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.
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.
Daniel Rzewnicki, MD, MPH
Daniel Rzewnicki is a resident physician in the Emory University Internal Medicine Residency Program interested in improving outcomes in critical care. Particularly, he is interested in leveraging existing data to answer new questions and in utilizing techniques in bioinformatics and machine learning to modernize and improve the treatment of sepsis and septic shock.
After earning his undergraduate degree from Grove City College, Daniel worked as a project coordinator for an HIV cohort study at the University of Pittsburgh where he developed clinical skills and interests as well as an interest in the use of an existing cohort to answer new questions. During this time, he also earned his master's degree in public health and interned for the population health division of the UPMC Health Plan, where he studied the use of just-in-time adaptive interventions to promote behavior change. It was the combination of these experiences that developed his interest in intervention approaches that could improve the health of a population while also being tailored to a particular individual.
Research Summary
As part of the StARR program, he is working with Dr. Siva Bhavani on precision medicine approaches for the treatment of sepsis. Namely, he will be utilizing an algorithm developed by Dr. Bhavani's lab to stratify patients into sepsis phenotypes using vital sign data and studying the benefits of antibiotics and corticosteroids for each phenotype. Additionally, he will be working to develop an algorithm that can accurately stratify patients into sepsis phenotypes with fewer data points so that patients could more rapidly receive tailored treatments that might improve survival in sepsis.
In addition to his work with StARR, he is also a member of his residency’s quality improvement Distinction Program. His hope is that gaining skills in quality improvement will allow him to gain translational and implementation skills that could allow his research findings to translate to clinical practice. His goal is to pursue training in pulmonary and critical care as well as clinical informatics with the vision of becoming a physician-scientist with the skillset capable of studying novel and tailored treatment approaches in critical care and implementing these approaches into practice.
Anamaria Dragan, MD
Anamaria Dragan is a resident physician with a deep interest in cardiovascular diseases, specifically cardiac transplantation and advanced heart failure. Throughout her academic career, Anamaria has explored several of her interests through research. She earned her undergraduate degree in neurobiology from The University of Texas at Austin, where she conducted research on antimicrobial resistance and neural processing of the visual system. During her medical training at McGovern Medical School, she studied the molecular mechanisms of learning and memory. She has recently devoted time to conducting clinical research on coronary microvascular disease and endothelial dysfunction during her residency.
Anamaria's current research focuses on the role of cardiac lymphatics in cardiac allograft vasculopathy (CAV). She has developed methods for quantifying CAV on surveillance angiograms and correlating her measurements to tissue lymphatic density, which earned her top recognition at Emory's Internal Medicine Resident Research Day. As a participant in the StARR program, she aims to explore new dimensions in her CAV research, with the goal of improving diagnostic methods and patient outcomes in heart transplantation.
Research Summary
Cardiac allograft vasculopathy (CAV) is a leading cause of death in patients beyond one year post-cardiac transplantation. The disease is characterized by diffuse, concentric intimal thickening of the allograft coronary arteries, leading to myocardial ischemia, graft failure, myocardial infarction, arrhythmias, and sudden death. Inflammatory and immunologic mechanisms primarily drive the pathophysiology of CAV. However, disruptions in lymphatic vasculature remain a largely unknown factor in the disease's mechanism. The cardiac lymphatic network facilitates the clearance of inflammatory mediators and excess fluid from the heart, and its disruption post-transplantation may impair drainage of inflammatory mediators, contributing to CAV development.
Anamaria's overarching hypothesis is that the disruption of the cardiac lymphatic network post-transplantation leads to reduced cardiac function and increased risk of CAV. To explore this, she proposes a retrospective study of heart transplant patients, utilizing endomyocardial biopsies and coronary angiograms to quantify cardiac lymphatics and their impact on allograft function, CAV development, and patient survival.
Nancy Wareing, MD, PhD
Nancy Wareing is an internal medicine resident who plans to pursue a fellowship in Rheumatology. Nancy graduated from UTHealth McGovern Medical School as a member of Alpha Omega Alpha and the MD Anderson UTHealth Houston Graduate School with a PhD in Biochemistry and Cell Biology in May 2023. During her time in medical school, she founded an organization to support fellow medical students interested in pursuing a career in academic medicine, particularly those who identify as belonging to underrepresented groups in academia. Her PhD work combined molecular and translational approaches to identify a novel gene, SIX1, as an early marker of skin fibrosis and established its role in promoting dermal fat loss in systemic sclerosis. As a physician-scientist, Nancy hopes to continue expanding our understanding of autoimmune diseases. Outside of work, Nancy enjoys exercise, cooking, and gardening.
Research Summary
As a StARR recipient, Nancy is working at the Emory Hope Clinic, combining the fields of translational immunology and nutrition to explore the link between processed food consumption, inflammation, and dysbiosis. She will compare the inflammatory profile and gut microbiota composition of individuals consuming heavily processed diets versus those on less processed diets using dietary analytics, modeling, and metagenomic sequencing techniques. Ultimately, she hopes her work can aid in developing preventive strategies and dietary interventions to mitigate inflammation-related health risks.