Division of Infectious Disease
The MUSC Infectious Diseases Division is a dynamic multidisciplinary academic group which strives to provide the best medical care, educational opportunities, and clinical research in the region. Over the past several years, the faculty and staff have doubled in size, and we have expanded our clinical and research programs substantially.
Our clinical and research strengths include nosocomial infections, HIV care, endocarditis, bone and joint infections, and vascular line management. The ID Division provides hospital consultations via three different faculty teams—A (the main MUSC hospital), B (Ashley River Towers and the Charleston VA), and C (solid organ transplant and hematologic malignancy complications). Out-patient services for a variety of infectious diseases—including unexplained fevers, surgical wound infections and abscesses, MRSA complications, endocarditis, sexually transmitted diseases and hepatitis--are provided full-time (Monday through Friday) in the Rutledge Towers 7th Floor clinics. Specialized clinics are available for prosthetic joint infections (Dr. Camelia Marculescu), atypical mycobacterial infections (Dr. Preston Church), and transplant complications (directed by Dr. Dannah Wray). A full range of Travel Medicine planning and prevention services are available (tropical medicine advice, vaccines, malaria prophylaxis, etc), including at our convenient East Cooper clinic location in Mt. Pleasant.
MUSC provides comprehensive care to over 1000 adults with HIV infection, and services are available regardless of insurance or ability to pay. The program has received continuous Ryan White Part B funding since the inception of the Health Resources and Service Administration Ryan White programs began over 20 years ago. In 2012, MUSC successfully applied for additional HRSA funding, Ryan White Part D, which provides support for care of HIV-infected women, children and youth. Services for HIV-infected patients include access to AIDS Drug Assistance programs, mail-order pharmacy services, adherence services, mental health and addiction counseling, full OB/GYN and reproductive health services, and a Transition Clinic (for transitioning HIV-infected youth from pediatric to adult internal medicine services). The VA hospital also provides multidisciplinary out-patient clinic services for HIV as well as other infectious diseases.
The Infectious Diseases group at MUSC may be the only academic center in the United States where placement of peripherally inserted central catheters (PICCs) is routinely performed by specially trained ID-boarded physician operators. Catheters may be tunneled or non-tunneled, antibiotic-impregnated, and can be placed with ultrasound guidance for difficult cases including morbidly obese patients, those with immunocompromising conditions, or special needs such as long-term antibiotic infusions, parenteral nutrition, or chemotherapy.
In terms of education, the ID Division provides leadership for the training of medical students, residents, and a variety of other health care trainees. MUSC has an American Board of Internal Medicine GME-accredited Infectious Diseases Fellowship, directed by Dr. Cassandra Salgado, which provides training in the breadth of in-patient and out-patient services and offers a variety of academic and research opportunities. In addition, MUSC is one of the few programs in the country to offer a fellowship for OB/GYN-trained physicians in Reproductive Infectious Diseases (with key mentoring from Dr. David Soper and Dr. Gweneth Lazenby in OB/GYN). These two fellowship programs foster cross-training while increasing opportunities for comprehensive care of patients with chronic infectious diseases. The ID Division participates in the general training of pharmacy students and residents, and there is also a PharmD ID residency program with expert mentoring provided by Dr. Sean Boger and Madelyne Cearley Bean, PharmD.
The ID Division provides leadership for a variety of MUSC hospital services. Dr. Salgado, who is also Vice Chairman of Medicine for Quality, runs robust Infection Control and Hospital Epidemiology programs, recently recognized for very low vascular line infection rates and novel approaches to preventing nosocomial infections related to environmental surfaces. Dr. John Gnann directs the Antibiotic Stewardship Program, which strives for the safest and most cost-effective antimicrobial protocols and strategies. Dr. Robert Cantey and Dr. Evgenia Kagan manage the Vascular Access Program, supervising the placement of PICC lines and leading teaching efforts related to safe placement and management of vascular catheters. The Transplant ID Service (Dr. Dannah Wray, Dr. John Gnann, and Dr. Tue Ngo) helps to coordinate services for hundreds of solid organ (heart, liver, kidney, lung) and stem cell transplant recipients each year.
The ID Division receives research funding from NIH, CDC, as well as pharmaceutical and biotech companies. Dr. Wei Jiang has an R01-funded immunology laboratory investigating innate immunity, vaccine responsiveness, microbial translocation, and gender differences in HIV/AIDS and other chronic inflammatory conditions. Dr. John Gnann is focused on herpes viruses (HSV, VZV, CMV), encephalitis viruses, and other unusual viral pathogens in addition to HIV clinical trials. Dr. Kilby and colleagues conduct novel HIV clinical trials related to integrase inhibitors, co-formulations of highly active antiretroviral therapy, and special outcomes studies for women and renally impaired patients. Dr. Wray conducts clinical trials related to endocarditis, invasive fungal infections, and the management of bacteremia. Dr. Marculescu has protocols relating to prosthetic joint infections. Dr. Lauren Richey has special interests in HIV epidemiology, screening and testing strategies. Collaborative studies are ongoing involving Immunology, Microbiology, Epidemiology, Pediatrics, Oncology, Orthopedics and other groups.