primary Influenza A Infection in Mice. PLoS One 2015; 10:e0138110. [PMID: 26413862 PMCID: PMC4586376 DOI: 10.1371/journal.pone.0138110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 08/26/2015] [Indexed: 01/23/2023] Open
Abstract
Current approaches to study transcriptional profiles post influenza infection typically rely on tissue sampling from one or two sites at a few time points, such as spleen and lung in murine models. In this study, we infected female C57/BL6 mice intranasally with mouse-adapted H3N2/Hong Kong/X31 avian influenza A virus, and then analyzed the gene expression profiles in four different compartments (blood, lung, mediastinal lymph nodes, and spleen) over 11 consecutive days post infection. These data were analyzed by an advanced statistical procedure based on ordinary differential equation (ODE) modeling. Vastly different lists of significant genes were identified by the same statistical procedure in each compartment. Only 11 of them are significant in all four compartments. We classified significant genes in each compartment into co-expressed modules based on temporal expression patterns. We then performed functional enrichment analysis on these co-expression modules and identified significant pathway and functional motifs. Finally, we used an ODE based model to reconstruct gene regulatory network (GRN) for each compartment and studied their network properties.
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Affiliation(s)
- Xing Qiu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, 14642, United States of America
| | - Shuang Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, 14642, United States of America
| | - Shannon P. Hilchey
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, 14642, United States of America
| | - Juilee Thakar
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, 14642, United States of America
- Department of Microbiology and Immunology, University of Rochester, Rochester, NY, 14642 United States of America
| | - Zhi-Ping Liu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, 14642, United States of America
- Department of Biomedical Engineering, Shandong University, Jinan, Shandong, China
| | - Stephen L. Welle
- Functional Genomics Center, University of Rochester, Rochester, NY, 14642, United States of America
| | - Alicia D. Henn
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, 14642, United States of America
- Department of Microbiology and Immunology, University of Rochester, Rochester, NY, 14642 United States of America
| | - Hulin Wu
- Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, 77030, United States of America
- * E-mail: (HW); (MSZ)
| | - Martin S. Zand
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, 14642, United States of America
- * E-mail: (HW); (MSZ)
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Wang J, Hilchey SP, Hyrien O, Huertas N, Perry S, Ramanunninair M, Bucher D, Zand MS. Multi-Dimensional Measurement of Antibody-Mediated Heterosubtypic Immunity to Influenza. PLoS One 2015; 10:e0129858. [PMID: 26103163 PMCID: PMC4478018 DOI: 10.1371/journal.pone.0129858] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/12/2015] [Indexed: 12/30/2022] Open
Abstract
The human immune response to influenza vaccination depends in part on preexisting cross-reactive (heterosubtypic) immunity from previous infection by, and/or vaccination with, influenza strains that share antigenic determinants with the vaccine strains. However, current methods for assessing heterosubtypic antibody responses against influenza, including the hemagglutination-inhibition (HAI) assay and ELISA, are time and labor intensive, and require moderate amounts of serum and reagents. To address these issues we have developed a fluorescent multiplex assay, mPlex-Flu, that rapidly and simultaneously measures strain specific IgG, IgA, and IgM antibodies against influenza hemagglutinin (HA) from multiple viral strains. We cloned, expressed and purified HA proteins from 12 influenza strains, and coupled them to multiplex beads. Assay validation showed that minimal sample volumes (<5 μl of serum) were needed, and the assay had a linear response over a four Log10 range. The assay detected nanogram levels of anti-influenza specific antibodies, had high accuracy and reproducibility, with an average percentage coefficient of variation (%CV) of 9.06 for intra-assay and 12.94 for inter-assay variability. Pre- and post-intramuscular trivalent influenza vaccination levels of virus specific Ig were consistent with HAI titer and ELISA measurements. A significant advantage of the mPLEX-Flu assay over the HAI assay is the ability to perform antigenic cartography, determining the antigenic distances between influenza HA’s, without mathematical correction for HAI data issues. For validation we performed antigenic cartography on 14 different post-influenza infection ferret sera assayed against 12 different influenza HA’s. Results were in good agreement with a phylogenetic tree generated from hierarchical clustering of the genomic HA sequences. This is the first report of the use of a multiplex method for antigenic cartography using ferret sera. Overall, the mPlex-Flu assay provides a powerful tool to rapidly assess the influenza antibody repertoire in large populations and to study heterosubtypic immunity induced by influenza vaccination.
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Affiliation(s)
- Jiong Wang
- Division of Nephrology, Department of Medicine and the Rochester Center for Biodefense Immune Modeling, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Shannon P. Hilchey
- Division of Nephrology, Department of Medicine and the Rochester Center for Biodefense Immune Modeling, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Ollivier Hyrien
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Nelson Huertas
- Division of Nephrology, Department of Medicine and the Rochester Center for Biodefense Immune Modeling, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Sheldon Perry
- Division of Nephrology, Department of Medicine and the Rochester Center for Biodefense Immune Modeling, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Manojkumar Ramanunninair
- Department of Microbiology and Immunology, New York Medical College, Valhalla, New York, United States of America
| | - Doris Bucher
- Department of Microbiology and Immunology, New York Medical College, Valhalla, New York, United States of America
| | - Martin S. Zand
- Division of Nephrology, Department of Medicine and the Rochester Center for Biodefense Immune Modeling, University of Rochester Medical Center, Rochester, New York, United States of America
- Rochester Center for Health Informatics, University of Rochester Medical Center, Rochester, New York, United States of America
- * E-mail:
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Abstract
Antibody mediated renal allograft rejection is a significant cause of acute and chronic graft loss. Recent work has revealed that AMR is a complex processes, involving B and plasma cells, donor-specific antibodies, complement, vascular endothelial cells, NK cells, Fc receptors, cytokines and chemokines. These insights have led to the development of numerous new therapies, and adaptation of others originally developed for treatment of hemetologic malignancies, autoimmune and complement mediated conditions. Here we review emerging insights into the pathophysiology of AMR as well as current and emerging therapies for both acute and chronic AMR. Finally, we discuss rational clinical trial design in light of antibody and B cell immunobiology, as well as appropriate efficacy metrics to identify robust protocols and therapeutic agents.
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Affiliation(s)
- Shaifali Sandal
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester NY
| | - Martin S. Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester NY
- Center for Biodefense Immune Modeling, University of Rochester Medical Center, Rochester NY
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Chen W, Kayler LK, Zand MS, Muttana R, Chernyak V, DeBoccardo GO. Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy. Clin Kidney J 2014; 8:71-8. [PMID: 25713713 PMCID: PMC4310434 DOI: 10.1093/ckj/sfu132] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 11/13/2014] [Indexed: 01/04/2023] Open
Abstract
Transplant renal artery stenosis (TRAS) is a well-recognized vascular complication after kidney transplant. It occurs most frequently in the first 6 months after kidney transplant, and is one of the major causes of graft loss and premature death in transplant recipients. Renal hypoperfusion occurring in TRAS results in activation of the renin–angiotensin–aldosterone system; patients usually present with worsening or refractory hypertension, fluid retention and often allograft dysfunction. Flash pulmonary edema can develop in patients with critical bilateral renal artery stenosis or renal artery stenosis in a solitary kidney, and this unique clinical entity has been named Pickering Syndrome. Prompt diagnosis and treatment of TRAS can prevent allograft damage and systemic sequelae. Duplex sonography is the most commonly used screening tool, whereas angiography provides the definitive diagnosis. Percutaneous transluminal angioplasty with stent placement can be performed during angiography if a lesion is identified, and it is generally the first-line therapy for TRAS. However, there is no randomized controlled trial examining the efficacy and safety of percutaneous transluminal angioplasty compared with medical therapy alone or surgical intervention.
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Affiliation(s)
- Wei Chen
- Department of Medicine , University of Rochester School of Medicine and Dentistry , Rochester, NY , USA ; Department of Medicine , Albert Einstein College of Medicine , Bronx, NY , USA
| | - Liise K Kayler
- Department of Surgery , Albert Einstein College of Medicine , Bronx, NY , USA
| | - Martin S Zand
- Department of Medicine , University of Rochester School of Medicine and Dentistry , Rochester, NY , USA
| | - Renu Muttana
- Department of Medicine , Maimonides Medical Center , Brooklyn, NY , USA
| | - Victoria Chernyak
- Department of Radiology , Albert Einstein College of Medicine , Bronx, NY , USA
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Abstract
Tofacitinib (tositinib, CP-690,550) is a small molecule inhibitor of Janus associated kinases, primarily JAK3 and JAK2, which inhibits cytokine signaling through the IL-2Rγ chain. In this article, we review the mechanism of action of tofacitinib, and pre-clinical and clinical data regarding its use in solid organ transplantation thus far. It is hoped that tofacitinib may form the basis for calcineurin-free immunosuppression, improving renal function while eliminating calcineurin inhibitor renal toxicity. Current studies suggest that tofacitinib is an effective immunosuppressive agent for renal transplantation, but it's use in current protocols carries an increased risk of CMV, BK, and EBV viral infection, anemia and leukopenia, and post-transplant lymphoproliferative disorder.
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Affiliation(s)
- Martin S Zand
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Box 675, Rochester, NY 14642, USA.
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Neild GH, Sandal S, Zand MS. Page kidney phenomenon secondary to an atypical presentation of Erdheim-Chester disease. Clin Kidney J 2013; 6:547-8. [PMID: 26120451 PMCID: PMC4438401 DOI: 10.1093/ckj/sft086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/03/2013] [Indexed: 12/24/2022] Open
Affiliation(s)
- G H Neild
- Division of Nephrology, School of Medicine and Dentistry , University of Rochester Medical Center , Rochester, NY , USA
| | - Shaifali Sandal
- Division of Nephrology, School of Medicine and Dentistry , University of Rochester Medical Center , Rochester, NY , USA
| | - Martin S Zand
- Division of Nephrology, School of Medicine and Dentistry , University of Rochester Medical Center , Rochester, NY , USA
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Li X, Miao H, Henn A, Topham DJ, Wu H, Zand MS, Mosmann TR. Ki-67 expression reveals strong, transient influenza specific CD4 T cell responses after adult vaccination. Vaccine 2012; 30:4581-4. [PMID: 22554464 PMCID: PMC3858959 DOI: 10.1016/j.vaccine.2012.04.059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 04/13/2012] [Accepted: 04/17/2012] [Indexed: 10/28/2022]
Abstract
Although previous studies have found minimal changes in CD4 T cell responses after vaccination of adults with trivalent inactivated influenza vaccine, daily sampling and monitoring of the proliferation marker Ki-67 have now been used to reveal that a substantial fraction of influenza-specific CD4 T cells respond to vaccination. At 4-6 days after vaccination, there is a sharp rise in the numbers of Ki-67-expressing PBMC that produce IFNγ, IL-2 and/or TNFα in vitro in response to influenza vaccine or peptide. Ki-67(+) cell numbers then decline rapidly, and 10 days after vaccination, both Ki-67(+) and overall influenza-specific cell numbers are similar to pre-vaccination levels. These results provide a tool for assessing the quality and quantity of CD4 T cell responses to different influenza vaccines, and raise the possibility that the anti-influenza T cell memory response may be qualitatively altered by vaccination, even if the overall memory cell numbers do not change significantly.
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Affiliation(s)
- Xi Li
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY
| | - Hongyu Miao
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY
| | - Alicia Henn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | - David J. Topham
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY
| | - Hulin Wu
- Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY
| | - Martin S. Zand
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | - Tim R. Mosmann
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY
- Corresponding Author at: David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 609, Rochester, NY 14642 Tel.: +1 585 273 1400 Fax: +1 585 273 2452
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Affiliation(s)
- Ollivier Hyrien
- Ollivier Hyrien is Assistant Professor, Department of Biostatistics and Computational Biology , and Martin S. Zand is Associate Professor, Department of Medicine, Nephrology Unit, University of Rochester Medical Center, Rochester, NY 14642. This research was funded by National Institutes of Health/NINDS grant NS39511 (O.H.) and by grant N01-AI-050020 (O.H. and M.Z.). Federal funds were received from the National Institute Allergy and Infectious Diseases, National Institutes of Health, Department of
| | - Martin S Zand
- Ollivier Hyrien is Assistant Professor, Department of Biostatistics and Computational Biology , and Martin S. Zand is Associate Professor, Department of Medicine, Nephrology Unit, University of Rochester Medical Center, Rochester, NY 14642. This research was funded by National Institutes of Health/NINDS grant NS39511 (O.H.) and by grant N01-AI-050020 (O.H. and M.Z.). Federal funds were received from the National Institute Allergy and Infectious Diseases, National Institutes of Health, Department of
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