Drug Resistance; Pneumonia; Respiratory Tract Infections; Infection Control; Pulmonary Disease, Chronic Obstructive
Status of Women in Medicine Committee (SWIM)
Yale Institute for Global Health
Professor Pettigrew's research focuses on pathobionts of the respiratory tract (e.g., Streptococcus pneumoniae and Haemophilus influenzae) and the growing public health threat of antibiotic resistance. Her current work utilizes a combined approach involving microbiology and infectious disease epidemiology to identify factors that influence whether pathobionts asymptomatically colonize or cause diseases such as pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD). Additional projects focus on how disruptions of homeostasis in the respiratory and gastrointestinal microbiota influence colonization resistance, development of antibiotic resistance, and risk of hospital-acquired infections.
Extensive Research Description
My research focuses on Streptococcus pneumoniae and non-typeable Haemophilus influenzae. The bacteria that I study asymptomatically colonize the respiratory tract of 10-50% of healthy individuals. While asymptomatic colonization is far more common than disease, S. pneumoniae and H. influenzae are important causes of bacterial infections in children and adults (e.g., otitis media, pneumonia, and exacerbations of chronic obstructive pulmonary disease (COPD)). Moreover, these infections are frequently, and controversially, treated with antibiotics. We use state-of-the-art methods that integrate clinical epidemiologic, and laboratory studies to elucidate factors that tip the balance between asymptomatic bacterial colonization and disease.
Additional projects focus on how disruptions of homeostasis in the respiratory and gastrointestinal microbiota influence colonization resistance, development of antibiotic resistance, and risk of hospital-acquired infections. We use data and specimens from clinical epidemiologic studies and next-generation sequencing methods to address several key questions including: 1) How does the duration of antibiotic use impact the prevalence of antibiotic resistance genes in the respiratory and gastrointestinal microbiota? 2) How do antibiotic induced changes in the composition and diversity of the gastrointestinal microbiota contribute to antibiotic-associated diarrhea? and 3) How does the diversity and composition of the microbiota relate to risk of colonization, expansion, and infection due to antibiotic-resistant pathogens? Over the long-term, our research will help identify new methods to exploit protective mechanisms provided by an intact microbiota and lead to new interventions to prevent development of antibiotic resistance and hospital-acquired infections.
Effect of fluoroquinolones and macrolides on eradication of Haemophilus influenzae and development of antibiotic resistance in chronic obstructive. pulmonary disease
Pettigrew, M.M., Tsuji, B, Gent, J. F., Jones, M. M., Sethi, S., Kong, Y., and Murphy, T.M. Antimicrobial Agents and Chemotherapy. 2016; 60:4151-8.
The human microbiota: novel targets for hospital acquired infections and antibiotic resistance.
Pettigrew, M.M., Johnson, J.K. and Harris, A.D. Annals of Epidemiology. 2016; 26:342-7.
Innovating in health care management education: Development of an accelerated MBA/MPH degree program at Yale.
Pettigrew, M.M., Forman, H.P., Pistell, A.F., and Nembhard, I.M. American Journal of Public Health. 2015; 105:S68-S72.
Changes in the pneumococcal transcriptome during transition from biofilm formation to invasive disease upon influenza A virus infection.
Pettigrew, M.M., Marks, L.R., Kong, Y., Gent, J. F. and Hakansson. Infection and Immunity. A.P. 2014; 82:4607-19.
Antibacterial resistance leadership group: Open for business.
Chambers, H. F., Bartlett, J. G., Bonomo, R. A., Cosgrove, S., Cross, H., Daum, R.S., Evans, S.R., Kreiswirth, B.N., Lautenbach, E., Patel, R., Pettigrew, M.M., Rodvoid, K., Spelling, B., and Fowler, V.G. Clinical Infectious Diseases. 2014; 58:1571-6.
Upper respiratory tract microbial communities, acute otitis media pathogens and antibiotic use in healthy and sick children.
Pettigrew, M.M., Laufer, A.S., Gent, J.F., Fennie, K.P., Kong, Y. and Metlay, J.P. Applied and Environmental Microbiology. 2012; 78:6262-70.
Microbial communities of the upper respiratory tract and otitis media.
Laufer, A.S., Metlay, J.P., Gent, J.F., Fennie, K.P., Kong, Y. and Pettigrew, M.M. mBio. 2011; 2: e00245-10.
Full List of PubMed Publications
- Blanco N, Harris AD, Rock C, Johnson JK, Pineles L, Bonomo RA, Srinivasan A, Pettigrew MM, Thom KA, the CDC Epicenters Program.: Risk Factors and Outcomes Associated with Multidrug-Resistant Acinetobacter baumannii upon Intensive Care Unit Admission. Antimicrob Agents Chemother. 2018 Jan; 2017 Dec 21. PMID: 29133567
- Murphy TF, Kirkham C, Gallo MC, Yang Y, Wilding GE, Pettigrew MM: Immunoglobulin A Protease Variants Facilitate Intracellular Survival in Epithelial Cells By Nontypeable Haemophilus influenzae That Persist in the Human Respiratory Tract in Chronic Obstructive Pulmonary Disease. J Infect Dis. 2017 Dec 5. PMID: 28968876
- Tsuji BT, Fisher J, Boadi-Yeboah R, Holden PN, Sethi S, Pettigrew MM, Murphy TF: Azithromycin Pharmacodynamics against 'Persistent' Haemophilus influenza in Chronic Obstructive Pulmonary Disease. Antimicrob Agents Chemother. 2017 Nov 27; 2017 Nov 27. PMID: 29180527
- Pettigrew MM, Alderson MR, Bakaletz LO, Barenkamp SJ, Hakansson AP, Mason KM, Nokso-Koivisto J, Patel J, Pelton SI, Murphy TF: Panel 6: Vaccines. Otolaryngol Head Neck Surg. 2017 Apr. PMID: 28372533
- Barenkamp SJ, Chonmaitree T, Hakansson AP, Heikkinen T, King S, Nokso-Koivisto J, Novotny LA, Patel JA, Pettigrew M, Swords WE: Panel 4: Report of the Microbiology Panel. Otolaryngol Head Neck Surg. 2017 Apr. PMID: 28372529
- Otsuka T, Brauer AL, Kirkham C, Sully EK, Pettigrew MM, Kong Y, Geller BL, Murphy TF: Antimicrobial activity of antisense peptide-peptide nucleic acid conjugates against non-typeable Haemophilus influenzae in planktonic and biofilm forms. J Antimicrob Chemother. 2017 Jan; 2016 Sep 28. PMID: 27986898
- Lewnard JA, Huppert A, Givon-Lavi N, Pettigrew MM, Regev-Yochay G, Dagan R, Weinberger DM: Density, Serotype Diversity, and Fitness of Streptococcus pneumoniae in Upper Respiratory Tract Cocolonization With Nontypeable Haemophilus influenzae. J Infect Dis. 2016 Nov 1; 2016 Aug 17. PMID: 27540112
- Niccolai LM, Pettigrew MM: The Role of Cognitive Bias in Suboptimal HPV Vaccine Uptake. Pediatrics. 2016 Oct; 2016 Sep 9. PMID: 27613774
- Pettigrew MM, Gent JF, Kong Y, Wade M, Gansebom S, Bramley AM, Jain S, Arnold SL, McCullers JA: Association of sputum microbiota profiles with severity of community-acquired pneumonia in children. BMC Infect Dis. 2016 Jul 8; 2016 Jul 8. PMID: 27391033
- Pettigrew MM, Tsuji BT, Gent JF, Kong Y, Holden PN, Sethi S, Murphy TF: Effect of Fluoroquinolones and Macrolides on Eradication and Resistance of Haemophilus influenzae in Chronic Obstructive Pulmonary Disease. Antimicrob Agents Chemother. 2016 Jul; 2016 Jun 20. PMID: 27139476
- Lewnard JA, Givon-Lavi N, Huppert A, Pettigrew MM, Regev-Yochay G, Dagan R, Weinberger DM: Epidemiological Markers for Interactions Among Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in Upper Respiratory Tract Carriage. J Infect Dis. 2016 May 15; 2015 Dec 23. PMID: 26704617
- Pettigrew MM, Johnson JK, Harris AD: The human microbiota: novel targets for hospital-acquired infections and antibiotic resistance. Ann Epidemiol. 2016 May; 2016 Mar 8. PMID: 26994507
- Murphy TF, Kirkham C, Jones MM, Sethi S, Kong Y, Pettigrew MM: Expression of IgA Proteases by Haemophilus influenzae in the Respiratory Tract of Adults With Chronic Obstructive Pulmonary Disease. J Infect Dis. 2015 Dec 1; 2015 May 20. PMID: 25995193
- Pettigrew MM, Forman HP, Pistell AF, Nembhard IM: Innovating in health care management education: development of an accelerated MBA and MPH degree program at Yale. Am J Public Health. 2015 Mar. PMID: 25706023
- Chao Y, Marks LR, Pettigrew MM, Hakansson AP: Streptococcus pneumoniae biofilm formation and dispersion during colonization and disease. Front Cell Infect Microbiol. 2014; 2015 Jan 13. PMID: 25629011
- Pettigrew MM, Marks LR, Kong Y, Gent JF, Roche-Hakansson H, Hakansson AP: Dynamic changes in the Streptococcus pneumoniae transcriptome during transition from biofilm formation to invasive disease upon influenza A virus infection. Infect Immun. 2014 Nov; 2014 Aug 18. PMID: 25135685
- Huang E, Gurzau AE, Hanson BM, Kates AE, Smith TC, Pettigrew MM, Spinu M, Rabinowitz PM: Detection of livestock-associated methicillin-resistant Staphylococcus aureus among swine workers in Romania. J Infect Public Health. 2014 Jul-Aug; 2014 May 10. PMID: 24821273
- Pettigrew MM, Laufer AS, Gent JF, Kong Y, Fennie KP, Metlay JP: Upper respiratory tract microbial communities, acute otitis media pathogens, and antibiotic use in healthy and sick children. Appl Environ Microbiol. 2012 Sep; 2012 Jun 29. PMID: 22752171
- Tekle YI, Nielsen KM, Liu J, Pettigrew MM, Meyers LA, Galvani AP, Townsend JP: Controlling antimicrobial resistance through targeted, vaccine-induced replacement of strains. PLoS One. 2012; 2012 Dec 5. PMID: 23227198
- Biello KB, Pettigrew MM, Niccolai LM: Multiple chlamydia infection among young women: comparing the role of individual- and neighbourhood-level measures of socioeconomic status. Sex Transm Infect. 2011 Dec; 2011 Sep 21. PMID: 21940727
- Pettigrew MM, Gent JF, Pyles RB, Miller AL, Nokso-Koivisto J, Chonmaitree T: Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection. J Clin Microbiol. 2011 Nov; 2011 Sep 7. PMID: 21900518
- Thomas JC, Figueira M, Fennie KP, Laufer AS, Kong Y, Pichichero ME, Pelton SI, Pettigrew MM: Streptococcus pneumoniae clonal complex 199: genetic diversity and tissue-specific virulence. PLoS One. 2011 Apr 14; 2011 Apr 14. PMID: 21533186
- Niccolai LM, Livingston KA, Laufer AS, Pettigrew MM: Behavioural sources of repeat Chlamydia trachomatis infections: importance of different sex partners. Sex Transm Infect. 2011 Apr; 2011 Jan 6. PMID: 21212380
- Laufer AS, Metlay JP, Gent JF, Fennie KP, Kong Y, Pettigrew MM: Microbial communities of the upper respiratory tract and otitis media in children. MBio. 2011 Feb 1; 2011 Feb 1. PMID: 21285435
- Laufer AS, Thomas JC, Figueira M, Gent JF, Pelton SI, Pettigrew MM: Capacity of serotype 19A and 15B/C Streptococcus pneumoniae isolates for experimental otitis media: Implications for the conjugate vaccine. Vaccine. 2010 Mar 11; 2010 Jan 10. PMID: 20067753
- Foulkes HB, Pettigrew MM, Livingston KA, Niccolai LM: Comparison of sexual partnership characteristics and associations with inconsistent condom use among a sample of adolescents and adult women diagnosed with Chlamydia trachomatis. J Womens Health (Larchmt). 2009 Mar. PMID: 19245304
- Thomas JC, Pettigrew MM: Multilocus sequence typing and pulsed field gel electrophoresis of otitis media causing pathogens. Methods Mol Biol. 2009. PMID: 18839348
- Pettigrew MM, Gent JF, Revai K, Patel JA, Chonmaitree T: Microbial interactions during upper respiratory tract infections. Emerg Infect Dis. 2008 Oct. PMID: 18826823
- Niccolai LM, Livingston KA, Teng FF, Pettigrew MM: Behavioral intentions in sexual partnerships following a diagnosis of Chlamydia trachomatis. Prev Med. 2008 Feb; 2007 Sep 4. PMID: 17936349
- Pettigrew MM, Gent JF, Zhu Y, Triche EW, Belanger KD, Holford TR, Bracken MB, Leaderer BP: Respiratory symptoms among infants at risk for asthma: association with surfactant protein A haplotypes. BMC Med Genet. 2007 Apr 2; 2007 Apr 2. PMID: 17407567
- Pettigrew MM, Gent JF, Zhu Y, Triche EW, Belanger KD, Holford TR, Bracken MB, Leaderer BP: Association of surfactant protein A polymorphisms with otitis media in infants at risk for asthma. BMC Med Genet. 2006 Aug 2; 2006 Aug 2. PMID: 16884531
- Pettigrew MM, Fennie KP, York MP, Daniels J, Ghaffar F: Variation in the presence of neuraminidase genes among Streptococcus pneumoniae isolates with identical sequence types. Infect Immun. 2006 Jun. PMID: 16714565
- Pettigrew MM, Fennie KP: Genomic subtraction followed by dot blot screening of Streptococcus pneumoniae clinical and carriage isolates identifies genetic differences associated with strains that cause otitis media. Infect Immun. 2005 May. PMID: 15845484
- Pettigrew MM, Gent JF, Triche EW, Belanger KD, Bracken MB, Leaderer BP: Association of early-onset otitis media in infants and exposure to household mould. Paediatr Perinat Epidemiol. 2004 Nov. PMID: 15535820
- Pettigrew MM: An array of diverse microbial genomes. Trends Biotechnol. 2004 Oct. PMID: 15450738
- Pettigrew MM, Gent JF, Triche EW, Belanger KD, Bracken MB, Leaderer BP: Infant otitis media and the use of secondary heating sources. Epidemiology. 2004 Jan. PMID: 14712142