Current StARR Scholars | Emory School of Medicine

Christina Lin, MD, PhD

Christina Lin, MD, PhD graduated from the Yale School of Medicine and the Yale School of Graduate Studies with a PhD in Microbiology in May 2020. Her PhD research focused on how a critical virulence factor, the Type III Secretion System (T3SS), is expressed in the opportunistic bacterial pathogen Pseudomonas aeruginosa and its effect on establishing acute infections. She completed her internal medicine residency at Emory School of Medicine. In her StARR research year, she will continue research on the antibiotic resistance patterns of carbapenem-resistant Gram-negative bacteria, as well as the epidemiology and clinical outcomes of infected patients. During residency, she also participated in the Global Health Distinction and Global Health Residency Scholars Program with medical rotations in Tuba City, Arizona on the Navajo reservation and Black Lion Hospital in Addis Ababa, Ethiopia. After Infectious Diseases fellowship, her career goals are to research bacterial pathogenesis and antibiotic resistance from global health and public health perspectives.

Research Summary

Few antibiotics are active against carbapenem-resistant Enterobacterales (CRE), making CRE infections difficult to treat and associated with high mortality. Heteroresistance (HR), the presence of antibiotic-resistant subpopulations within a primary isogenic population, may be a potential but overlooked contributor to treatment failure. There are limited data on the activity against CRE of three newer beta-lactam/beta-lactamase inhibitor (BL/BLI) combinations: imipenem-relebactam [I-R], ceftazidime-avibactam [CZA], and meropenem-vaborbactam [MVB]. During her StARR research year, Dr. Lin will research patient risk factors associated with CRE infections demonstrating HR to standard and novel antibiotics. She will: 1. Determine the prevalence and frequency of HR in CRE to novel and last-line antibiotics; 2. Identify which specific patient risk factors are associated with HR-CRE infections as compared to non-HR CRE; and 3. Explore if HR-CRE with demonstrated HR to last-line antibiotics are associated with 90-day mortality.

Krishan Patel, MD

Krishan Patel is an internal medicine resident who plans to pursue a fellowship in cardiovascular diseases. His current research interests involve advanced heart failure and cardiac transplantation. He completed his undergraduate studies at UCLA with degrees in neuroscience, Spanish, and international development studies. He subsequently graduated from the Keck School of Medicine of USC with distinction in research and as a member of Alpha Omega Alpha and the Gold Humanism Honor Society. Outside of medicine, Krishan enjoys cooking & eating and playing & watching basketball.

Research Summary

As a StARR grant recipient, Krishan plans to study cardiac allograft vasculopathy (CAV), which is a process that causes diffuse coronary luminal narrowing in heart transplant recipients, thought to be largely driven by immune and inflammatory mechanisms. He will learn and apply data science methods, such as clustering algorithms, in hopes of finding patterns of biomarkers that can accurately identify presence and progression of CAV. The ultimate goals of these studies would be to better predict which patients need CAV screening with invasive angiography and which patients may benefit from different immuno-modulatory treatments based on biomarker profiles.

Dylan Charles Koundakjian, MD

Dylan Koundakjian is a resident physician in the Emory University Internal Medicine Residency Program interested in the study of antibiotic resistance (AR). Particularly, he is curious to understand factors that lead to selection of antibiotic resistance genes in the hospital environment, as well as host factors that might protect against colonization/infection with antibiotic-resistant organisms.

After earning his undergraduate degree from Duke University, Dylan studied HIV and human immunology as a research technician in Bruce Walker’s lab at the Ragon Institute of MGH, MIT, and Harvard, investigating host factors that contribute to new HIV infection and viral spread. He also contributed to studies investigating optimal HLA Class I binding peptides in HIV and COVID-19 infections based on a network analysis of critical viral residues unable to escape immune system detection through mutation. He helped design and execute several laboratory assays including lentiviral induction of a genome-wide CRISPR-Cas9 knockout library, CRISPR-Cas9 guide design for primary T-cell gene editing, and generation of 20 HLA allele-specific cell lines for peptide affinity testing. These projects illustrated how the relationship between pathogen and host dictates the course of disease, a principle he wishes to apply to the growing antibiotic resistance pandemic.

Research Summary

As part of the StARR program, he is working with the Emory University Antibiotic Resistance Center to investigate other host-pathogen relationships. Namely, he is working with the Emory Investigational Clinical Microbiology Core to establish a cohort of bacterial isolates from hospitalized patients infected with multidrug resistant organisms (MDROs). He is using clinical, spatial, antibiotic susceptibility and next-generation sequencing data generated from this cohort to track genomic and metagenomic signatures of AR persistence using the Bactopia computational pipeline. His initial work has identified potentially unrecognized transmission of MDROs from infected patients to non-infected controls discovered via genomic surveillance of patient- and hospital environmentally derived cultures. The goal for this work is to better elucidate the epidemiology of MDRO infections in the hospital, to determine clinical and microbiological risk factors for susceptibility to infection and/or colonization.

In addition to his work with StARR, he is also a member of his residency’s HIV Distinction Program in which he carries a continuity panel of patients living with HIV in the metro Atlanta area. His goal is to apply his clinical and research experiences towards becoming a physician-scientist specializing in Infectious Diseases, to both investigate novel therapeutic options in this rapidly evolving field, as well as provide care for the patients afflicted by them, who are often the most vulnerable in our society.