2024-2025 review

Dr. Powel Kazanjian - Nearly Two Decades of Leadership

After nearly two decades of leadership, Powel Kazanjian, MD, stepped down as chief of the division. Throughout his tenure he led the division to tremendous success. Dr. Kazanjian developed innovative programs such as the Multidisciplinary Endocarditis Program, Antibiotic Stewardship, HIV/AIDS Treatment Program, Transplant Infectious Disease Service, and telemedicine outreach. In addition, several faculty members were inducted into prestigious groups including the American Society of Clinical Investigation and National Academy of Medicine under his mentorship. "I consider myself blessed to have worked with wonderful students, residents, fellows, and colleagues each point along the way," stated Dr. Kazanjian. During his last year as chief, Dr. Kazanjian made strides in his research on the history of transmittable infectious diseases like HIV, syphilis, and botulism, as well as the history of American bacteriology. He published his book, Persisting Pandemics: Syphilis, AIDS, and COVID, which examines the persistence of pandemics despite the use of public health tools to eradicate them. Dr. Kazanjian leaves behind a legacy as division chief, Michigan Medicine, and the University of Michigan community with his scholarly contributions and teachings in medical history.

Patient Care highlights

We diagnose, treat, and help prevent the spread of illnesses caused by viruses, bacteria, and other pathogens. With over 6,500 consultations per year, we are the highest volume service at the University of Michigan Health System.

New Atypical Mycobacteria Clinic

Over the last two years, we launched our Bronchiectasis and Nontuberculous Mycobacteria Clinic. Led by Anastasia Wasylyshyn, MD, and Sarah Brown, MD, the clinic cares for patients with nontuberculous mycobacterial pulmonary disease and bronchiectasis and has increased utilization and decreased wait times.

Progress in Antifungal Treatments

Our division continued its work toward investigating new treatments against mold, fungi, and other rare and resistant fungal infections. Under the direction of Marisa Miceli, MD, we gained access to a new generation of medications and innovative delivery methods through clinical trials—offering hope to patients who previously had few or no treatment options.

Improving Quality and Safety with Complex Outpatient Antimicrobial Therapy

Our Complex Outpatient Antimicrobial Therapy (COpAT) Program was created to improve the quality and safety of care for patients discharged on antibiotics, especially those with bone and joint infections. Under the leadership of Shiwei Zhou, MD, we increased oral antibiotic use, decreased central venous catheter use, and conducted outreach to manage side effects which has greatly reduced length of stay and readmission rates. Since the program's inception, we were able to exceed the goals we initially set:

• Enrolled 77 patients into COpAT.
• Increased oral and long-acting antibiotic utilization by 46%.
• Decreased 30-day readmission rate by 5%.
• Decreased antibiotic and line-associated adverse events by 6%.
• Decreased median length of stay from eight to six days.

Advancing Endocarditis Treatment with Multidisciplinary Care

Endocarditis, an infection of the heart valves, can lead to severe complications across multiple organ systems. Our Multidisciplinary Endocarditis Team Director, Sarah Kurz, MD; and Co-Leader, Jamie Riddell IV, MD, have continued to collaborate on infective endocarditis treatment through interdisciplinary meetings and continuous communication with cardiology and cardiothoracic surgery. As a result:

• in-hospital mortality for infective endocarditis patients decreased below 10%.
• length of stay decreased by five to six days per patient.
• more than 70% of patients are now receiving the operations they need, compared with only 30–40% previously.

Advancing HIV/AIDS Treatment

Started by Powel Kazanjian, MD, 29 years ago, our HIV/AIDS Treatment Program (HATP) has provided exceptional care to this vulnerable and stigmatized patient population. Today, the HATP is led by Jamie Riddell IV, MD, and includes two medical assistants, four social workers, a health educator or tobacco treatment specialist, a nutritionist, data lead, and six dedicated faculty members. In addition to regular office visits, the HATP provides patients with access to mental health services, health education, social support, and financial assistance.

research highlights

Genomics of Infectious Disease Pathogens

In 2024, the National Institutes of Health granted the division $10 million to help accelerate the understanding of pathogens that threaten human life. The award was given to establish the Michigan Infectious Disease Genomics (MIDGE) Center for use of whole genome sequencing and functional genomic assays to determine how genetic differences among strains or isolates affect the behavior, transmission, and drug resistance of viral, bacterial, and fungal pathogens. Under lead investigators - Adam Lauring, MD, PhD; Evan Snitkin, PhD; and Teresa O’Meara, PhD, the multidisciplinary team has studied a wide range of disease threats such as SARS-VoV2, influenza, carbapenem resistant Enterobacteriales, and Candida auris, that account for millions of infections and deaths in our communities each year. “Our goal is to identify the genetic differences – the mutations – in pathogens that are circulating in our communities in order to figure out what makes them better at transmitting from one person to another, better at becoming resistant to our drugs, or in some cases, cause more severe disease” stated Dr. Adam Lauring.

New Findings in HIV Research

New findings in HIV research have offered a path forward in the development of drugs that could potentially help cure HIV. Research by Kathleen Collins, MD, and her lab, published in JCI Insight and Nature Communications, revealed that HIV latency is driven by limited viral factors like Trans-activator of transcription (or Tat), which can be overcome to reactivate latent virus and viral protein R (Vpr) facilitates viral spread by degrading PU.1, weakening immune defenses. Other work has shown that HIV manipulates endosomal acidification by reducing NHE6 to promote immune evasion, with distinct roles for the Vif and Nef proteins in this process.

Continued COVID-19 Research

Our division continues to investigate COVID-19, its variants, and its effect on vulnerable patient populations:

• Adam Lauring, MD, PhD, continued genomic surveillance activities, tracking different variants of SARS-CoV-2 circulating in Michigan and the populations affected. In addition, our division completed its fourth year of participating in the CDC-sponsored Influenza and Other Viruses in the Acutely Ill (IVY) Network, which assesses clinical outcomes of individuals hospitalized with COVID-19, influenza, and respiratory syncytial virus (RSV) infection.
• In an article for The Conversation, Powel Kazanjian, MD, explored how COVID-19 mirrors past epidemics in demonstrating that scientific advances alone are insufficient to eradicate disease. His analysis underscored the critical role of socioeconomic and political forces in shaping public health responses and outcomes. "The evolution of the COVID-19 pandemic – from devastation to optimism for eradication, to persistent, uneven spread of disease – may seem unprecedented. As an infectious disease doctor and medical historian, however, I see similarities to other epidemics, including syphilis, AIDS and tuberculosis. Vaccines, medications and other biomedical breakthroughs are necessary to eliminate epidemic diseases," stated Dr. Kazanjian.

Tracking New Respiratory Viruses Across Michigan

Adam Lauring, MD, PhD, and his team performed surveillance that track new respiratory viruses and strains in the state. Their work has been crucial for presenting communities with vaccination guidelines and other preventative measures, as well as ensuring vaccine coverage. His team also participated in national surveillance networks that evaluate vaccine effectiveness, deliver data to government entities to inform public policy, and provide timely alerts about impending outbreaks. When a viral influenza strain sweeps through Michigan, timely public warnings alert parents so they can quickly obtain a flu shot and prevent complications or hospitalization. The team has also looked to collaborate on tracking influenza in wild animals in Michigan's poultry and dairy farms to guide timely health measures and protect families now and in the future. In a study published in the New England Journal of Medicine, co-authored by Dr. Lauring, showed one dose of an antiviral medication lowers the chance of transmitting influenza to family members by about 30% - significantly slowing the viral shedding that infects close contacts.

Artificial Intelligence Guidance for Reducing Clostridioides Difficile

Krishna Rao, MD, co-authored a study in JAMA Network Open on artificial intelligence (AI) guidance for clinicians aimed at reducing the spread of Clostridioides difficile, a deadly bacterium. The protocol significantly reduced antibiotic prescriptions, a factor that increases infection risk for vulnerable patients, with 10-15% fewer days on antimicrobials, and did not increase length of stay, readmission rate, or mortality. Applied to never-before-seen patients, predictions aligned with true risk, showing the model worked. When trained specifically for Michigan Medicine, comparing the year-long intervention with the pre-AI period, Clostridioides difficile trended downward from 5.76 to 5.65 per 10,000 patient days.

Biomarker Study for Reducing Ventilator-Associated Pneumonia

The current guideline-recommended antibiotic treatment durations for ventilator-associated pneumonia have posed risks of overtreatment-promoting antimicrobial resistance and adverse drug events, as well as undertreatment, and have increased the likelihood of pneumonia recurrence and sepsis-related complications. The Ventilator-associated pneumonia Biomarker Evaluation (or VIBE) study, led by Owen Albin, MD, and other University of Michigan researchers, aimed to identify an alveolar biomarker signature associated with treatment response and informing antibiotic duration in future clinical trials.

Education highlights

Our mission of uniting clinical excellence with innovative teaching to cultivate the next generation of leaders continues to grow. Through dynamic learning environments, mentorship, and collaboration, we equip trainees with the knowledge and skills to advance patient care and discovery. Some of our highlights include:

• Our Infectious Diseases Fellowship Program has graduated over 100 trainees and is one of the leading programs in the country dedicated to preparing physicians for excellence in the diagnosis and management of infectious diseases and to advancing the field through research and education.
• In 2024, two fellows - Louis Saravolatz, MD, and Elizabeth Scruggs-Wodkowski, MD - accepted positions within our division.
• Emily Abodler, MD, served on the Infectious Diseases Society of America's Medical Education Community of Practice Working Groups, holding the position of vice-chair of a working group.
• Owen Albin, MD, was recognized for his contributions to teaching in the medical school to residency transition program.
• Adam Lauring, MD, PhD, was elected to the fellowship in the American Academy of Microbiology - which recognizes excellence, originality, service, and leadership in the microbial sciences.
• Danica Rockney, MD and Marten Hawkins, MD, were appointed as assistant program directors for the fellowship program, focusing on curriculum, mentorship, and stewardship education.
• Shiwei Zhou, MD, was accepted to participate in the Community of Leaders Program in the Infectious Diseases Society of America Leadership Academy.

Bridging Clinical Education Across Continents

Elizabeth Scruggs-Wodkowski, MD, traveled to Okinawa and Kyoto, Japan in 2025 as part of an international visiting professorship for the University of Michigan and the Ann Arbor Veterans Affairs' Health System. She provided teaching through case-based monitoring report style sessions with residents in the Muribushi Residency Teaching Program. Throughout her stay, Dr. Scruggs-Wodkowski visited eight hospitals on the island and participated in case conferences with residents in groups of 10-40 per session. She also rounded with the infectious diseases team at Kyoto University Hospital, which included a trip to their microbiology lab.