Dr. W. Charles Huskins at Mayo Clinic

W. Charles Huskins, MD, MSc
Professor of Pediatrics, Mayo Clinic College of Medicine and Science
Consultant, Division of Pediatric Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic
Associate Chair of Quality, Mayo Clinic Children’s

1. What is your specialty and your primary area of focus?

• Pediatric Infectious Diseases
• Healthcare Epidemiology
• Infection Prevention and Control
• Antimicrobial Stewardship

2. Please tell us a bit about Mayo Clinic.

Mayo Clinic is an academic medical center that focuses on team-based multidisciplinary care to advance the care of patients with the most critical and complex medical conditions, as well as to promote health to people wherever they may live. Mayo Clinic has medical centers in Minnesota, Arizona, and Florida. Additionally, Mayo Clinic provides care to patients through the Mayo Clinic Health System, which offers regional population-based health care, and the Mayo Clinic Care Network, which is a network of care providers to enable patients to access medical expertise close to their homes. As a pediatrician, I work in Mayo Clinic Children’s, which focuses on providing multidisciplinary care for the benefit of children.

3. Please tell us about your research team—sub- or co-investigators, key study coordinators, research nurses, and others—who play a vital role in ARLG studies.

I have had the privilege to work with two outstanding multidisciplinary research teams as a part of two ARLG research efforts.

The Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children (SCOUT-CAP) Randomized Clinical Trial

I led the design and conduct of the SCOUT-CAP trial with

• Dr. Scott Evans, who guided us in the application of the Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR) to the design of the study and analysis of the results;
• Dr. Theo Zaoutis, who helped develop the concept for the study;
• the site investigators and their study teams who conducted the study, led by Drs. Derek Williams and Buddy Creech; and
• Dr. Melinda Pettigrew, who led the microbiome portion of the trial.

The Multi-Drug Resistant Organisms (MDRO) Network

I have served as the lead site investigator overseeing Mayo Clinic’s role in the MDRO Network and its multiple studies. I worked with my colleague, Dr. Robin Patel, Director of ARLG's Laboratory Center and Co-Director of the Bacteriology Laboratory at Mayo Clinic, and collaborated with a host of exceptionally talented microbiologists and study coordinators.

4. Which ARLG projects have you participated in as a clinical trial site?

As noted above, I participated in the SCOUT-CAP and MDRO Network studies SNAP, CRACKLE II, POP, and SHREC. This work was tremendously interesting and professionally rewarding to me, as evidenced by the publications below. The opportunity to work with ARLG leaders and the research teams involved in both efforts has been one of the highlights of my research career.

Mayo Clinic has also participated in ARLG studies led by other principal investigators, including BCID, DISK, and RAPIDS-GN.

Read more about these ARLG studies.

Publications

Evans SR, Rubin D, Follmann D, Pennello G, Huskins WC, Powers JH, Schoenfeld D, Chuang-Stein C, Cosgrove SE, Fowler VG Jr, Lautenbach E, Chambers HF. Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR). Clin Infect Dis. 2015 Sep 1;61(5):800-6. doi: 10.1093/cid/civ495. Epub 2015 Jun 25. Erratum in: Clin Infect Dis. 2023 Jan 6;76(1):182. doi: 10.1093/cid/ciac352. PMID: 26113652; PMCID: PMC4542892.

Huskins WC, Fowler VG Jr, Evans S. Adaptive Designs for Clinical Trials: Application to Healthcare Epidemiology Research. Clin Infect Dis. 2018 Mar 19;66(7):1140-1146. doi: 10.1093/cid/cix907. PMID: 29121202; PMCID: PMC6018921.

Williams DJ, Creech CB, Walter EB, Martin JM, Gerber JS, Newland JG, Howard L, Hofto ME, Staat MA, Oler RE, Tuyishimire B, Conrad TM, Lee MS, Ghazaryan V, Pettigrew MM, Fowler VG Jr, Chambers HF, Zaoutis TE, Evans S, Huskins WC; The DMID 14-0079 Study Team. Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children: The SCOUT-CAP Randomized Clinical Trial. JAMA Pediatr. 2022 Mar 1;176(3):253-261. doi: 10.1001/jamapediatrics.2021.5547. PMID: 35040920; PMCID: PMC8767493.

Pettigrew MM, Kwon J, Gent JF, Kong Y, Wade M, Williams DJ, Creech CB, Evans S, Pan Q, Walter EB, Martin JM, Gerber JS, Newland JG, Hofto ME, Staat MA, Fowler VG, Chambers HF, Huskins WC; Antibacterial Resistance Leadership Group. Comparison of the Respiratory Resistomes and Microbiota in Children Receiving Short versus Standard Course Treatment for Community-Acquired Pneumonia. mBio. 2022 Apr 26;13(2):e0019522. doi: 10.1128/mbio.00195-22. Epub 2022 Mar 24. PMID: 35323040; PMCID: PMC9040816.

Kwon J, Kong Y, Wade M, Williams DJ, Creech CB, Evans S, Walter EB, Martin JM, Gerber JS, Newland JG, Hofto ME, Staat MA, Chambers HF, Fowler VG, Huskins WC, Pettigrew MM. Gastrointestinal Microbiome Disruption and Antibiotic-Associated Diarrhea in Children Receiving Antibiotic Therapy for Community-Acquired Pneumonia. J Infect Dis. 2022 Sep 21;226(6):1109-1119. doi: 10.1093/infdis/jiac082. PMID: 35249113; PMCID: PMC9492313.

Tamma PD, Komarow L, Ge L, Garcia-Diaz J, Herc ES, Doi Y, Arias CA, Albin O, Saade E, Miller LG, Jacob JT, Satlin MJ, Krsak M, Huskins WC, Dhar S, Shelburne SA, Hill C, Baum KR, Bhojani M, Greenwood-Quaintance KE, Schmidt-Malan SM, Patel R, Evans SR, Chambers HF, Fowler VG Jr, van Duin D; Antibacterial Resistance Leadership Group. Clinical Impact of Ceftriaxone Resistance in Escherichia coli Bloodstream Infections: A Multicenter Prospective Cohort Study. Open Forum Infect Dis. 2022 Oct 27;9(11):ofac572. doi: 10.1093/ofid/ofac572. PMID: 36381622; PMCID: PMC9645644.

Fisher M, Komarow L, Kahn J, Patel G, Revolinski S, Huskins WC, van Duin D, Banerjee R, Fries BC. Carbapenem-resistant Enterobacterales in Children at 18 US Health Care System Study Sites: Clinical and Molecular Epidemiology From a Prospective Multicenter Cohort Study. Open Forum Infect Dis. 2024 Jan 8;11(2):ofad688. doi: 10.1093/ofid/ofad688. PMID: 38390459; PMCID: PMC10883725.

Weston G, Giri A, Komarow L, Ge L, Baum KR, Abbenante E, Gallagher JC, Jacob JT, Kaye KS, Kim AC, Huskins WC, Zervos M, Herc E, Patel R, Van Duin D, Doi Y. Clinical outcomes in patients infected with ertapenem-only-resistant Enterobacterales versus multi-carbapenem-resistant Enterobacterales. J Antimicrob Chemother. 2024 Aug 1;79(8):1929-1937. doi: 10.1093/jac/dkae186. PMID: 38863337; PMCID: PMC11290877.

Mackow NA, Shao W, Ge L, Komarow L, Jiang J, Boutzoukas A, Chen L, Garcia-Diaz J, Herc ES, Doi Y, Arias CA, Albin O, Saade E, Miller LG, Jacob JT, Satlin MJ, Krsak M, Huskins WC, Dhar S, Shelburne SA, Hill C, Alby K, Sadler JM, Hill BM, Greenwood-Quaintance KE, Schmidt-Malan SM, Patel R, Fowler VG Jr, Tamma PD, Kreiswirth BN, van Duin D; Antibacterial Resistance Leadership Group. Escherichia coli ST131 Drives Carbapenem Use for E. Coli Bloodstream Infections. Clin Infect Dis. 2026 Mar 6:ciag160. doi: 10.1093/cid/ciag160. Epub ahead of print. PMID: 41795867.

Gottesdienera LS, Li Y, Greenwood-Quaintance KE, Komarow L, Ariase CA, Cober E, Herc ES, Alenazi TH, Kaye KS, Huskins WC, Figueroa J, Vilchez S, Fries BC, Leroi M, McCarty TP, Rioseco ML, Munita JM, Stryjewski ME, Reyes J, Che L, Kreiswirth BN, Hill C, Baum K, Villegas MV, Paterson DL, Bonomo RA, Chambers HF, Fowler Jr. VG, Patel R, Doi Y, van Duinn D, Satlin MJ, on behalf of the Antibacterial Resistance Leadership Group and Multi-Drug Resistant Organism Network Investigators. Resistance to novel β-lactam/β-lactamase inhibitors among carbapenem-resistant Pseudomonas aeruginosa and clinical implications in the Prospective Observational Pseudomonas (POP) Study. Antimicrob Agents and Chemother (in press).

5. Have you been involved with the ARLG in another capacity?

I served as a member of the Special Interest Panel in Pediatrics, which was a component of the original ARLG.

6. Why is the mission of ARLG important to you?

The ARLG has conducted critical studies that have each been innovative, but ARLG has also enhanced the application of innovative study designs across multiple studies to advance the field more effectively. An example is the Desirability of Outcome Ranking (DOOR). We used this novel approach to design the SCOUT-CAP trial, but investigators have used DOOR in multiple subsequent MDRO studies to evaluate patient outcomes more holistically. Another example is the use of adaptive trial designs in the evaluation of new diagnostic methods, such as the MASTERMIND platform study approach.

7. Is there anything else you’d like to share about your work with the ARLG?

One of the greatest benefits and pleasures of working with the ARLG is the opportunity to work with a multidisciplinary group of people who are visionary, motivated, highly skilled, consummately professional, and very collegial. I highly recommend the opportunity to anyone, but especially to junior faculty who will be able to engage in (and lead!) important work and learn from the best.