Russell Laboratory

Research Topics

• Prevention, diagnosis, and treatment of pediatric bacterial tracheostomy-associated respiratory tract infections
• Pediatric post-tracheotomy outcomes

Research Overview

The aim of Dr. Russell’s current research projects is to determine risk factors for development of bacterial respiratory tract infections in pediatric patients with tracheostomy. He hopes to develop evidence-based guidelines for prevention, diagnosis and treatment of bacterial respiratory tract infections in this vulnerable population. Despite being the most common potentially preventable condition for which pediatric patients with tracheostomy are hospitalized, there is little clinical research surrounding the prevention and management of respiratory infections in this population. Dr. Russell’s previous work in studying variations in treatment has demonstrated that children with tracheostomy hospitalized with bacterial respiratory tract infections have 30-day inpatient/ED readmission rates over 30% with variation in length of stay and resource utilization. This work has also led to identifying that patients less than 12 months old with certain complex chronic conditions and chronic ventilator dependency are at the highest risk for longer length of stay and hospital readmission within 30 days.

In addition, Dr. Russell’s work studying risk factors for bacterial tract infections after tracheostomy placement at CHLA has shown that post-tracheotomy Pseudomonas aeruginosa acquisition are associated with increased odds of readmission for bacterial respiratory tract infections within 12 months after tracheostomy placement. In a multi-center study, the data showed that young, Hispanic children with multiple complex chronic conditions who use Medicaid insurance and are discharged home have the highest risk of hospitalization for a bacterial respiratory tract infection after tracheotomy.

Dr. Russell is the Principal Investigator for a multicenter, prospective observational cohort study to evaluate how clinicians use clinical information to diagnose and treat suspected bacterial tracheostomy-associated infections and to identify factors associated with antibiotic overuse in this population. Dr. Russell’s research is currently supported by the Southern California Clinical and Translational Science Institute and the Gerber Foundation.

Lab Team

Christopher Russell, MD, MS, Principal Investigator
Dr. Christopher Russell oversees clinical research strategic initiatives and efforts for the Division of Hospital Medicine. The objective of his own research is to improve the prevention, diagnosis and treatment of bacterial respiratory tract infections in children with medical complexity. Most recently he was the recipient of a three-year award from the Gerber Foundation to support this work. In addition, he has piloted a working group within the division to design goals and projects focused on studying health disparities within the CHLA patient and provider population.

Journne Herrera, BS, Clinical Research Assistant
Journne Herrera completed her undergraduate studies at the University of California, Los Angeles. She collaborates closely with the research team to facilitate protocol development, data extraction and subject recruitment for studies involving children with medical complexities. She has experience in clinical and community-based research related to the social determinants of obesity in adolescents and behavioral health disparities in Filipino youth. She hopes to improve patient outcomes and quality of care in underrepresented communities through research.

Sabrina Sedano, BS, Clinical Research Assistant
Sabrina Sedano completed her undergraduate studies at the University of California, Riverside. She works collaboratively with the research teams on the PHIS+ Shunt Infection Prevention and CLIMB clinical studies of children with hydrocephalus. She is interested in helping improve the quality of care for children with medical complexities and promoting research among minority groups. She works closely with families participating in the research projects, as well as overseeing data workflow and archiving.

Publications

Featured Publications:

• Russell, CJ, Simon TD, Neely MN. Development of Chronic Pseudomonas aeruginosa-Positive Respiratory Cultures in Children with Tracheostomy. Lung. 2019 Dec. PMCID: PMC6934374. View in: PubMed  
• Miyakawa R, Barreto NB, Kato RM, Neely MN, Russell CJ; Early Use of Anti-influenza Medications in Hospitalized Children With Tracheostomy.; Pediatrics; 2019 View in: PubMed
• Russell CJ, Simon TD, Mamey MR, Newth CJL, Neely MN; Pseudomonas aeruginosa and post-tracheotomy bacterial respiratory tract infection readmissions.; Pediatric Pulmonology; 2017. View in: PubMed
• Russell CJ, Thurm C, Hall M, Simon TD, Neely MN, Berry JG; Risk factors for hospitalizations due to bacterial respiratory tract infections after tracheotomy.; Pediatric Pulmonology; 2018. View in: PubMed
• Russell CJ, Mack WJ, Schrager SM, Wu S; Care Variations and Outcomes for Children Hospitalized With Bacterial Tracheostomy-Associated Respiratory Infections.; Hospital Pediatrics; 2016. View in: PubMed

For full list of publications, view MyBibliography

Current Funding

• The Gerber Foundation
• Southern California Clinical and Translational Sciences Institute

Ongoing Projects

• Diagnosis and Treatment Patterns for Suspected Bacterial Tracheostomy-Associated INfections (bTRAINs)

A multicenter prospective study to describe diagnostic and antibiotic treatment patterns and clinical outcomes in children with tracheostomy being evaluated with bTRAINS. This observational study will follow patients with tracheostomy and associate diagnostic patterns with the primary outcome of bTRAIN treatment.

• Microbiome Analysis in Post-Tracheotomy Airway for the Diagnosis and Treatment of pediatric Bacterial Tracheostomy-Associated Infections

This study aims to differentiate post-tracheostomy airway microbiome patterns in asymptomatic states and bTRAIN states. The findings will inform clinical care by reducing antibiotic administration, development of antibiotic-resistant bacteria, and hospitalization for intravenous antibiotics.

Participating Sites

• Children’s National Medical Center
• Cincinnati Children’s Hospital Medical Center
• Johns Hopkins All Children’s Hospital
• Seattle Children’s Hospital
• University of Pittsburgh