Member Spotlight: Joseph St. Geme III

Joseph St. Geme III, MD, FPIDS, is Chair of the Department of Pediatrics, Physician-in-Chief, President of the Medical Staff, President of the Physician Practice Association, and the Madlyn and Leonard Abramson Endowed Chair in Pediatrics at the Children’s Hospital of Philadelphia. In addition, he is Professor of Pediatrics and Microbiology and Chair of the Department of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

Dr. St. Geme received his medical degree from Harvard Medical School. He completed his pediatric residency and chief residency at the Children’s Hospital of Philadelphia and then pursued postdoctoral training in microbiology and infectious diseases at Stanford University, working in the laboratory of Lasker Awardee Stanley Falkow and receiving clinical training at Lucile Packard Children’s Hospital.

He currently serves on the St. Jude-PIDS Fellowship Committee and is a past PIDS President.

Why Pediatric ID? I think it’s fair to say that there were a variety of factors that influenced my decision to pursue pediatrics and pediatric infectious diseases. The fact that my father and grandfather were pediatricians probably influenced my leaning toward pediatrics from an early age. Regarding pediatric infectious diseases, I spent a summer during college working in an infectious diseases-immunology research lab studying breast milk immunity against E. coli, first piquing my interest in infectious diseases. When I was in medical school, I especially enjoyed the first-year microbiology course, and I was invited to serve as a teaching assistant for this course the next year, providing additional experience that drew me to infectious diseases.

When I was a resident I had a variety of clinical interests, but I especially liked the approach to patients who had possible infections, including the process of developing a differential diagnosis, undertaking testing to evaluate the range of diagnostic possibilities, establishing a definitive diagnosis, and then implementing specific treatment tailored to the diagnosis and observing response to therapy. I also found it appealing that infectious diseases are highly prevalent in pediatrics, thus allowing me to function as a general pediatrician as well as a subspecialist.  

In thinking about how my scientific interests have evolved, during my chief residency my middle son was born and 12 hours into life developed tachypnea and had a generalized seizure, ultimately being diagnosed with group B streptococcal meningitis. That was a worrisome time and motivated me to focus my future research efforts on bacterial pathogenesis (as an aside, my son did quite well, responding to treatment, leaving the hospital after 17 days, and ultimately graduating from Stanford and Harvard).

Where have you taken your ID focus? I feel very fortunate to have been able to help establish the St. Jude-PIDS Pediatric Infectious Diseases Research Conference and the St. Jude-PIDS Fellowship Award in Basic and Translational Research. Both of these programs are a consequence of my friendship with Elaine Tuomanen, who approached me shortly after she was named Chair of the Department of Infectious Diseases at St. Jude and asked me about how we might leverage resources at St. Jude to strengthen the field of pediatric infectious diseases. The St. Jude-PIDS Conference and the St. Jude-PIDS fellowship have been in place for nearly 25 years now and have been quite successful. Indeed, the roster of individuals who have received support from the St. Jude-PIDS Fellowship Award in Basic and Translational Research is quite impressive, people who are largely shaping the state of research in pediatric infectious disease.

I’ve always gained great satisfaction from participating in the process of discovery and generating new knowledge, and I remain very excited about the research in my lab, which has focused on understanding the pathogenesis of disease due to Haemophilus influenzae since my time as a fellow and on delineating the pathogenesis of disease due to Kingella kingae for nearly 20 years. I have been very fortunate to have a large number of talented people in my lab over the years, including graduate students and post-doctoral fellows. Currently, I benefit enormously from a former graduate student of mine who is now my lab manager and a research scientist at CHOP and who helps me mentor trainees in the lab.  

What is a recent development in peds ID you are working on? The long-term goal of my research has been to translate understanding of bacterial pathogenic mechanisms into novel approaches to treatment or prevention of bacterial disease. Along these lines, I’m especially excited about recent work by one of my graduate students examining the vaccine potential of the nontypeable H.influenzae HMW1 and HMW2 adhesins, which we’ve characterized in great detail and play a key role in nontypeable H.influenzae colonization of the nasopharynx, an essential step in the pathogenesis of H. influenzae localized respiratory tract disease. Finding H. influenzae antigens that protect against both homologous and heterologous strains has been a challenge in the field, and we’re building on this recent work with a series of additional studies, hoping to move closer to a vaccine effective against all strains of H. influenzae. I’m also excited about work by another student who recently performed an elegant phylogenetic analysis of the Kingella genus. This analysis elucidated the mechanism by which virulence evolved in Kingella kingae. It’s an amazing story that represents a prototype for understanding how virulence evolves and how new pathogens emerge.

On a separate note, I want to highlight our extremely strong Division of Infectious Diseases at CHOP. I feel great pride that we’ve been able to build on the historic strength in infectious diseases at CHOP, highlighted by giants like Werner and Gertrude Henle, Stanley Plotkin, Paul Offit, and others. The Division includes an incredible collection of experts who as a group are outstanding clinicians, educators, and investigators, with expertise in infection prevention and control, antibiotic stewardship, clinical microbiology, global health, vaccine development, clinical epidemiology, clinical research, and laboratory research.

What do you enjoy most about being a PIDS member? What keeps you renewing your membership? I’ve had an affinity and an affection for PIDS ever since I first learned about the society when I was a junior faculty member. It’s an amazing community of people, and I’ve always looked forward to PIDS academic functions and social functions because of the opportunity to spend time with many friends and colleagues.

In considering the future of PIDS, I think it’s critical that we work on expanding the workforce in pediatric infectious diseases. We need to emphasize that this is an incredibly exciting time in infectious diseases, more so than ever before in my career. The tools that we have now to understand new pathogens, emerging pathogens, pathogenic mechanisms, immune mechanisms, and immune deficiencies and to develop new approaches to treatment and prevention are truly staggering, providing enormous opportunities to have an impact on child health. I hope we can all exude enthusiasm when we‘re spending time with medical students and residents as they’re thinking about their future careers and whether to pursue subspecialty training. Pediatric Infectious Diseases is a truly great profession and a truly great field.