Our division has become more internally specialized over the past 50 years in response to growing needs and has evolved to include the below clinical and research programs.
Antimicrobial Stewardship Program
In 2010, we established the Antimicrobial Stewardship Program in response to the increasing epidemic of drug resistant organisms in the hospital setting. Stewardship programs were formed in many hospitals in the country at this time, as the largely educational approach to use antibiotics rationally failed to reduce antibiotic overuse. The genesis of the program nationwide was to curb unnecessary antimicrobial use in order to reduce wasteful use of limited and non-renewable resources (e.g., antibiotics that are active against bacteria as they exist today), minimize harm to the patient (by avoiding unnecessary adverse reactions, superinfections, and Clostridia difficile infection) and avoid the never ceasing process of resistant microbes.
Our program received the Antimicrobial Stewardship Center of Excellence designation from the Infectious Diseases Society of America. This designation recognizes institutions that have the policies and processes in place to deliver high-quality stewardship services consistently, execute novel stewardship principles, and demonstrate a high-level commitment to improving antimicrobial use and reducing resistance.
Tejal Gandhi, MD serves as the medical director of our Antimicrobial Stewardship Program. The program provides general education services to clinical teams throughout the hospital, as well as individual feedback to physicians who have prescribed an antibiotic that does not meet established indications and advice on administering an effective, alternate antibiotic. Moreover, using a formulary of restricted antibiotics, the program has reduced inappropriate use of newer agents through a process of prior authorization. The program has resulted in a substantial reduction of inappropriate antibiotic use.
Fecal Microbiota Transplant Program
The Fecal Microbiota Transplant Program, established in 2013, was implemented to address the rising number of patients being diagnosed with recurrent Clostridium difficile infection, also called CDI or C. diff, a serious bacterial infection that can cause inflammation of the colon, diarrhea, fever, and abdominal cramps, and can sometimes result in death. C. diff primarily occurs when the indigenous bacteria in a person’s gut is removed by an antibiotic being used to treat a separate condition, thereby hindering the body’s ability to fight off the infection.
Fecal Microbiota Transplant (FMT) is a procedure where healthy fecal material is placed into a person infected with C. diff. The goal of the FMT procedure is to repopulate the colon with healthy bacteria and cure the person of the infection.
HIV/AIDS Treatment Program
In 1995, in response to the AIDS epidemic, we established the HIV/AIDS Treatment Program (HATP), with Powel H. Kazanjian, MD, PhD as the director. The program provides comprehensive care for the whole person, utilizing a multi-focused team approach that addresses not only the patient's medical needs, but also psychosocial needs.
Mission and Goals
Our HIV/AIDS Treatment Program describes its mission with three goals:
- Provide excellent comprehensive and longitudinal primary and specialty care for all people living with HIV/AIDS.
- Provide education and training along standards of quality related to HIV/AIDS care to other health providers, both within and outside of Michigan Medicine.
- Maintain an active clinical research program, offering expanded access to new and promising treatments for all people living with HIV/AIDS.
Meet the Team
- Powel Kazanjian, MD, PhD (Medical Director) – Division Chief and Professor of Internal Medicine, Professor of Epidemiology, and Professor of History
- Sandro Cinti, MD – Professor of Internal Medicine
- Tejal Gandhi, MD – Professor of Internal Medicine
- Kevin Gregg, MD – Professor of Internal Medicine
- Daniel Kaul, MD – Professor of Internal Medicine
- James Riddell IV, MD – Professor of Internal Medicine
In the past, we have focused our research efforts on the development of many of the antiretroviral medications that are presently in common use today. Currently, we are working on finding more long-term curative therapies by studying the HIV reservoir. In particular, we are interested in bone marrow stem cells as a reservoir site, as well as immune cells associated with the GI tract. We also are investigating strategies to improve HIV adherence in Mozambique. All of these studies are collaborative in nature and involve large teams leveraging their individual areas of expertise to solve complex problems.
- Powel Kazanjian, MD, PhD
- Sandro Cinti, MD
- Tejal Gandhi, MD
- Kevin Gregg, MD
- Daniel Kaul, MD
- James Riddell IV, MD
Our HIV/AIDS Treatment Program (HATP) has received funding from the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS Program since 1995. The Ryan White HIV/AIDS Program funds grants to states, cities/counties, and local community-based organizations to provide care and treatment services to people living with HIV to improve health outcomes and reduce HIV transmission among hard-to-reach populations.
Our program currently receives Ryan White HIV/AIDS Program Part C funding from HRSA and Part B funding through the Michigan Department of Health and Human Services (MDHHS). Additionally, MDHHS also funds the HATP for tobacco cessation services. The HATP is funded to provide primary medical care services, mental health services, psychiatric services, nutritional services, medical case management, and emergency financial assistance.
Please visit the HIV/AIDS Treatment Program on UofMHealth.org for more information.
Support Our Work
Making a gift to our program will support our research and understanding of HIV and AIDS in order to advance patient care. To make a gift, please visit the HIV/Aids Education & Research online giving page.
Multidisciplinary Endocarditis Team
Endocarditis is an infection of the heart valves which can cause severe illness involving many organ systems requiring a team approach to optimally care for patients with this infection. Our Multidisciplinary Endocarditis Team (MET), led by Sarah Kurz, MD, includes specialists from infectious diseases, cardiology, neurology, and cardiac surgery. In addition, we collaborate with internists, interventional radiologists, nuclear medicine physicians, addiction medicine providers, and other health care providers on an as needed basis. Since the multidisciplinary approach began, significant improvements to patient outcomes have been observed.
Overseas Travel Clinic
Transplant Infectious Disease Service
Many patients need to take medications to prevent rejection of their transplanted organ or to prevent “graft versus host disease”. This suppression of the immune system makes organ and stem cell transplant recipients susceptible to a variety of infections. In 2005, we established the Transplant Infectious Disease Service to provide expertise and institute protocols for the prevention and treatment of infection that can occur in transplant patients.
We provide inpatient and outpatient consultation and care to the Michigan Medicine Transplant Center, which performs over 300 transplants annually, making it the largest and most experienced transplant center in Michigan, and to the Bone Marrow Transplant Program, where over 200 adult stem cell transplants are performed annually. Our service also provides consultation to patients referred by physicians throughout the state of Michigan.
Daniel Kaul, MD, director of the program, leads a team of four Division of Infectious Diseases faculty members who specialize in infectious disease transplant care. Our team works closely with the transplant surgeons and the transplant support team to provide the best possible care to our patients.
Meet the Team
- Daniel Kaul, MD (Medical Director) – Professor of Internal Medicine – Publications
- Kevin Gregg, MD – Professor of Internal Medicine – Publications
- Marisa Miceli, MD – Professor of Internal Medicine – Publications
- Lindsay Petty, MD – Associate Professor of Internal Medicine – Publications
- James Riddell, MD – Professor of Internal Medicine – Publications