About
Jennifer C. Pisano, MD, is an Associate Professor of Medicine in the Department of Medicine at The University of Chicago. Her clinical interests include Antimicrobial Stewardship and Transplant Infections. Dr. Pisano has contributed to research on infections and mortality in ICU patients undergoing continuous renal replacement therapy, as well as on the prevention and treatment of cancer-related infections, including guidelines published in NCCN Clinical Practice Guidelines in Oncology. Her work also encompasses studies on antimicrobial treatments for Clostridioides difficile infections, infection-related complications after prostate biopsy, and antibiotic stepdown strategies for bacteremia. She has investigated infection risks in solid organ transplant recipients and the microbiology of post-prostate biopsy complications, among other topics. Dr. Pisano's research focuses on improving infection management and outcomes in critically ill and transplant patient populations.
Research topics
- Medicine
- Internal medicine
- Virology
- Intensive care medicine
- Surgery
- Emergency medicine
- Immunology
- Gastroenterology
Selected publications
Blood Purification · 2026-01-13
articleINTRODUCTION: Antibiotic dosing in critically ill patients receiving continuous renal replacement therapy (CRRT) is challenging due to altered pharmacokinetics, variability in CRRT delivery, and limited dosing guidance. Optimizing therapy is essential, as underdosing may drive resistance and overdosing may increase toxicity, including cefepime-associated neurotoxicity. METHODS: We conducted a retrospective single-center study of ICU patients who received CRRT and at least one dose of cefepime, meropenem, or piperacillin-tazobactam between 2016 and 2020. Delivered CRRT dose was calculated from effluent rates. Daily antibiotic doses across CRRT phases were summarized, and resistance development was evaluated for Pseudomonas aeruginosa and Enterobacter cloacae using logistic regression. RESULTS: Of 954 eligible ICU patients, 661 met inclusion criteria. Median delivered CRRT dose was 29.5 mL/kg/h (IQR 25.0-33.5); 57.7% received ≥30 mL/kg/h, while only 9.6% were within the KDIGO-recommended 20-24.9 mL/kg/h. Median CRRT duration was 144 h (IQR 84-312), initiated a median of 2.3 days after ICU admission. Median daily doses during CRRT were 2.5 g for cefepime, 1.5 g for meropenem, and 10.8 g for piperacillin-tazobactam. Treatment-emergent resistance occurred in 17.6% of P. aeruginosa and 14.3% of E. cloacae isolates, while baseline resistance was common in Escherichia coli (20.5%) and Klebsiella pneumoniae (27.3%). In multivariable models, longer treatment duration (OR 1.07/day, 95% CI: 1.06-1.08), higher CRRT dose (OR 1.13 per 5 mL/kg/h, 95% CI: 1.10-1.16), and lower daily antibiotic dose (OR 0.65 per g/day, 95% CI: 0.61-0.70) were independently associated with cefepime resistance (AUC 0.73), with similar findings for meropenem (AUC 0.80). CONCLUSION: Antibiotic dosing during CRRT was at the lower end of the therapeutic range and was associated with treatment-emergent resistance in exploratory analyses. These findings highlight the potential importance of CRRT-informed dosing strategies and underscore the need for careful balance between efficacy and toxicity.
Open Forum Infectious Diseases · 2026-01-01
articleOpen accessAbstract Background While expert guidelines provide recommendations for peri-operative antimicrobial choice and duration for liver transplant recipients, few randomized studies have been conducted in this population. We aimed to understand transplant center practices around perioperative orthotopic liver transplant (OLT) prophylaxis.FIGURE 1:Criteria used to define ‘high-risk’ for antibacterial perioperative OLT prophylaxis in centers who risk stratify antibacterial prophylaxis, n=11 centers. Note that the majority of centers, 72%, required only one criteria to be met to be considered ‘high-risk,’ while the rest required multiple criteria.FIGURE 2:Criteria used to define ‘high-risk’ for antifungal perioperative OLT prophylaxis in centers who risk stratify antifungal prophylaxis, n=30 centers. Note that the majority of centers, 70%, required only one criteria to be met to be considered ‘high-risk,’ while the rest required multiple. Methods We sent a survey via REDCap to providers and pharmacists within the American Society of Transplantation’s Infectious Disease Community of Practice discussion board. The survey included questions on institutional practices of peri-OLT antimicrobial choice and duration. Narrow-spectrum antibiotics were defined as lacking anti-pseudomonal coverage such as cefazolin or ceftriaxone with metronidazole or ampicillin-sulbactam. Vancomycin and antifungals were considered separately. Centers were considered to use ‘risk stratification’ if different recommendations for antimicrobial choice or duration were given based upon perceived risk of the recipient.FIGURE 3:Post OLT antifungal prophylaxis recommendations from centers who do not risk-stratify (dark blue) compared to those who stratified into low-risk (grey) and high-risk (light blue). Results Clinicians from 38 unique institutions, representing all 11 UNOS regions, filled out the survey. Most respondents (86%) were physicians, Table 1. Few centers (29%) risk-stratified surgical-site peri-OLT antibacterial prophylaxis, while most (79%) used risk-stratification for antifungal prophylaxis. Definitions for ‘high-risk’ were widely variable across both categories, Figures 1 & 2, though the most agreed upon criteria included re-transplantation, re-operation after OLT, and requiring renal replacement therapy. While most recommended broad-spectrum antibacterials for less than or equal to 48 hours, there was significantly more variation in both antifungal of choice, Figure 3, as well as duration. Few (21%) institutions incorporate microbiologic screening for MRSA, CRE, VRE, and ESBLs into peri-OLT prophylaxis recommendations. Eight centers (21%) had a standardized protocol for recommended antimicrobial use for pre-OLT candidates hospitalized for decompensated liver failure. Conclusion There is significant variability between transplant centers in antimicrobial use around the time of OLT. Further research is also needed to determine whether high versus low-risk patients warrant different prophylaxis practices. Disclosures Jonathan Hand, MD, AstraZeneca: Advisor/Consultant|AstraZeneca: Grant/Research Support|Ferring: Grant/Research Support|Innoviva: Advisor/Consultant|Janssen: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Scynexis: Grant/Research Support|The Antibiotic Resistance Leadership Group (ARLG): Grant/Research Support|The Antibiotic Resistance Leadership Group (ARLG): Honoraria Margaret Jorgenson, PharmD, BCTXP, Merck: Advisor/Consultant|Merck: Grant/Research Support Rebecca Nirmal Kumar, MD, AstraZeneca: Advisor/Consultant|AstraZeneca: Grant/Research Support|Pfizer: Grant/Research Support
BMC Nephrology · 2025-07-01 · 2 citations
articleOpen accessBACKGROUND: Critically ill patients receiving continuous renal replacement therapy (CRRT) are at increased risk for multidrug-resistant infections and infection-related mortality. Altered pharmacokinetics in CRRT may contribute to inadequate antimicrobial exposure and therapeutic failure. However, limited data exist on infection burden and resistance patterns specific to this population. METHODS: We conducted a retrospective cohort study of ICU patients receiving continuous venovenous hemodialysis (CVVHD) at a tertiary academic center between May 2016 and April 2020. Patients were included if they received CRRT for ≥ 48 h, had at least one positive microbial culture, and received at least one antimicrobial of interest. Data were collected on infection sources, pathogens, resistance patterns, and mortality. RESULTS: Among 661 CRRT recipients, 394 (59.6%) had at least one positive culture. The most common infection sites were respiratory (69.0%), skin and soft tissue (53.8%), and intra-abdominal (38.8%). Intra-abdominal and bloodstream infections had the highest mortality (63.7% and 57.7%, respectively). Vancomycin-resistant E. faecium (83.3%), cefepime-resistant A. baumannii (100%), and P. aeruginosa with high β-lactam resistance were prominent. These resistance profiles diverged from general ICU trends. CONCLUSION: ICU patients receiving CRRT experience high rates of multidrug-resistant infections and associated mortality. Tailored dosing strategies, including dual empiric coverage in select cases, and CRRT-specific antimicrobial stewardship are essential to improve outcomes in this high-risk population.
Curbing inappropriate <i>C. difficile</i> treatment in patients receiving concomitant laxatives
Antimicrobial Stewardship & Healthcare Epidemiology · 2025-01-01
articleOpen accessAbstract In the setting of universal Clostridioides difficile screening, we implemented an alert that triggered when C. difficile treatment was ordered in patients who recently received laxatives. This resulted in C. difficile treatment avoidance in 37% of patients and was associated with drug cost savings of $143,905 over a 10-month period.
P-1786. Implementation of a Clinical Pathway to Educate Clinicians on Changing Epidemiology
Open Forum Infectious Diseases · 2025-01-29
articleOpen accessAbstract Background Since 8/31/2022, 39,998 new arrivals have made Chicago their home, with the majority coming from Latin America. Epidemiological diversity in these countries of origin as well as infection risks encountered on the journey to the US have resulted in increased requests for advice from Infectious Diseases (ID) specialists and a need for rapid education of clinicians, raising the question of how to best address this knowledge gap. Initial Triage Algorithm Clinicians are directed to this algorithm when first presented with a febrile new arrival or returning traveler. Methods Using Chicago Department of Public Health (CDPH) data, Epic® (Verona, WI), CDC’s online information for clinicians, and expert advice, we quantified relevant epidemiologic changes, curated a list of high priority topics, and developed an algorithmic approach to fever in new arrivals for the general clinician. After three cycles of revision within our interdisciplinary Antimicrobial Stewardship Program (ASP), this document was uploaded to the highly utilized ASP website for all providers on 4/26/2024. Differential Diagnosis Assistance after Malaria Ruled Out Clinicians are directed to this figure after completing the initial algorithm and ruling out malaria to consider additional neglected tropical diseases in their differential diagnosis. Results On review of epidemiologic data, we found that Chicago had 0 Measles cases in 2019, 5 cases in 2023, and 64 cases in 2024 as of 4/23/2024. Varicella incidence in Chicago rose from a median of 53 cases/year during 2005-2022 to roughly 400 cases in 2023, with 322 confirmed cases arising from new arrival shelters, and nearly half occuring among adults 18 years and older. University of Chicago Medicine (UCM) diagnosed an average of 3.7 cases of malaria from 2010-2021, 7 cases in 2022, and 9 cases in 2023. The New Arrivals Clinical Pathway, informed by these epidemiologic changes, provides general guidance on diagnosis and treatment for high frequency infections and a basic risk assessment strategy for high consequence pathogens. It also provides instructions on how to isolate individuals based on risk factors and clinical features and directs clinicians to contact Infection Control and ID specialists when appropriate. New Arrivals Clinical Pathway Table of Contents, Section 1: Fever in a Returning Traveler/New Arrival Schema When first opening the New Arrivals Clinical Pathway, clinicians are presented with these stepwise instructions in section 1, easily navigable via hyperlinks to relevant content. Conclusion The ongoing influx of new arrivals into Chicago, coupled with a housing crisis and congregant living conditions in shelters have rapidly changed the epidemiology of infectious diseases in Chicago, in turn creating a need for rapid education of clinicians. Using an easily accessible, readable, algorithmic model assists non-ID providers and ID trainees in triage and initial management of these increasingly common diseases. New Arrivals Clinical Pathway Table of Contents, Section 2: List of Neglected/Tropical Diseases to Consider Section 2 provides a convenient reference for neglected tropical diseases for all clinicians taking care of recent arrivals and returning travelers. It is organized by geographic region, and provides details regarding diagnosis, treatment, and infection control requirements for each disease. Disclosures Jennifer Pisano, MD, Beckman Coulter: Advisor/Consultant
Journal of the National Comprehensive Cancer Network · 2024-11-01 · 60 citations
articleThere is an increased risk of infection in patients with cancer that results in higher morbidity and mortality. Several risk factors can predispose these patients to infectious complications. Some such factors include immunocompromised states like neutropenia, allogeneic hematopoietic cell transplantation, and graft-versus-host disease, while others include immunosuppressive agents like corticosteroids, purine analogs, monoclonal antibodies, and other emerging cancer therapeutics like CAR T-cell therapy. The NCCN Guidelines for the Prevention and Treatment of Cancer-Related Infections address infection concerns that may be observed in these immunocompromised populations and characterize the major pathogens to which patients with cancer are susceptible, with a focus on the prevention, diagnosis, and treatment of major common and opportunistic infections. This paper highlights 2 recently updated sections of the guidelines, namely, infection concerns related to CAR T-cell therapy and antimicrobial prophylaxis recommendations, including vaccination, in patients at high-risk for infections.
Open Forum Infectious Diseases · 2024-03-16 · 8 citations
articleOpen accessAmong solid organ transplant recipients taking belatacept, 15% developed invasive fungal diseases. The most common invasive fungal diseases were aspergillosis (56%) and candidiasis (22%). The infected cohort was more likely to receive basiliximab, undergo lung transplantation, or identify as White. Higher rates of aspergillosis were seen in this lung cohort than previously reported.
Open Forum Infectious Diseases · 2024-06-28 · 9 citations
articleOpen accessAbstract Background The purpose of this study was to compare the efficacy and safety of intravenous (IV) versus oral (PO) stepdown therapy for uncomplicated streptococcal bacteremia. Methods This multicenter, retrospective study included adult patients with uncomplicated streptococcal bacteremia between 1 July 2019 and 1 July 2022. Patients who received IV therapy for the full treatment course were compared to patients who transitioned to PO therapy after initial IV therapy. The primary outcome was clinical success, defined as absence of infection recurrence, infection-related readmission, and infection-related mortality at 90 days. Secondary outcomes included microbiological success, length of stay (LOS), and IV line–associated complications. Results Of 238 patients included, 47.1% received PO stepdown therapy. Clinical success occurred in 94.4% and 94.6% in the IV only and PO stepdown groups, respectively (P = .946). Patients who transitioned to PO therapy received a median duration of IV therapy of 3.9 days (interquartile range, 2.9–7.3 days). Line complications were more frequent in the IV only group, primarily driven by catheter-related infections (7.2% vs 0%, P = .002). LOS was significantly shorter in the PO stepdown group (5.5 vs 9.2 days, P &lt; .001). Conclusions Patients transitioned to PO antibiotics for uncomplicated streptococcal bacteremia had similar rates of clinical success compared to patients who received only IV therapy. With consideration of infectious source, severity of illness, and comorbidities, PO stepdown following initial IV antibiotics for uncomplicated streptococcal bacteremia in select patients is a reasonable approach that may result in decreased LOS and line-related complications.
Evaluation of a Ureteral Stent Removal Protocol in Adult Kidney Transplant Recipients
Open Forum Infectious Diseases · 2024-08-30 · 4 citations
articleOpen accessAbstract Existing literature on best practices to reduce the risk of infectious complications associated with ureteral stent removal in kidney transplant recipients is limited. Prior to 2021, a formal process surrounding stent removal was not in place at our institution. In June 2021, a stent removal protocol was established. This protocol included the following: obtaining a preprocedure urine culture, prescribing universal culture-directed antimicrobial prophylaxis, earlier stent removal posttransplant, and patient education. We performed a retrospective quasi-experimental study of kidney transplant recipients who had their stents removed between July 2020 and June 2022. The primary outcome was the incidence of infectious complications within 30 days. Infectious complications were defined as urinary tract infection and bacteremia due to urinary source, as well as hospitalization, emergency department visit, or outpatient encounter for possible urinary tract infection. Secondary objectives included infectious and immunologic complications within 30 days to 1 year from transplant. During this study period, 239 adult kidney transplant recipients were included: 88 in the preprotocol group and 151 in the protocol group. The median time to stent removal was shorter in the protocol group (25 vs 36 days, P &lt; .001). More patients in the protocol group received preprocedure antibiotics (99% vs 36%, P &lt; .001). Infectious complications were higher in the preprotocol group (9% vs 3%, P = .035). Overall, the stent removal protocol was associated with fewer infectious complications (odds ratio, 0.18; 95% CI, 0.05–0.73). Further investigation is necessary to determine which individual interventions, if any, drive this benefit.
When is vancomycin prophylaxis necessary? Risk factors for MRSA surgical site infection
Antimicrobial Stewardship & Healthcare Epidemiology · 2024-01-01 · 7 citations
articleOpen accessBackground: (MRSA) colonized. Unfortunately, vancomycin prophylaxis remains common due to the overestimation of MRSA risk and the desire to cover MRSA in patients with certain healthcare-associated characteristics. To optimize vancomycin prophylaxis, we sought to identify risk factors for MRSA SSI. Methods: This was a single-center, case-control study of patients with a postoperative SSI after undergoing a National Healthcare Safety Network operative procedure over eight years. MRSA SSI cases were compared to non-MRSA SSI controls. Forty-two demographic, medical, and surgical characteristics were evaluated. Results: Of the 441 patients included, 23 developed MRSA SSIs (rate = 5.2 per 100 SSIs). In the multivariable model, we identified two independent risk factors for MRSA SSI: a history of MRSA colonization or infection (OR, 9.0 [95% CI, 1.9-29.6]) and hip or knee replacement surgery (OR, 3.8 [95% CI, 1.3-9.9]). Hemodialysis, previous hospitalization, and prolonged hospitalization prior to the procedure had no measurable association with odds of MRSA SSI. Conclusions: Patients with prior MRSA colonization or infection had 9-10 times greater odds of MRSA SSI and patients undergoing hip and knee replacement had 3-4 times greater odds of MRSA SSI. Healthcare-associated characteristics, such as previous hospitalization or hemodialysis, were not associated with MRSA SSI. Our findings support national recommendations to reserve vancomycin prophylaxis for patients who are MRSA colonized, as well as those undergoing hip and knee replacement, in the absence of routine MRSA colonization surveillance.
Frequent coauthors
- 119 shared
Natasha N. Pettit
University of Chicago
- 94 shared
Cynthia T. Nguyen
University of Chicago
- 73 shared
L. Silvia Munoz‐Price
Spine Institute on the Emerald Coast
- 66 shared
Curtis J. Donskey
Geriatric Research Education and Clinical Center
- 65 shared
David P. Calfee
Communities In Schools of Orange County
- 65 shared
Trevor Van Schooneveld
Nebraska Medical Center
- 61 shared
Tara N. Palmore
New York Proton Center
- 61 shared
Abhishek Deshpande
New York Proton Center
Labs
- Resume-aware match score
- Save to shortlist
- AI-drafted outreach
See your match with Jennifer C. Pisano
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