Overview
Early life exposure to and colonization with microbes has a profound influence on the education of the immune system and susceptibility to viral and bacterial infections later in life. My research is focused on the influence of the upper respiratory microbiome on the development of recurrent respiratory infections, including acute otitis media (AOM), the leading cause of antibiotic prescriptions and healthcare consultations among children. Importantly, some children develop recurrent infections that are thought to be linked to dysbiosis of the nasopharyngeal microbiome. My overarching goals are to identify alterations in the upper respiratory microbiome associated with AOM and to elucidate host factors and exposures that predispose some children to the development of recurrent AOM episodes.
Children's Health & Discovery Initiative:
The prenatal period, infancy, childhood, and adolescence, represent critical time periods of human development that include more developmental milestones than any other period of the lifespan. Conditions during these developmental windows – including biological, social, economic, health, and environmental factors – have a profound impact on lifelong health. The Children’s Health and Discovery Initiative (CHDI) was founded on the hypothesis that interventions early in life will improve population health across the lifespan. To this end, the overarching goal of the CHDI is to create a robust coalition of multidisciplinary investigators and a pipeline of infrastructure, data, and research projects focused on developing innovative approaches to identifying and modulating early life factors that impact lifelong health and well-being.
Current Appointments & Affiliations
Recent Publications
Age and antibiotic use influence longitudinal dynamics of the upper respiratory microbiome in children with recurrent acute otitis media.
Journal Article mSphere · December 23, 2025 UNLABELLED: The upper respiratory tract (URT) microbiome has emerged as a key component of acute otitis media (AOM) pathophysiology; however, few studies conducted to date have evaluated URT microbiome composition in children with recurrent AOM (rAOM). We ... Full text Link to item CiteUnsupervised Coverage Sampling to Enhance Clinical Chart Review Coverage for Computable Phenotype Development: Simulation and Empirical Study.
Journal Article JMIR Med Inform · November 27, 2025 BACKGROUND: Developing computable phenotypes (CP) based on electronic health records (EHR) data requires "gold-standard" labels for the outcome of interest. To generate these labels, clinicians typically chart-review a subset of patient charts. Charts to b ... Full text Link to item CitePediatric T cell and B cell responses to SARS-CoV-2 infection.
Journal Article JCI Insight · October 22, 2025 BACKGROUNDUnderstanding age-associated differences in acute and memory adaptive immunity to SARS-CoV-2 and how they contribute to more favorable outcomes in children is critically important.METHODSWe evaluated SARS-CoV-2-specific T cell, B cell, and antibo ... Full text Link to item CiteRecent Grants
Developing strategies to identify candidate individuals for early genetic therapies
ResearchCollaborator · Awarded by Eunice Kennedy Shriver National Institute of Child Health and Human Development · 2024 - 2029Duke University Program in Environmental Health
Inst. Training Prgm or CMEMentor · Awarded by National Institute of Environmental Health Sciences · 2019 - 2029Clinical and host microbiome features in the development of acute otitis media
ResearchPrincipal Investigator · Awarded by National Institute of Allergy and Infectious Diseases · 2023 - 2028View All Grants