Ebbing Lautenbach
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 1954–2026
About
Ebbing Lautenbach, MD, MPH, MSCE, is the Robert Austrian Professor and a Senior Scholar at the Center for Clinical Epidemiology and Biostatistics within the Perelman School of Medicine at the University of Pennsylvania. He serves as the Director of Research in the Department of Healthcare Epidemiology and Infection Control at the Hospital of the University of Pennsylvania and is a Chief in the Division of Infectious Diseases. Lautenbach is also a Fellow at the Institute on Aging and a Senior Fellow at the Leonard Davis Institute of Health Economics at the same institution. His educational background includes a BS in Chemistry and Psychology from Calvin College, an MD from Columbia University College of Physicians and Surgeons, an MPH from Columbia University School of Public Health, and an MSCE in Clinical Epidemiology from the University of Pennsylvania School of Medicine. Lautenbach's research focuses on infectious diseases, antimicrobial resistance, and epidemiology, contributing significantly to understanding postoperative outcomes, organ donor microbiology, urinary tract infections, and antimicrobial resistance patterns. He is actively involved in clinical epidemiology, infection control, and public health initiatives, holding multiple roles that support research, education, and clinical practice at Penn Medicine.
Research topics
- Internal medicine
- Medicine
- Microbiology
- Biology
- Genetics
- Virology
Selected publications
<i>Escherichia coli</i> ST131 Drives Carbapenem Use for <i>E. coli</i> Bloodstream Infections
Clinical Infectious Diseases · 2026-03-04 · 1 citations
articleBACKGROUND: Ceftriaxone-resistant Escherichia coli infections are increasingly common, partially due to the emergence of E. coli sequence type 131 (ST131) including its subclade C2/H30Rx that produce extended-spectrum β-lactamases (ESBL). METHODS: A prospective cohort including 14 US sites, which enrolled monomicrobial ceftriaxone-resistant and susceptible E. coli BSI cases in a 1:1 ratio, was used to compare ST131 versus non-ST131 E. coli BSI, with specific attention to E. coli ST131 C2/H30Rx. Desirability of outcome ranking (DOOR) was determined at 30 days after infection onset. RESULTS: This analysis included 282 patients with E. coli BSI; 43% (121/282) were E. coli ST131, and 23% (66/282) belonged to the C2/H30Rx subclade. Resistance to ceftriaxone was present in 79% (96/121) ST131, 86% (57/66) E. coli ST131 C2/H30Rx, and 27% (43/161) E. coli non-ST131. Compared to patients with non-ST131 E. coli BSI, patients with ST131 BSI were older (median 70 years, [Q1 62, Q3 76] years vs. 65 years, [51, 74]; p = 0.005) and more often admitted from long-term care facilities (21/121 [17%] vs 7/161 [4%], p <0.001). Overall and empiric carbapenem use was more frequent in the treatment of patients with ST131 BSI compared with non-ST131 BSI (overall 89/121 [74%] vs 50/161 [31%]; empiric: 58/121 [48%] vs. 31/161 [19%], p <0.001). DOOR outcomes were similar between groups. CONCLUSIONS: Most ceftriaxone-resistant E. coli from US patients with E. coli BSI belong to ST131, particularly E. coli ST131 C2/H30Rx, serving as an important driver of carbapenem use.
UNC Libraries · 2026-02-13
articleOpen accessBackground People living with HIV (PLWH) make up a significant proportion of the population in sub-Saharan Africa, and there exists a significant gap in research on the burden and associated risk factors for extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in this population. We describe the risk factors associated with ESCrE colonization in nonhospitalized PLWH. Methods This is a secondary data analysis of nonhospitalized adult PLWH included in a regional surveillance cohort study describing colonization with ESCrE in Botswana. Participants underwent rectal swab sampling to identify ESCrE. Bivariate and multivariable analysis was used to determine risk factors associated with ESCrE colonization. Results A total of 546 adult PLWH were recruited over 3 districts and were included in this analysis. The mean (standard deviation) age was 42 (10.4) years, and 448 (82.1%) were women. Our findings demonstrated that 27.3% (149/546) of participants screened positive for ESCrE rectal colonization. Independent risk factors {adjusted odds ratio (aOR) [95% CI]} for ESCrE colonization included recent hospitalization (3.37 [1.13–9.98]), at least 1 household member with ESCrE colonization (1.74 [1.01–3.00]), and recruitment before the countrywide COVID-19 lockdown (2.01 [1.33–3.04]). Recent antibiotic use had an elevated OR for ESCrE colonization that did not achieve statistical significance in the adjusted analysis (aOR: 1.84 [.92–3.68]). Conclusions Hospitalization and colonization of other household members with ESCrE are important factors associated with colonization with ESCrE, as seen in other populations. The prevalence of ESCrE following the COVID-19 lockdown was significantly lower, suggesting the presence of factors that were protective against colonization. It is unclear how long these effects lasted.
Risk Factors for Community Colonization With Extended-Spectrum Cephalosporin-Resistant Enterobacterales Among People Living With HIV in Botswana
Open MIND · 2026-01-01
articleBackground People living with HIV (PLWH) make up a significant proportion of the population in sub-Saharan Africa, and there exists a significant gap in research on the burden and associated risk factors for extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in this population. We describe the risk factors associated with ESCrE colonization in nonhospitalized PLWH. Methods This is a secondary data analysis of nonhospitalized adult PLWH included in a regional surveillance cohort study describing colonization with ESCrE in Botswana. Participants underwent rectal swab sampling to identify ESCrE. Bivariate and multivariable analysis was used to determine risk factors associated with ESCrE colonization. Results A total of 546 adult PLWH were recruited over 3 districts and were included in this analysis. The mean (standard deviation) age was 42 (10.4) years, and 448 (82.1%) were women. Our findings demonstrated that 27.3% (149/546) of participants screened positive for ESCrE rectal colonization. Independent risk factors {adjusted odds ratio (aOR) [95% CI]} for ESCrE colonization included recent hospitalization (3.37 [1.13–9.98]), at least 1 household member with ESCrE colonization (1.74 [1.01–3.00]), and recruitment before the countrywide COVID-19 lockdown (2.01 [1.33–3.04]). Recent antibiotic use had an elevated OR for ESCrE colonization that did not achieve statistical significance in the adjusted analysis (aOR: 1.84 [.92–3.68]). Conclusions Hospitalization and colonization of other household members with ESCrE are important factors associated with colonization with ESCrE, as seen in other populations. The prevalence of ESCrE following the COVID-19 lockdown was significantly lower, suggesting the presence of factors that were protective against colonization. It is unclear how long these effects lasted.
Pharmacokinetics of Dalbavancin in Complicated <i>Staphylococcus aureus</i> Bacteremia
JAMA Network Open · 2026-04-18 · 1 citations
articleOpen accessImportance: Dalbavancin is an alternative to prolonged intravenous therapy for complicated Staphylococcus aureus bacteremia, yet its pharmacokinetics (PK) in patients with this condition are uncertain. Objective: To characterize dalbavancin PK and evaluate associations of total and unbound exposures of dalbavancin with clinical success in patients with complicated S aureus bacteremia. Design, Setting, and Participants: This study was an exploratory prespecified secondary analysis of PK and exposure response within Dalbavancin as an Option for Treatment of S aureus Bacteremia (DOTS), a multicenter, randomized, open-label, assessor-blinded clinical trial conducted from April 2021 to December 2023. Data analysis was conducted from January 2024 to December 2025. Adults with complicated S aureus bacteremia who achieved bloodstream clearance were randomized to dalbavancin or standard therapy; PK analyses included dalbavancin recipients with at least 1 postdose concentration measurement. Intervention: Dalbavancin 1500 mg intravenously on days 1 and 8 (1125 mg for patients with severe kidney impairment not receiving dialysis). Main Outcomes and Measures: Individual exposure metrics, including day 22 concentration and area under the concentration-time curve (AUC) from days 0 to 22, were derived using nonlinear mixed-effects population PK modeling. Exposure metrics were then assessed for association with clinical success at day 70 (exposure-response analysis). Results: A total of 97 patients (mean [SD] age, 54.5 [15.8] years; 69 male [71.1%]) contributing 640 PK samples were included. Clearance was estimated at 0.066 L/h (95% CI, 0.062 to 0.069 L/h), and the central volume of distribution was estimated at 5.67 L (95% CI, 5.37 to 5.99 L). Interindividual variability was 22.6% (95% CI, 18.9% to 25.6%) for clearance and 19.7% (95% CI, 13.8% to 25.0%) for the central volume of distribution. Clearance increased with creatinine clearance according to a power function (exponent, 0.21; 95% CI, 0.16 to 0.30). Distribution volumes increased with body weight following power relationships, including the central volume (exponent, 0.57; 95% CI, 0.37 to 0.86), second peripheral volume (0.82; 95% CI, 0.37 to 1.46), and third peripheral volume (0.56; 95% CI, 0.30 to 0.82). Albumin was inversely associated with the second peripheral volume (exponent, -0.81; 95% CI, -1.79 to -0.32) and unbound-fraction scaling factor (exponent, -0.78; 95% CI, -0.98 to -0.54), and age was positively associated with the third peripheral volume via a power relationship (exponent, 0.63; 95% CI, 0.44 to 0.83). Among 93 evaluable patients, 72 individuals (77.4%) achieved clinical success at day 70. Patients with a day 22 concentration greater than 32 μg/mL (30 patients [32.3% of evaluable patients receiving dalbavancin]) had higher clinical success compared with 63 patients with a day 22 concentration of 32 μg/mL or less (29 patients [96.7%] vs 43 patients [68.3%]; adjusted difference, 25.3 percentage points; 95% CI, 3.5-47.0 percentage points) and experienced similar rates of serious adverse events (8 patients [26.7%] vs 27 patients [42.9%]; unadjusted difference, -16.2 percentage points, 95% CI -36.2 to 3.8 percentage points). Conclusions and Relevance: In this study, dalbavancin pharmacokinetics were predictably influenced by kidney function, body weight, albumin levels, and age, and higher total day 22 concentrations were associated with greater clinical success without increased serious adverse events. These findings are exploratory and support further evaluation of exposure-guided dosing strategies. Trial Registration: Clinical Trials.gov Identifier: NCT04775953.
Fast Antimicrobial Susceptibility Testing for Gram-Negative Bacteremia
JAMA · 2026-04-18
articleOpen accessImportance: Novel blood culture diagnostics provide rapid antimicrobial susceptibility testing (AST) results for bacteria causing bloodstream infections (BSIs) but have unclear clinical impact. Objective: To evaluate clinical outcomes of blood culture testing using a rapid AST method compared with standard AST in patients with BSIs caused by gram-negative bacilli in regions with high prevalence of antimicrobial resistance. Design, Setting, and Participants: Open-label randomized clinical trial that enrolled participants from December 2023 to May 2025 (final follow-up, June 18, 2025) at 7 medical centers in Greece (n = 2), India (n = 1), Israel (n = 3), and Spain (n = 1). Hospitalized patients (adults and children) with BSIs caused by gram-negative bacilli were eligible. Statistical analysis was conducted from August 2025 to January 2026. Intervention: Patients were randomized to undergo blood culture evaluation using rapid, phenotypic AST directly from positive blood cultures plus standard susceptibility testing (n = 413) vs standard susceptibility testing alone (n = 437). Local antimicrobial stewardship teams reviewed all patients and provided treatment recommendations. Main Outcomes and Measures: The primary outcome was a desirability of outcome ranking (DOOR) at day 30, with 3 categories (alive without deleterious events, alive with deleterious events, and death). The difference between rapid and standard testing was summarized as the probability that the DOOR outcomes were more desirable in the rapid testing group. Superiority was concluded if the lower limit of the 95% CI exceeded 50%. Secondary outcomes included 30-day mortality, length of hospitalization, intensive care unit admission, acquisition of hospital-acquired infections, time to effective antibiotic therapy within 3 days, and time to antibiotic escalation or deescalation within 3 days. Results: Of the 899 patients randomized, 850 were included in the primary outcome analysis (median [IQR] age, 72 [21] years; 43% female). The probability that DOOR outcomes were more favorable in the rapid testing group was 48.8% (95% CI, 45.3%-52.4%). Median time to effective antibiotic therapy was not different between the groups in the as-randomized population. Median time to antibiotic escalation or deescalation was faster in the rapid testing group by 14 hours (95% CI, 6-22) in the as-randomized population. There were no differences between the groups in other secondary outcomes. In the prespecified subgroup with carbapenem-resistant infections, median time to effective therapy was 9.5 hours in the rapid testing group vs 28 hours in the standard testing group (difference, -18 hours [95% CI, -42 to 6]). Conclusions and Relevance: Among patients with gram-negative bacilli BSIs, rapid blood culture AST was not superior to standard testing by DOOR. When considered with other efficacy and safety outcomes, these findings may help inform the use of rapid susceptibility testing in clinical practice. Trial Registration: ClinicalTrials.gov Identifier: NCT06174649.
medRxiv · 2025-06-05 · 2 citations
preprintOpen accessABSTRACT Background To ameliorate the antibiotic resistance crisis, the drivers of resistance emergence (i.e., de novo evolution) and resistance spread (i.e., cross-transmission) must be better understood. Methods Whole-genome sequencing and susceptibility testing were performed on clinical carbapenem-resistant Klebsiella pneumoniae isolates collected from August 2014 to July 2015 across 12 hospitals. Ancestral state reconstruction partitioned patients with resistant strains into those that likely acquired resistance via de novo evolution or cross-transmission. Logistic regression was used to evaluate the associations between patient characteristics/exposures and these two pathways: resistance due to predicted within-host emergence of resistance, and resistance due to predicted cross-transmission. This framework is available in the user-friendly R package, phyloAMR ( https://github.com/kylegontjes/phyloAMR ). Results Phylogenetic analysis of 386 epidemic lineage carbapenem-resistant Klebsiella pneumoniae sequence type 258 isolates revealed differences in the relative contribution of de novo evolution and cross-transmission to the burden of resistance to five antibiotics. Clade-specific variations in rates of resistance emergence and their frequency and magnitude of spread were detected for each antibiotic. Phylogenetically-informed regression modeling identified distinct clinical risk factors associated with each pathway. Exposure to the cognate antibiotic was an independent risk factor for resistance emergence (trimethoprim-sulfamethoxazole, colistin, and beta-lactam/beta-lactamase inhibitors) and resistance spread (trimethoprim-sulfamethoxazole, amikacin, and colistin). In addition to antibiotic exposures, comorbidities (e.g., stage IV+ decubitus ulcers) and indwelling devices (e.g., gastrostomy tubes) were detected as unique risk factors for resistance spread. Conclusions Phylogenetic contextualization generated insights and hypotheses into how bacterial genetic background, patient characteristics, and clinical practices influence the emergence and spread of antibiotic resistance.
The Journal of Infectious Diseases · 2025-09-12 · 4 citations
articleOpen accessBACKGROUND: To ameliorate the antibiotic resistance crisis, the drivers of resistance emergence and resistance spread must be better understood. METHODS: Whole-genome sequencing and susceptibility testing were performed on clinical carbapenem-resistant Klebsiella pneumoniae isolates collected from August 2014 to July 2015 across 12 long-term acute care hospitals. Ancestral state reconstruction partitioned patients with resistant strains into those that likely acquired resistance via de novo evolution or cross-transmission. Logistic regression was used to evaluate the associations between patient characteristics/exposures and these 2 pathways: resistance due to predicted within-host emergence of resistance and resistance due to predicted cross-transmission. This framework is available in the user-friendly R package, phyloAMR (https://github.com/kylegontjes/phyloAMR). RESULTS: Phylogenetic analysis of 386 epidemic lineage carbapenem-resistant K. pneumoniae sequence type 258 isolates revealed differences in the relative contribution of de novo evolution and cross-transmission to the burden of resistance to 5 antibiotics. Clade-specific variations in rates of resistance emergence and their frequency and magnitude of spread were detected for each antibiotic. Phylogenetically informed regression modeling identified distinct clinical risk factors associated with each pathway. Exposure to the cognate antibiotic was an independent risk factor for resistance emergence (trimethoprim-sulfamethoxazole, colistin, and novel beta-lactam/beta-lactamase inhibitors) and resistance spread (trimethoprim-sulfamethoxazole, amikacin, and colistin). In addition to antibiotic exposures, comorbidities (eg, stage IV + decubitus ulcers) and indwelling medical devices (eg, gastrostomy tubes) were detected as unique risk factors for resistance spread. CONCLUSIONS: Phylogenetic contextualization generated insights and hypotheses into how bacterial genetic background, patient characteristics, and clinical practices influence the emergence and spread of antibiotic resistance.
Illness Severity Among Heart Transplant Recipients Following 2018 Allocation Change
American Journal of Transplantation · 2025-08-01
articleSenior authorDeveloping and implementing a family-led infection prevention bundle for hospitalized neonates
Research Square · 2025-11-07
preprintOpen accessMicrobiology Spectrum · 2025-09-03
letterOpen access
Recent grants
NIH · $2.8M · 2011
NIH · $430k · 2016
NIH · $1.5M · 2014
NIH · $667k · 2006
Infectious Diseases Clinical Epidemiology Training Program
NIH · $6.9M · 2003–2025
Frequent coauthors
- 230 shared
Warren B. Bilker
University of Pennsylvania
- 169 shared
Suzanne Bradley
- 156 shared
Carol Chenoweth
University of Michigan–Ann Arbor
- 151 shared
David J. Weber
University of North Carolina at Chapel Hill
- 148 shared
Pam Tolomeo
University of Pennsylvania
- 136 shared
Neil O. Fishman
Hospital of the University of Pennsylvania
- 130 shared
Ann Arbor
Klinikum Saarbrücken
- 121 shared
Carol A. Kauffman
University of Arizona
Labs
Ebbing Lautenbach LaboratoryPI
Awards & honors
- Robert Austrian Professor
- Fellow, Institute on Aging, Perelman School of Medicine, Uni…
- Senior Fellow, Leonard Davis Institute of Health Economics,…
- Resume-aware match score
- Save to shortlist
- AI-drafted outreach
See your match with Ebbing Lautenbach
PhdFit ranks faculty by your research interests, methods, and publications — grounded in their actual work, not templates.
- Free to start
- No credit card
- 30-second signup