I am an infectious disease physician with dual training in clinical epidemiology and pharmacometrics, supported by an NIH Career Development award. My clinical interest in tuberculosis began during my residency at NYU/Bellevue Hospital, and I currently see patients at the Global Tuberculosis Institute in Newark, NJ. This background has steered my interest in understanding the patient factors that relate to variability in the pharmacokinetics and the pharmacodynamics of anti-infective therapies, with a particular focus on tuberculosis and nontuberculous mycobacterial (NTM) infections. The program has four areas of interest as discussed below.
Immune activation, gut damage, and pharmacokinetic variability of anti-tuberculosis drugs in HIV/tuberculosis patients. Current efforts in our laboratory are focusing on the expression and activity of membrane drug transporters and key drug metabolizing enzymes relevant for anti-TB therapies, combined with clinical studies of anti-tuberculosis drug pharmacokinetics in HIV-infected patients. The goal of this work is to link the observations of low anti-TB drug serum exposures in patients with HIV infection or other chronic diseases with a mechanistic understanding of the regulation of drug transporters and metabolizing enzymes in the context of inflammatory or metabolic disease.
Developing a point-of-care assay for therapeutic drug monitoring during tuberculosis treatment in resource limited settings. We are evaluating urine colorimetry as a simple platform for measuring anti-tuberculosis drug exposure, which could be a low-cost approach appropriate for high burden settings where blood-based methods of therapeutic drug monitoring would not be feasible.
The role of initial drug resistance in the outcomes of tuberculous meningitis. Meningitis is the most devastating manifestation of tuberculosis. I have led investigations of the epidemiology of drug resistant tuberculous meningitis, using surveillance data collected by the National Tuberculosis Surveillance System at the Centers for Disease Control and Prevention. More recently, I have developed a collaboration with the New York City Department of Health and Mental Hygiene, linking of the tuberculosis registry with the vital statistics database to examine the long-term mortality of tuberculous meningitis patients, both during and after treatment.
Clinical epidemiology of nontuberculous mycobacterial infections in a high prevalence setting. In collaboration with investigators at the Perelman School of Medicine at the University of Pennsylvania, we are building a clinical cohort of nontuberculous mycobacterial patients from the greater Philadelphia region, which has one of the highest prevalence rates of NTM infections in the United States. The goals of this work are to pursue fundamental questions regarding acquisition and progression of disease, including the role of genetic and immunologic factors.
Vinnard C, Longworth S, Mezochow A, Patrawalla A, Kreiswirth BN, Hamilton K (2016) Deaths Related to Nontuberculous Mycobacterial Infections in the United States, 1999-2014. Ann Am Thorac Soc 13: 1951-1955. PMI: 27607541
Vinnard C, King L, Munsiff S, Crossa A, Iwata K, Pasipanodya J, Proops D, Ahuja S (2016) Long-term Mortality of Patients With Tuberculous Meningitis in New York City: A Cohort Study. Clin Infect Dis. PMI: 27927856
Mediavilla JR, Patrawalla A, Chen L, Chavda KD, Mathema B, Vinnard C, Dever LL, Kreiswirth BN (2016) Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States. MBio 7. PMI: 27578755
Arif N, Yousfi S, Vinnard C (2016) Deaths from necrotizing fasciitis in the United States, 2003-2013. Epidemiol Infect 144: 1338-1344. PMI: 26548496
Zivich S, Cauterucci M, Allen S, Vetter M, Vinnard C (2015) Long-term virologic outcomes following bariatric surgery in patients with HIV. Obes Res Clin Pract 9: 633-635. PMI: 26411387
Yates F, Janakiraman A, Headly A, Linkin DR, Vinnard C (2015) Attitudes towards latent tuberculosis among physicians in training: the role of BCG vaccination. J Community Health 40: 364-366. PMI: 25236656
Longworth SA, Blumberg EA, Barton TD, Vinnard C (2015) Non-tuberculous mycobacterial infections after solid organ transplantation: a survival analysis. Clin Microbiol Infect 21: 43-47. PMI: 25636926
Longworth SA, Vinnard C, Lee I, Sims KD, Barton TD, Blumberg EA (2014) Risk factors for nontuberculous mycobacterial infections in solid organ transplant recipients: a case-control study. Transpl Infect Dis 16: 76-83. PMI: 24350627
Vinnard C, Linkin DR, Localio AR, Leonard CE, Teal VL, Fishman NO, Hennessy S (2013) Effectiveness of interventions in reducing antibiotic use for upper respiratory infections in ambulatory care practices. Popul Health Manag 16: 22-27. PMI: 23113630
Vinnard C, Gopal A, Linkin DR, Maslow J (2013) Isoniazid Toxicity among an Older Veteran Population: A Retrospective Cohort Study. Tuberc Res Treat 2013: 549473. PMI: 23365735
Vinnard C, Wileyto EP, Bisson GP, Winston CA (2012) First Use of Multiple Imputation with the National Tuberculosis Surveillance System. Epidemiol Res Int 2013. PMI: 23658856
Vinnard C, Winston CA, Wileyto EP, MacGregor RR, Bisson GP (2011) Isoniazid-resistant tuberculous meningitis, United States, 1993-2005. Emerg Infect Dis 17: 539-542. PMI: 21392454
Vinnard C, Winston CA, Wileyto EP, MacGregor RR, Bisson GP (2011) Multidrug resistant tuberculous meningitis in the United States, 1993-2005. J Infect 63: 240-242. PMI: 21784099
Vinnard C, Winston CA, Wileyto EP, Macgregor RR, Bisson GP (2010) Isoniazid resistance and death in patients with tuberculous meningitis: retrospective cohort study. BMJ 341: c4451. PMI: 20819874
Vinnard C, Macgregor RR (2009) Tuberculous meningitis in HIV-infected individuals. Curr HIV/AIDS Rep 6: 139-145. PMI: 19589299