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Thomas Murray, MD, PhD

Associate Professor of Pediatrics (Infectious Disease)

Contact Information

Thomas Murray, MD, PhD

Mailing Address

  • Pediatrics

    333 Cedar St PO Box 208064, PO Box 208035

    New Haven, CT 06520-8064

    United States

Yale Medicine

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Research Summary

Children with the genetic disease Cystic Fibrosis get multiple lung infections with a bacteria called Pseudomonas aeruginosa. These infections lead to frequent hospitalizations and a decreased quality of life for these children. Pseudomonas infections are difficult to treat because the bacteria form organized communities called biofilms that are often resistant to antibiotics. Dr Murray’s research focuses on understanding the optimal methods to disinfect home respiratory equipment that can be contaminated with Psreudomonas and other bacteria. Dr Murray also studies how the immune system in CF is altered when it interacts with Pseudomonas and is collaborating with Dr Emanuela Bruscia to study drugs that improve the immune response to bacteria for CF patients. The long term goal of this work is to find a fast, easy, relaibel disinfection method for families with CF and study novel drugs that may help treat and prevent CF lung infections and the inflammation that is involved.

Extensive Research Description

Pulmonary infection in cystic fibrosis (CF): Prevention, pathogenesis and treatment

Global Aim: Identify optimal methods to prevent and treat pulmonary infections in children with CF. There are two arms of the research program:1) Understanding the host/pathogen interaction and inflammation in CF; 2) Disinfection and infection prevention in the CF home and in the community

1) Understanding the host/pathogen interaction and inflammation in CF.

Increased inflammation in the CF lung contributes to premature patient morbidity and mortality. Both chronic infection and underlying dysfunction of the immune system in CF are fundamental to this increased inflammation. Heme-oygenase (HO), an enzyme that activates anti-inflammatory and anti-microbial cellular responses, is reduced in CF. Dr. Emanuela Bruscia and I are leading a team that is testing potential therapies (see below) to restore HO activity and reduce inflammation to normal levels. Furthermore, we are studying the interaction between Pseudomonas aeruginosa, a common CF pulmonary pathogen, and CF host cells to understand how chronic infection prevents the resolution of inflammation.

This work involves a novel drug, Sanguinate (Prolong pharmaceuticals), bovine hemoglobin saturated with carbon monoxide, as a potent anti-inflammatory and anti-microbial drug that, in vitro, can reduce the hyper-inflammation observed in CF macrophages via correcting the reduced expression of the

HO pathway. Future work will study whether Sanguinate has in vivo antimicrobial and anti-inflammatory properties in animal models of pulmonary infection. If successful, these studies will lay the groundwork for potential clinical trials partnering with the Cystic Fibrosis Foundation Therapeutic Drug Network.

2) Disinfection and infection prevention in the CF home and community.

The burden of home care for children and families with CF is extensive, requiring multiple daily treatments. Home respiratory equipment can be contaminated with lung pathogens, providing a potential source of re-infection with each nebulization. I have studied how different home disinfection techniques kill common CF bacterial pathogens on nebulizers and whether repeated disinfection with these methods changes nebulizer function. Recently, this disinfection research has extended beyond CF to the community, studying bacterial contamination from hand dryers in bathrooms to determine optimal hand drying techniques.

Future questions regarding infection prevention that my team is working on include: 1) What is the risk to patients for aerosolizing bacteria on home nebulizer equipment? Few studies have examined the factors, (e.g. biofilm formation, hydration) that impact bacterial dispersion during nebulization. 2) Do all disinfection methods work equally well on clinical isolates? We will test clinical CF bacterial isolates under different disinfection conditions to determine the preferred method. 3) Do user friendly disinfection methods result in improved patient quality of life? We will measure compliance and the burden of home care for different disinfection methods. We anticipate that the results of these studies will be generalizable beyond the CF population and impact families with other diseases that require home nebulizers. I continue to study infection prevention in the community comparing bacterial contamination from different hand drying methods, forced air hand dryers or paper towels, with a focus on anaerobic bacteria including Clostridium difficile. This work will help determine best practice hand drying techniques.

Coauthors

Research Interests

Pediatrics

Public Health Interests

Infectious Diseases

Research Image

mucoid Pseudomonas aeruginosa

A clinical strain from a patient with Cystic Fibrosis

Selected Publications

  • Shifting focus toward healthcare-associated bloodstream infections: The need for neonatal intensive care unit-specific NHSN definitions.Advani SD, Murray TS, Murdzek CM, Aniskiewicz MJ, Bizzarro MJ. Shifting focus toward healthcare-associated bloodstream infections: The need for neonatal intensive care unit-specific NHSN definitions. Infection Control And Hospital Epidemiology 2020, 41: 181-186. PMID: 31694731, DOI: 10.1017/ice.2019.310.
  • The Ethics of Fecal Microbiota Transplant as a Tool for Antimicrobial Stewardship Programs.Murray TS, Herbst J. The Ethics of Fecal Microbiota Transplant as a Tool for Antimicrobial Stewardship Programs. The Journal Of Law, Medicine & Ethics : A Journal Of The American Society Of Law, Medicine & Ethics 2019, 47: 541-554. PMID: 31957576, DOI: 10.1177/1073110519897730.
  • Oxygen nipple and nut (Christmas tree) adaptor contamination rates and decontamination with disinfecting wipes.Colandrea NA, Cleary ML, Peaper DR, Sullivan LK, Martinello RA, Murray TS. Oxygen nipple and nut (Christmas tree) adaptor contamination rates and decontamination with disinfecting wipes. Infection Control And Hospital Epidemiology 2020, 41: 396-399. PMID: 31983357, DOI: 10.1017/ice.2020.9.
  • Targeting the Heme Oxygenase 1/Carbon Monoxide Pathway to Resolve Lung Hyper-Inflammation and Restore a Regulated Immune Response in Cystic Fibrosis.Di Pietro C, Öz HH, Murray TS, Bruscia EM. Targeting the Heme Oxygenase 1/Carbon Monoxide Pathway to Resolve Lung Hyper-Inflammation and Restore a Regulated Immune Response in Cystic Fibrosis. Frontiers In Pharmacology 2020, 11: 1059. PMID: 32760278, PMCID: PMC7372134, DOI: 10.3389/fphar.2020.01059.
  • Unmasking symptomatic dermatographism in the time of COVID-19.Wong KH, Murray T, Osborn R, Soffer GK. Unmasking symptomatic dermatographism in the time of COVID-19. Postgraduate Medical Journal 2021, 97: 402. PMID: 32913035, DOI: 10.1136/postgradmedj-2020-138688.
  • COVID-19 Transmission in US Child Care Programs.Gilliam WS, Malik AA, Shafiq M, Klotz M, Reyes C, Humphries JE, Murray T, Elharake JA, Wilkinson D, Omer SB. COVID-19 Transmission in US Child Care Programs. Pediatrics 2021, 147 PMID: 33055228, DOI: 10.1542/peds.2020-031971.
  • Severe Acute Respiratory Syndrome Coronavirus 2 Testing in Children in a Large Regional US Health System During the Coronavirus Disease 2019 Pandemic.Peaper DR, Murdzek C, Oliveira CR, Murray TS. Severe Acute Respiratory Syndrome Coronavirus 2 Testing in Children in a Large Regional US Health System During the Coronavirus Disease 2019 Pandemic. The Pediatric Infectious Disease Journal 2021, 40: 175-181. PMID: 33399431, PMCID: PMC8852689, DOI: 10.1097/INF.0000000000003024.
  • Mass severe acute respiratory coronavirus 2 (SARS-CoV-2) testing of asymptomatic healthcare personnel.Roberts SC, Peaper DR, Thorne CD, Sussman LS, Murray TS, Choi SJ, Pettker CM, Russi MB, Martinello RA. Mass severe acute respiratory coronavirus 2 (SARS-CoV-2) testing of asymptomatic healthcare personnel. Infection Control And Hospital Epidemiology 2021, 42: 625-626. PMID: 33487206, PMCID: PMC7853752, DOI: 10.1017/ice.2021.9.
  • Mass severe acute respiratory coronavirus 2 (SARS-CoV-2) testing of asymptomatic healthcare personnel - ERRATUM.Roberts SC, Peaper DR, Thorne CD, Sussman LS, Murray TS, Choi SJ, Pettker CM, Russi MB, Martinello RA. Mass severe acute respiratory coronavirus 2 (SARS-CoV-2) testing of asymptomatic healthcare personnel - ERRATUM. Infection Control And Hospital Epidemiology 2021, 1. PMID: 33779533, DOI: 10.1017/ice.2021.107.
  • Persistent Leg Drainage in a Pediatric Trauma Patient.Howard A, Rychalsky MR, Murray TS. Persistent Leg Drainage in a Pediatric Trauma Patient. The Pediatric Infectious Disease Journal 2021, 40: 597-599. PMID: 33956759, DOI: 10.1097/INF.0000000000003004.
  • Incidence of Multisystem Inflammatory Syndrome in Children Among US Persons Infected With SARS-CoV-2.Payne AB, Gilani Z, Godfred-Cato S, Belay ED, Feldstein LR, Patel MM, Randolph AG, Newhams M, Thomas D, Magleby R, Hsu K, Burns M, Dufort E, Maxted A, Pietrowski M, Longenberger A, Bidol S, Henderson J, Sosa L, Edmundson A, Tobin-D'Angelo M, Edison L, Heidemann S, Singh AR, Giuliano JS, Kleinman LC, Tarquinio KM, Walsh RF, Fitzgerald JC, Clouser KN, Gertz SJ, Carroll RW, Carroll CL, Hoots BE, Reed C, Dahlgren FS, Oster ME, Pierce TJ, Curns AT, Langley GE, Campbell AP, Balachandran N, Murray TS, Burkholder C, Brancard T, Lifshitz J, Leach D, Charpie I, Tice C, Coffin SE, Perella D, Jones K, Marohn KL, Yager PH, Fernandes ND, Flori HR, Koncicki ML, Walker KS, Di Pentima MC, Li S, Horwitz SM, Gaur S, Coffey DC, Harwayne-Gidansky I, Hymes SR, Thomas NJ, Ackerman KG, Cholette JM. Incidence of Multisystem Inflammatory Syndrome in Children Among US Persons Infected With SARS-CoV-2. JAMA Network Open 2021, 4: e2116420. PMID: 34110391, PMCID: PMC8193431, DOI: 10.1001/jamanetworkopen.2021.16420.
  • COVID-19 Vaccine Uptake Among US Child Care Providers.Patel KM, Malik AA, Lee A, Klotz M, Humphries JE, Murray T, Wilkinson D, Shafiq M, Yildirim I, Elharake JA, Diaz R, Reyes C, Omer SB, Gilliam WS. COVID-19 Vaccine Uptake Among US Child Care Providers. Pediatrics 2021, 148 PMID: 34452977, DOI: 10.1542/peds.2021-053813.
  • Association of Child Masking With COVID-19-Related Closures in US Childcare Programs.Murray TS, Malik AA, Shafiq M, Lee A, Harris C, Klotz M, Humphries JE, Patel KM, Wilkinson D, Yildirim I, Elharake JA, Diaz R, Reyes C, Omer SB, Gilliam WS. Association of Child Masking With COVID-19-Related Closures in US Childcare Programs. JAMA Network Open 2022, 5: e2141227. PMID: 35084484, PMCID: PMC8796014, DOI: 10.1001/jamanetworkopen.2021.41227.
  • Bacterial Surface Detachment during Nebulization with Contaminated Reusable Home Nebulizers.Harris JC, Collins MS, Huang PH, Schramm CM, Nero T, Yan J, Murray TS. Bacterial Surface Detachment during Nebulization with Contaminated Reusable Home Nebulizers. Microbiology Spectrum 2022, 10: e0253521. PMID: 35107362, PMCID: PMC8809330, DOI: 10.1128/spectrum.02535-21.
  • Telehealth Reduces Missed Appointments in Pediatric Patients with Tuberculosis Infection.Zhao A, Butala N, Luc CM, Feinn R, Murray TS. Telehealth Reduces Missed Appointments in Pediatric Patients with Tuberculosis Infection. Tropical Medicine And Infectious Disease 2022, 7 PMID: 35202221, PMCID: PMC8877294, DOI: 10.3390/tropicalmed7020026.
  • A mixed-methods evaluation on the efficacy and perceptions of needleless connector disinfectants.Roberts SC, Hendrix CA, Edwards LM, Feinn RS, Martinello RA, Murray TS. A mixed-methods evaluation on the efficacy and perceptions of needleless connector disinfectants. Infection Control And Hospital Epidemiology 2022, 1-4. PMID: 35387702, DOI: 10.1017/ice.2022.72.
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