Member Spotlight: Leena Mithal

Leena B. Mithal, MD, MSCI, FPIDS is Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago. She is Director of the Pediatric Infectious Diseases Fellowship program and Director of the Master of Science in Clinical Investigation degree program at Northwestern University. Dr. Mithal earned her medical degree at Northwestern University Feinberg School of Medicine. She completed her residency training at Texas Children’s Hospital and Baylor College of Medicine and her pediatric infectious diseases fellowship at Lurie Children’s Hospital and Northwestern University.

Dr. Mithal served as chair of the FPIDS Task Force and is currently a member-at-large on the Membership Engagement Committee. She is also active with the PIDS Advocacy Task Force.

Why pediatric ID? I always enjoyed pediatric medicine and treating children. I was lucky to have early exposure to pediatric ID as an inpatient rotation during medical school with Dr. Tina Tan as attending and Dr. Evan Anderson as the fellow. I love the critical thinking that went into figuring out why a healthy child who should be thriving is ill. It is fulfilling to apply our knowledge and skills to make a diagnosis that can often be treated successfully, restoring health and a long life potential. I value thinking about the whole child, seeing patients of all age ranges, and treating previously health patients as well as those with chronic illnesses. The ever-changing, intellectually stimulating work really drew me. Witnessing several passionate clinical and research faculty and how much they enjoyed their work, even while eating peanut butter and jelly on crackers in the break room as the day got late (our very own PIDS president-elect Dr. Deb Palazzi), was inspiring.

Where have you taken your pediatric ID focus? I was a neonatal hospitalist before my fellowship, knowing I would be specializing in infectious diseases. When considering my research focus, I kept coming back to that neonatal experience and witnessing antibiotic decision-making in the NICU. That spawned my niche in neonatal and congenital infections and my research program.

I focus on microbial exposures during pregnancy, the perinatal period, and early life and the interactions with host immune system that can impact health outcomes. A key part of my work is toward novel diagnostics for neonatal sepsis using umbilical cord blood or the placenta. Harnessing important perinatal data can help guide our management and the antibiotic exposures of newborn babies who may not benefit and may be harmed by antibiotics in the absence of a true invasive infection. My research agenda encompasses both a primary microbial focus and a broader perinatal exposome landscape that facilitates several avenues of clinical and translational investigation. I have some wonderful collaborations with colleagues in maternal fetal medicine obstetrics, perinatal pathology, neonatology, and immunology. We need to collaborate on both sides of the placenta to understand the exposures before and after birth. It is an understudied area that, in my view, sets that life trajectory for health or disease early on.

What is a recent development in pediatric ID that you are working on? My most recent work was published last week in JCI Insight, Cord blood proteomics identifies biomarkers of early-onset neonatal sepsis. This is one of the culmination products of my career development award and the foundation for an R01 proposal.

We used untargeted proteomics, a technology that broadly quantifies proteins in a sample, of umbilical cord blood. This cord blood is a readily available specimen that reflects the state of baby’s health at the time of birth. We identified cord blood biomarkers through proteomics that distinguished newborns with early onset sepsis from controls that we then validated and built a diagnostic tool. We applied the cord blood diagnostic tool to a cohort of babies with “presumed sepsis” who were treated with prolonged antibiotics and only a small subset aligned with newborns with proven early onset sepsis, and the majority clustered as controls.  

This potential diagnostic tool using cord blood may help us identify babies with and without infection, ensuring targeted antibiotic treatment and minimizing early life antibiotic exposure for many preterm infants treated for presumed sepsis. This discovery requires further validation and collaborative multi-site trials.

What do you enjoy most about being a PIDS member? What keeps you renewing your membership? I find PIDS to be a very meaningful community to be part of. While I find other professional societies are also fulfilling, PIDS to me is a welcoming, conducive home aligned with what I care about, think about, and the people I connect with most. I feel that it is an organization where I can truly have an impact, where my voice can be heard, and that has an important national footprint.

For example, I felt honored to be asked to lead the Society’s recent efforts in the FPIDS Task Force to review and update the process for granting the society’s esteemed fellowship. While I am not the most senior person in our field, I could make a significant contribution and hopefully have a positive impact on the Society and the pediatric ID community. In these times, our camaraderie and collective impact is more important than ever.