Pediatric Research

David A. Hunstad, M.D. dhunstad@wustl.edu

Division Chief, Infectious Diseases

Professor, Infectious Diseases

Professor, Molecular Microbiology

View my lab

Infectious Diseases Molecular Microbiology

phone: (314) 454-6050

Research Interests

Dr. Hunstad evaluates children on the Infectious Diseases service at St. Louis Children's Hospital. With his research team in the McDonnell Pediatric Research Building and Northwest Tower, he studies the interactions of Gram-negative bacteria with their hosts. He is particularly interested in mechanisms by which Gram-negative pathogens modulate host immune responses in order to establish infection. Related projects in the laboratory explore how chaperone proteins help bacteria to assemble virulence factors on their surfaces, and how bacterial adhesins can be leveraged to deliver antimicrobials to bacteria residing in host epithelia. His goal is to develop new targets for prevention and treatment of Gram-negative bacterial infections of the urinary tract, gastrointestinal tract, and central nervous system. He is the Director of the Pediatric ID Division and co-founded the Wash U Pediatric Physician-Scientist Training Program with his colleague Tony French, MD, PhD.

Education

BA, summa cum laude, Carleton College, 1991
MD, Washington University School of Medicine, 1995

Training

Intern and Resident in Pediatrics, St. Louis Children's Hospital, 1995 - 1998
Chief Resident in Pediatrics, St. Louis Children's Hospital, 1998 - 1999
Fellow, Pediatric Infectious Diseases, Washington University, 2000 - 2003

Licensure and Board Certification

1998 - PresMO, Physician and Surgeon
1999 - PresAmerican Board of Pediatrics
2003 - PresABP Sub-board of Pediatric Infectious Diseases
2008Neonatal Resuscitation Program

Honors and Awards

Dean's List, Carleton College, 1987 - 1991
CRC Press Award, Carleton College, 1988
Phi Beta Kappa Sophomore Award, Carleton College, 1989
Barry M. Goldwater Foundation Scholarship, 1990 - 1991
USA Today All-USA Academic Team, 1990 - 1991
Virgil Loeb, MD, Distinguished Alumni Scholarship, Washington University, 1991 - 1995
Finalist, American College of Physicians Award for Excellence in Physical Diagnosis, 1994
Fellow, Pediatric Scientist Development Program, 2001 - 2004
NIH Pediatric Research Loan Repayment Program Award, 2002 - 2006
Scholar, WU Child Health Research Center of Excellence, 2005 - 2008
Wall of Honor, SOAR Program, Red Wing, MN, 2006
Basil O'Connor Scholar Award, March of Dimes Foundation, 2009
Residents' Lecture Award (x2), St. Louis Children's Hospital, 2010
David Hunstad, MD, Distinguished Alumni Scholarship named by Washington University School of Medicine, 2015
Fellow, Pediatric Infectious Diseases Society, 2015
Residents’ Lecture Award, St. Louis Children’s Hospital, 2015
Best Doctors in America (St. Louis Magazine), 2015 - 2018
Featured New Member, American Pediatric Society, 2017
Elected Member, Alpha Omega Alpha, 2018
Faculty Achievement Award, WU Medical Center Alumni Association, 2019
Fellow, Infectious Diseases Society of America, 2020

Selected Publications view all (53)

Publication Co-Authors

Gregory A. Storch, M.D.

Stephanie S Cabler

Duha Al-Zubeidi

Jeffrey J. Bednarski, M.D., Ph.D.

Christopher McPherson

Keith A. Hruska, M.D.

Kristine Wylie, Ph.D.

Barbara B. Warner, M.D., MSc

Andrew J. White, M.D.

Maleewan Kitcharoensakkul, MD, MSCI

Anthony R. French, MD, PhD

Rachel C. Orscheln, M.D.

Alexis M. Elward, M.D., M.P.H.

Jane M. Garbutt, M.D.

Kelleigh Briden

David A. Rosen, M.D., Ph.D.

Todd N. Wylie

Stephanie A. Fritz, M.D., M.S.C.I.

Melanie Yarbrough

Reich, Patrick

Kevin Baszis, M.D.

S. Celeste Morley, M.D., Ph.D.

1.	McLellan LK, McAllaster MR, Kim AS, Tóthová Ľ, Olson PD, Pinkner JS, Daugherty AL, Hreha TN, Janetka JW, Fremont DH, Hultgren SJ, Virgin HW, Hunstad DA. A host receptor enables type 1 pilus-mediated pathogenesis of Escherichia coli pyelonephritis. PLoS Pathog. 2021;17(1):e1009314. PMID:33513212
2.	Hreha TN, Collins CA, Daugherty AL, Griffith JM, Hruska KA, Hunstad DA. Androgen-Influenced Polarization of Activin A-Producing Macrophages Accompanies Post-pyelonephritic Renal Scarring. Front Immunol. 2020;11:1641. PMCID:PMC7399094 PMID:32849562
3.	Hreha TN, Collins CA, Daugherty AL, Twentyman J, Paluri N, Hunstad DA. TGFβ1 orchestrates renal fibrosis following Escherichia coli pyelonephritis. Physiol Rep. 2020;8(6):e14401. PMCID:PMC7104652 PMID:32227630
4.	Olson PD, McLellan LK, Hreha TN, Liu A, Briden KE, Hruska KA, Hunstad DA. Androgen exposure potentiates formation of intratubular communities and renal abscesses by Escherichia coli. Kidney Int. 2018. doi:10.1016/j.kint.2018.04.023 PMID:30041870
5.	Olson PD, Hruska KA, Hunstad DA. Androgens enhance male urinary tract infection severity in a new model. J Am Soc Nephrol. 2016;27(6):1625-34. PMCID:PMC4884108 PMID:26449605
6.	Loughman JA, Yarbrough ML, Tiemann KM, Hunstad DA. Local generation of kynurenines mediates inhibition of neutrophil chemotaxis by uropathogenic Escherichia coli. Infect Immun. 2016;84(4):1176-83. PMCID:PMC4807489 PMID:26857571
7.	Wagers PO, Tiemann KM, Shelton KL, Kofron WG, Panzner MJ, Wooley KL, Youngs WJ, Hunstad DA. Imidazolium salts as small-molecule urinary bladder exfoliants in a murine model. Antimicrob Agents Chemother. 2015;59(9):5494-5502. doi:10.1128/AAC.00881-15 PMCID:PMC4538537 PMID:26124168
8.	Danka ES, Hunstad DA. Cathelicidin augments epithelial receptivity and pathogenesis in experimental Escherichia coli cystitis. J Infect Dis. 2015;211(7):1164-73. doi:10.1093/infdis/jiu577 PMCID:PMC4366604 PMID:25336727
9.	Lim YH, Tiemann KM, Heo GS, Wagers PO, Rezenom YH, Zhang S, Zhang F, Youngs WJ, Hunstad DA, Wooley KL. Preparation and in vitro antimicrobial activity of silver-bearing degradable polymeric nanoparticles of polyphosphoester-block-poly(L-lactide). ACS Nano. 2015;9(2):1995-2008. doi:10.1021/nn507046h PMCID:PMC4455953 PMID:25621868
10.	Lau ME, Danka ES, Tiemann KM, Hunstad DA. Bacterial lysis liberates the neutrophil migration suppressor YbcL from the periplasm of uropathogenic Escherichia coli. Infect Immun. 2014;82(12):4921-30. PMCID:PMC4249291 PMID:25183735

1.	McLellan LK, McAllaster MR, Kim AS, Tóthová Ľ, Olson PD, Pinkner JS, Daugherty AL, Hreha TN, Janetka JW, Fremont DH, Hultgren SJ, Virgin HW, Hunstad DA. A host receptor enables type 1 pilus-mediated pathogenesis of Escherichia coli pyelonephritis. PLoS Pathog. 2021;17(1):e1009314. PMID:33513212
2.	McLellan LK, Daugherty AL, Hunstad DA. Sex differences in population dynamics during formation of kidney bacterial communities by uropathogenic Escherichia coli. Infect Immun. 2021. PMID:33468577
3.	Hreha TN, Collins CA, Daugherty AL, Griffith JM, Hruska KA, Hunstad DA. Androgen-Influenced Polarization of Activin A-Producing Macrophages Accompanies Post-pyelonephritic Renal Scarring. Front Immunol. 2020;11:1641. PMCID:PMC7399094 PMID:32849562
4.	Cabler SS, Hogan PG, Fritz SA, Bednarski JJ, Hunstad DA. Incidence and treatment of hemophagocytic lymphohistiocytosis in hospitalized children with Ehrlichia infection. Pediatr Blood Cancer. 2020;e28436. PMID:32706439
5.	Hogan PG, Parrish KL, Mork RL, Boyle MG, Muenks CE, Thompson RM, Morelli JJ, Sullivan ML, Hunstad DA, Wardenburg JB, Rzhetsky A, Gehlert SJ, Burnham CD, Fritz SA. HOME2: Household vs. Personalized Decolonization in Households of Children with Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infection - A Randomized Clinical Trial. Clin Infect Dis. 2020. PMID:32521007
6.	Hogan PG, Mork RL, Thompson RM, Muenks CE, Boyle MG, Sullivan ML, Morelli JJ, Williams CV, Sanchez N, Hunstad DA, Wardenburg JB, Gehlert SJ, Burnham CD, Rzhetsky A, Fritz SA. Environmental Methicillin-resistant Staphylococcus aureus Contamination, Persistent Colonization, and Subsequent Skin and Soft Tissue Infection. JAMA Pediatr. 2020;174(6):552-562. PMCID:PMC7105954 PMID:32227144
7.	Hreha TN, Collins CA, Daugherty AL, Twentyman J, Paluri N, Hunstad DA. TGFβ1 orchestrates renal fibrosis following Escherichia coli pyelonephritis. Physiol Rep. 2020;8(6):e14401. PMCID:PMC7104652 PMID:32227630
8.	Parrish KL, Wylie KM, Reich PJ, Hogan PG, Wylie TN, Kennedy CR, Lainhart W, Hunstad DA, Burnham CD, Fritz SA. Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates. J Pediatric Infect Dis Soc. 2018. PMID:30285124
9.	Kulkarni DH, McDonald KG, Knoop KA, Gustafsson JK, Kozlowski KM, Hunstad DA, Miller MJ, Newberry RD. Goblet cell associated antigen passages are inhibited during Salmonella typhimurium infection to prevent pathogen dissemination and limit responses to dietary antigens. Mucosal Immunol. 2018;11(4):1103-1113. PMCID:PMC6037413 PMID:29445136
10.	Olson PD, McLellan LK, Hreha TN, Liu A, Briden KE, Hruska KA, Hunstad DA. Androgen exposure potentiates formation of intratubular communities and renal abscesses by Escherichia coli. Kidney Int. 2018. doi:10.1016/j.kint.2018.04.023 PMID:30041870
11.	Yarbrough ML, Briden KE, Mitsios JV, Weindel AL, Terrill CM, Hunstad DA, Dietzen DJ. Mass spectrometric measurement of urinary kynurenine-to-tryptophan ratio in children with and without urinary tract infection. Clin Biochem. 2018;56:83-88. PMCID:PMC6007864 PMID:29679555
12.	Cho S, Heo GS, Khan S, Huang J, Hunstad DA, Elsabahy M, Wooley KL. A vinyl ether-functional polycarbonate as a template for multiple postpolymerization modifications. Macromolecules. 2018;51:3233-3242. doi:10.1021/acs.macromol.8b00047 PMCID:PMC6002957 PMID:29915431
13.	Rosen DA, Twentyman J, Hunstad DA. High levels of cyclic di-GMP in Klebsiella pneumoniae attenuate virulence in the lung. Infect Immun. 2018;86(2):00647-17. doi:10.1128/IAI.00647-17 PMCID:PMC5778367 PMID:29158434
14.	Olson PD, McLellan LK, Liu A, Briden KL, Tiemann KM, Daugherty AL, Hruska KA, Hunstad DA. Renal scar formation and kidney function following antibiotic-treated murine pyelonephritis. Dis Model Mech. 2017;10(11):1371-1379. PMCID:PMC5719254 PMID:28882930
15.	DeBord MA, Southerland MR, Wagers PO, Tiemann KM, Robishaw NK, Whiddon KT, Konopka MC, Tessier CA, Shriver LP, Paruchuri S, Hunstad DA, Panzner MJ, Youngs WJ. Synthesis, characterization, in vitro SAR and in vivo evaluation of N,N'bisnaphthylmethyl 2-alkyl substituted imidazolium salts against NSCLC. Bioorg Med Chem Lett. 2017;27(4):764-775. PMCID:PMC5575737 PMID:28126518
16.	Olson PD, Hruska KA, Hunstad DA. Androgens enhance male urinary tract infection severity in a new model. J Am Soc Nephrol. 2016;27(6):1625-34. PMCID:PMC4884108 PMID:26449605
17.	Loughman JA, Yarbrough ML, Tiemann KM, Hunstad DA. Local generation of kynurenines mediates inhibition of neutrophil chemotaxis by uropathogenic Escherichia coli. Infect Immun. 2016;84(4):1176-83. PMCID:PMC4807489 PMID:26857571
18.	Rosen DA, Hilliard JK, Tiemann KM, Todd EM, Morley SC, Hunstad DA. Klebsiella pneumoniae FimK promotes virulence in murine pneumonia. J Infect Dis. 2016;213(4):649-58. doi:10.1093/infdis/jiv440 PMCID:PMC4721909 PMID:26347570
19.	Wagers PO, Tiemann KM, Shelton KL, Kofron WG, Panzner MJ, Wooley KL, Youngs WJ, Hunstad DA. Imidazolium salts as small-molecule urinary bladder exfoliants in a murine model. Antimicrob Agents Chemother. 2015;59(9):5494-5502. doi:10.1128/AAC.00881-15 PMCID:PMC4538537 PMID:26124168
20.	Wang JW, Hogan PG, Hunstad DA, Fritz SA. Vitamin D sufficiency and Staphylococcus aureus infection in children. Pediatr Infect Dis J. 2015;34(5):544-5. doi:10.1097/INF.0000000000000667 PMCID:PMC4400212 PMID:25860535
21.	Danka ES, Hunstad DA. Cathelicidin augments epithelial receptivity and pathogenesis in experimental Escherichia coli cystitis. J Infect Dis. 2015;211(7):1164-73. doi:10.1093/infdis/jiu577 PMCID:PMC4366604 PMID:25336727
22.	Lim YH, Tiemann KM, Heo GS, Wagers PO, Rezenom YH, Zhang S, Zhang F, Youngs WJ, Hunstad DA, Wooley KL. Preparation and in vitro antimicrobial activity of silver-bearing degradable polymeric nanoparticles of polyphosphoester-block-poly(L-lactide). ACS Nano. 2015;9(2):1995-2008. doi:10.1021/nn507046h PMCID:PMC4455953 PMID:25621868
23.	Lau ME, Danka ES, Tiemann KM, Hunstad DA. Bacterial lysis liberates the neutrophil migration suppressor YbcL from the periplasm of uropathogenic Escherichia coli. Infect Immun. 2014;82(12):4921-30. PMCID:PMC4249291 PMID:25183735
24.	Al-Zubeidi D, Burnham CA, Hogan PG, Collins R, Hunstad DA, Fritz SA. Molecular epidemiology of recurrent cutaneous methicillin-resistant Staphylococcus aureus infections in children. J Pediatric Infect Dis Soc. 2014;3(3):261-264. doi:10.1093/jpids/pit046 PMCID:PMC4381745 PMID:25844165
25.	Kitcharoensakkul M, Schulz CG, Kassel R, Khanna G, Liang S, Ngwube A, Baszis KW, Hunstad DA, White AJ. Scurvy revealed by difficulty walking: three cases in young children. J Clin Rheumatol. 2014;20(4):224-8. doi:10.1097/RHU.0000000000000101 PMID:24847751
26.	Heble DE Jr, McPherson C, Nelson MP, Hunstad DA. Vancomycin trough concentrations in overweight or obese pediatric patients. Pharmacotherapy. 2013;33(12):1273-7. doi:10.1002/phar.1321 PMID:23798327
27.	Lau ME, Hunstad DA. Quantitative assessment of human neutrophil migration across a cultured bladder epithelium. J Vis Exp. 2013;81:e50919. doi:10.3791/50919 PMCID:PMC3934319 PMID:24300797
28.	El Feghaly RE, Hunstad DA. A newborn with hydrops, hydrocephalus and ophthalmologic abnormalities. J Ped Infect Dis Soc. 2013;2:391-393. PMID:26619503
29.	Fritz SA, Tiemann KM, Hogan PG, Epplin EK, Rodriguez M, Al-Zubeidi DN, Bubeck Wardenburg J, Hunstad DA. A serologic correlate of protective immunity against community-onset Staphylococcus aureus infection. Clin Infect Dis. 2013;56(11):1554-61. doi:10.1093/cid/cit123 PMCID:PMC3641868 PMID:23446627
30.	Lau ME, Loughman JA, Hunstad DA. YbcL of uropathogenic Escherichia coli suppresses transepithelial neutrophil migration. Infect Immun. 2012;80(12):4123-32. doi:10.1128/IAI.00801-12 PMCID:PMC3497442 PMID:22966043
31.	McPherson C, Warner B, Hunstad DA, Elward A, Acosta EP. Oseltamivir dosing in premature infants. J Infect Dis. 2012;206(6):847-50. doi:10.1093/infdis/jis471 PMID:22807525
32.	Loughman JA, Hunstad DA. Induction of indoleamine 2,3-dioxygenase by uropathogenic bacteria attenuates innate responses to epithelial infection. J Infect Dis. 2012;205(12):1830-9. doi:10.1093/infdis/jis280 PMCID:PMC3415894 PMID:22474038
33.	Lin LY, Tiemann KM, Li Y, Pinkner JS, Walker JN, Hultgren SJ, Hunstad DA, Wooley KL. Synthetic polymer nanoparticles conjugated with FimH(A) from E. coli pili to emulate the bacterial mode of epithelial internalization. J Am Chem Soc. 2012;134(9):3938-41. doi:10.1021/ja2091917 PMCID:PMC3325780 PMID:22360307
34.	Loughman JA, Hunstad DA. Attenuation of human neutrophil migration and function by uropathogenic bacteria. Microbes Infect. 2011;13(6):555-65. doi:10.1016/j.micinf.2011.01.017 PMCID:PMC3092803 PMID:21315174
35.	Zhang B, Watts KM, Hodge D, Kemp LM, Hunstad DA, Hicks LM, Odom AR. A second target of the antimalarial and antibacterial agent fosmidomycin revealed by cellular metabolic profiling. Biochemistry. 2011;50(17):3570-7. doi:10.1021/bi200113y PMCID:PMC3082593 PMID:21438569
36.	Horvath DJ Jr, Li B, Casper T, Partida-Sanchez S, Hunstad DA, Hultgren SJ, Justice SS. Morphological plasticity promotes resistance to phagocyte killing of uropathogenic Escherichia coli. Microbes Infect. 2011;13(5):426-37. doi:10.1016/j.micinf.2010.12.004 PMCID:PMC3071881 PMID:21182979
37.	Fritz SA, Krauss MJ, Epplin EK, Burnham CA, Garbutt J, Dunne WM, Hunstad DA, Storch GA. The natural history of contemporary Staphylococcus aureus nasal colonization in community children. Pediatr Infect Dis J. 2011;30(4):349-51. doi:10.1097/INF.0b013e3181fe075e PMCID:PMC3077955 PMID:21412205
38.	Li Y, Hindi K, Watts KM, Taylor JB, Zhang K, Li Z, Hunstad DA, Cannon CL, Youngs WJ, Wooley KL. Shell crosslinked nanoparticles carrying silver antimicrobials as therapeutics. Chem Commun (Camb). 2010;46(1):121-3. doi:10.1039/b916559b PMCID:PMC2978063 PMID:20024313
39.	Nicholson TF, Watts KM, Hunstad DA. OmpA of uropathogenic Escherichia coli promotes postinvasion pathogenesis of cystitis. Infect Immun. 2009;77(12):5245-51. doi:10.1128/IAI.00670-09 PMCID:PMC2786482 PMID:19797074
40.	Orscheln RC, Hunstad DA, Fritz SA, Loughman JA, Mitchell K, Storch EK, Gaudreault M, Sellenriek PL, Armstrong JR, Mardis ER, Storch GA. Contribution of genetically restricted, methicillin-susceptible strains to the ongoing epidemic of community-acquired Staphylococcus aureus infections. Clin Infect Dis. 2009;49(4):536-42. doi:10.1086/600881 PMCID:PMC2965061 PMID:19589082
41.	Loughman JA, Fritz SA, Storch GA, Hunstad DA. Virulence gene expression in human community-acquired Staphylococcus aureus infection. J Infect Dis. 2009;199(3):294-301. doi:10.1086/595982 PMCID:PMC2843142 PMID:19115951
42.	Watts KM, Hunstad DA. Components of SurA required for outer membrane biogenesis in uropathogenic Escherichia coli. PLoS One. 2008;3(10):e3359. doi:10.1371/journal.pone.0003359 PMCID:PMC2556385 PMID:18836534
43.	Justice SS, Hunstad DA, Cegelski L, Hultgren SJ. Morphological plasticity as a bacterial survival strategy. Nat Rev Microbiol. 2008;6(2):162-8. doi:10.1038/nrmicro1820 PMID:18157153
44.	Miller AS, Hunstad DA. Salmonella ovarian abscess in an adolescent. Pediatr Infect Dis J. 2007;26(6):548-9. doi:10.1097/INF.0b013e31804b21b2 PMID:17529879
45.	Hunstad DA, French AR. Histoplasmosis in a child with JRA on low-dose methotrexate. Rheumatology (Oxford). 2007;46(1):177-8. doi:10.1093/rheumatology/kel375 PMID:17114804
46.	Justice SS, Hunstad DA, Seed PC, Hultgren SJ. Filamentation by Escherichia coli subverts innate defenses during urinary tract infection. Proc Natl Acad Sci U S A. 2006;103(52):19884-9. doi:10.1073/pnas.0606329104 PMCID:PMC1750882 PMID:17172451
47.	Justice SS, Lauer SR, Hultgren SJ, Hunstad DA. Maturation of intracellular Escherichia coli communities requires SurA. Infect Immun. 2006;74(8):4793-800. doi:10.1128/IAI.00355-06 PMCID:PMC1539609 PMID:16861667
48.	Justice SS, Hunstad DA, Harper JR, Duguay AR, Pinkner JS, Bann J, Frieden C, Silhavy TJ, Hultgren SJ. Periplasmic peptidyl prolyl cis-trans isomerases are not essential for viability, but SurA is required for pilus biogenesis in Escherichia coli. J Bacteriol. 2005;187(22):7680-6. doi:10.1128/JB.187.22.7680-7686.2005 PMCID:PMC1280321 PMID:16267292
49.	Hunstad DA, Justice SS, Hung CS, Lauer SR, Hultgren SJ. Suppression of bladder epithelial cytokine responses by uropathogenic Escherichia coli. Infect Immun. 2005;73(7):3999-4006. doi:10.1128/IAI.73.7.3999-4006.2005 PMCID:PMC1168571 PMID:15972487
50.	Roberts JA, Kaack MB, Baskin G, Chapman MR, Hunstad DA, Pinkner JS, Hultgren SJ. Antibody responses and protection from pyelonephritis following vaccination with purified Escherichia coli PapDG protein. J Urol. 2004;171(4):1682-5. doi:10.1097/01.ju.0000116123.05160.43 PMCID:PMC2838480 PMID:15017266
51.	Schilling JD, Martin SM, Hunstad DA, Patel KP, Mulvey MA, Justice SS, Lorenz RG, Hultgren SJ. CD14- and Toll-like receptor-dependent activation of bladder epithelial cells by lipopolysaccharide and type 1 piliated Escherichia coli. Infect Immun. 2003;71(3):1470-80. PMCID:PMC148872 PMID:12595465
52.	Hunstad DA, Cohen AH, St Geme JW 3rd. Successful eradication of mucormycosis occurring in a pulmonary allograft. J Heart Lung Transplant. 1999;18(8):801-4. PMID:10512529
53.	Mohrig JR, Rosenberg RE, Apostol JW, Bastienaansen M, Evans JW, Franklin SJ, Frisbie CD, Fu SS, Hamm ML, Hirose CB, Hunstad DA, James TL, King RW, Larson CJ, Latham HA, Owen DA, Stein KA, Warnet R. Diastereoselectivity of enolate anion protonation: H/D exchange of beta-substituted ethyl butanoates in ethanol-d. J Am Chem Soc. 1997;119:479-486.