Wald/DeMuri Research Group

Our research is mainly focused on upper respiratory infections (URI) in children such as sinusitis, otitis media and pharyngitis.

Sinusitis in Children "Viruses and the Nasopharyngeal Microbiome"

This NIH sponsored study is designed to determine the burden of acute bacterial sinusitis in children and to determine the role of the nasopharyngeal microbiome and antecedent acute viral infections on the development of acute bacterial sinusitis in children. Children are followed prospectively for one year to determine which subjects develop sinusitis and which resolve their URI spontaneously. Examining the bacterial diversity of the nasopharyngeal microbiome in health and after viral infection will provide critical insights with regard to many secondary bacterial infections of the respiratory tract. Defining mechanisms by which respiratory viruses cause major changes in the nasopharyngeal microbiome will lead to new preventative measures.

Duration of Treatment of Sinusitis

Acute bacterial sinusitis is one of the most common reasons for office visits and results in millions of antibiotic prescriptions per year. However, the optimal duration of therapy for sinusitis has not been studied. In this randomized, placebo-controlled trial sponsored by the Thrasher Foundation, five days of antibiotic therapy is being compared with 14 days. Outcome measures are the number of treatment failures in each group, number of patients improved, and the number of patients cured. In addition, a swab for culture of the nasopharynx is obtained before and after treatment to determine if antibiotic resistance is more prevalent in patients treated with longer courses of antibiotics.

Gene Expression in the Carrier State of Group A Streptococci

It has been recognized that some children carry the Group A streptococcus (GAS) in the pharynx and yet are asymptomatic. Carriage of GAS may confound the diagnosis of acute pharyngitis and may serve as a reservoir of infection to others. In this study, we seek to understand the differences in GAS between children who are infected and those who are carriers. We are identifying children who are carriers of GAS in a pediatric office practice. In collaboration with the UW Biotechnology Center, gene expression analysis using next-generation sequencing technology will be performed on swabs obtained from children who are acutely infected and from carriers.  Gene expression will be compared using statistical methods. Differences in gene expression will potentially identify proteins that may serve as markers of the carrier state.