Susan Richardson, MD, FRCP(C)
The Hospital for Sick Children
Interim Chief, Paediatric Laboratory Medicine
Paediatric Laboratory Medicine
Senior Associate Scientist
University of Toronto
Laboratory Medicine & Pathobiology
Public Health Ontario Laboratories, Public Health Ontario
- Rapid diagnosis of invasive fungal infections in the immunocompromised host
- Risk factors and long-term neurological outcome of neonatal candidiasis
- Optimization of pediatric diagnostic microbiology
- Rapid diagnosis of viral respiratory infections
- Molecular diagnostics as applied to pediatric infectious diseases
Improvements in the diagnosis and understanding of pediatric infectious diseases
Infections in children are very common and differ in important ways from those seen in adults. Infections are a common cause of visits to and admissions to Sick Kids in children who suffer from chronic conditions and diseases that impair their immune system, and also in otherwise healthy children. Our goal is to improve the diagnosis of these infections, so that every child with a probable infection stands the best chance of having that infection diagnosed. To do this we apply our understanding of the basic disease process that we observe combined with the latest research techniques.
One main area in which we are making progress is in the diagnosis of pediatric respiratory infections (i.e. colds, flu-like illnesses). Enhanced by our experience with SARS in 2003, we have tested or developed very sensitive molecular techniques based on detecting very small amounts of genetic material of the viruses in question. This experience has permitted us to be able to rapidly detect cases of newly emerging infections such as SARS, avian influenza, MERS coronavirus and pandemic influenza and to distinguish them from other less severe infections such as RSV and parainfluenza infection. This will have a significant impact on the control of the spread of these infections should they be introduced or re-introduced into our community.
We also specialize in developing molecular tests that are focused on pediatric infectious pathogens, such as Kingella kingae, the most common cause of infectious arthritis in children less than 4 years of age; adenovirus, a common cause of infection in pediatric bone marrow transplant recipients and a range of herpes viruses which are also common causes of infection in the immune compromised child.
We take our role in developing, testing, implementing and studying the utility of microbiologic tests for the diagnosis of infections in children very seriously, and strive to be leaders in developing and publishing standards for optimal patient care in this area.
Fungal Infections in the Immunocompromised Host
The focus of this work is on the pathogenesis, diagnosis, treatment and outcome of serious invasive fungal infections that occur primarily in the immunocompromised host. These infections are increasing as the population of successfully treated cancer and transplant patients increases, with their concomitant immunosuppression. The work in our laboratory is focused on the development of techniques for the rapid detection of invasive fungal infections by amplification of DNA. We have developed a molecular test that can detect all species of fungi that may be present in patients with suspected invasive fungal infection, in addition to a molecular test that is designed to detect the most common species of Aspergillus, a fungus that causes life-threatening disease in the immune compromised host.
Neonatal candidiasis is a serious problem in pre-term infants, and is increasing in incidence with the successful resuscitation of ever younger, smaller and more immature babies. We have studied the risk factors associated with the acquisition of this infection and its long term neuro-physiological outcome in a multi-center Canadian study, in addition to the devastating consequences of this infection in extremely premature babies that acquire this infection in the perinatal period.
A Multi-Jurisdictional Study to Determine the Impact of Repeated Immunization on Influenza Vaccine Effectiveness in Young Children. Canadian Immunization Research Network. PI: Kwong J. Collaborator(s): Buchan S, Campitelli M, Crowcroft N, Gubbay J, Karnauchow T, Katz K, Loeb M, McGeer A, McNally D, Richardson D, Richardson S, Simor A, Smieja M, Zahariadis G, Drews S, Russell M, Simmonds K, Svenson L, Thompson M. 140,000 CAD. 2016 Apr - 2018 Mar
Linking Laboratory and Administrative Data to Study Influenza and Influenza Vaccine Epidemiology. Canadian Institutes of Health Research (CIHR). PI: Kwong J. Collaborator(s): Crowcroft N, Gubbay J, Karnauchow T, Katz K, McGeer A, Ng S, Richardson D, Richardson S, Rosella L, Zahariadis G. 228,197 CAD. 2013 Oct - 2015 Sep
Severe Influenza in Infants, Children and Youths: Role of Clinical and Epidemiologic Risk Factors. Canadian Institutes of Health Research (CIHR). Collaborator(s): Tran D, Bettinger J, Dery P, Gubbay J, Halperin S, Ipp M, Le Saux N, Loeb M, McGeer A, Moore D, Paterson A, Richardson SE, Salvadori M, Schuh S, Vaudry W. 910,857 CAD. 2012 Jun - 2018 Jul
2007 AMMI Canada Distinguished Service Award
Association of Medical Microbiology and Infectious Disease (AMMI) Canada
John B. Walter Prize for Course Design and Development. Department of Laboratory Medicine and Pathobiology, University of Toronto. 2001.
McTaggart LR, Brown EM, Richardson SE. Phylogeographic Analysis of Blastomyces dermatitidis and Blastomyces gilchristii Reveals an Association with North American Freshwater Drainage Basins. PLOS One. 2016 Jul 18.
Doern CD, Richardson SE. Diagnosis of Urinary Tract Infections in Children. Journal of Clinical Microbiology. 2016. J Clin Microbiol 2016; 54(9):2233-2242
Campigotto A, Richardson S, Sebert M, McElvania TeKippe E, Chakravarty A, Doern C. Low Utility of the Pediatric Isolator Blood Culture System for the Detection of Fungemia in Children: A Ten Year Review. Journal of Clinical Microbiology. 2016. In Press (Trainee publication, Medical Microbiology resident).
Al-Zaidy SA, MacGregor D, Mahant S, Richardson SE, Bitnun A. Neurological Complications of PCR-Proven M. pneumoniae Infections in Children: Prodromal Illness Duration May Reflect Pathogenetic Mechanism. Clinical Infectious Diseases. 2015 Oct 1;61(7):1092-1098 (Trainee publication, Paediatric Neurology Fellow).
Squissato V, Yucel YH, Richardson SE, Alkhotani A, Wong DT, Nijhawan N, Chan CC. Colletotrichum truncatum Species Complex: Treatment Considerations and Review of the Literature for an Unusual Pathogen Causing Fungal Keratitis and Endophthalmitis. Medical Mycology Case Reports. 2015 Sep;9:1-6.
Patrick K, Ali M, Richardson SE, Gassas A, Egeler M, Krueger J, Lowry J, Allen U, Schechter-Finkelstein T. The Yield of Monitoring for HSV & VZV Viremia in Pediatric Hematopoietic Stem Cell Transplant Patients. Pediatric Transplantation. 2015 Sep;19(6):640-644
Hutspardol S, Essa M, Richardson S, Schechter T, Ali M, Krueger J, Fujii H, Egeler RM, Gassas A. Significant Transplant-Related Mortality from Respiratory Virus Infections Within the First 100 Days in Children Post Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. 2015 Jun 24
Schwartz KL, Sheffield H, Richardson SE, Sung L, Morris SK. Invasive Fusariosis: A Single Pediatric Center 15-Year Experience. Journal of the Pediatric Infectious Diseases Society. 2015 Jun;4(2):163-170 (Trainee publication, Paediatric Infectious Diseases Resident).
Hatchette TF, Drews SJ, Grudeski E, Booth T, Martineau C, Dust K, Garceau R, Gubbay J, Karnauchow T, Krajden M, Levett PN, Mazzulli T, McDonald RR, McNabb A, Mubareka S, Needle R, Petrich A, Richardson S, Rutherford C, Smieja M, Tellier R, Tipples G, Leblanc JJ. Detection of Enterovirus D68 in Canadian Laboratories. Journal of Clinical Microbiology. 2015 May 1;53(5):1748-1751.
Shalhoub S, Luong ML, Howard SJ, Richardson S, Singer LG, Chaparro C, Keshavjee S, Akinlolu Y, Rostein C, Mazzulli T, Husain S. Rate of CYP51A Mutation in Aspergillus Fumigatus Among Lung Transplant Recipients with Targeted Prophylaxis. Journal of Antimicrobial Chemotherapy. 2015 Apr;70(4):1064-1067.
Asner SA, Rose W, Petrich A, Richardson S, Tran DJ. Is Virus Co-Infection a Predictor of Severity in Children with Viral Respiratory Infections? Clinical Microbiology and Infection. 2015 Mar;21(3):264.e1-6 (Trainee publication, Paediatric Infectious Diseases Fellow).
Bitnun A, Richardson SE. Childhood Encephalitis in Canada in 2015. Canadian Journal of Infectious Diseases and Medical Microbiology. 2015 Mar;26(2):69-72.
McTaggart LR, Doucet J, Witkowska M, Richardson SE. Antimicrobial Susceptibility Among Clinical Nocardia Species Identified by Multilocus Sequence Analysis. Antimicrobial Agents and Chemotherapy. 2015 Jan;59(1):269-275.
Science M, MacGregor D, Richardson SE, Mahant S, Tran D, Bitnun A. Central Nervous System Complications of Varicella-Zoster Virus. The Journal of Pediatrics. 2014 Oct;165(4):779-785.
Asner SA, Petrich A, Hamid JS, Mertz D, Richardson SE, Smieja M. Clinical Severity of Rhinovirus/Enterovirus Compared to Other Respiratory Viruses in Children. Influenza and Other Respiratory Viruses. 2014 Aug;8(4):436-442.
Barton M, O’Brien K, Robinson JL, Davies DH, Simpson K, Asztalos E, Langley JM, LeSaux N, Sauve R, Synnes A, Tan B, de Repentigny L, Rubin E, Hui C, Kovacs L, Richardson SE. Invasive Candidiasis in Low Birth Weight Preterm Infants: Risk Factors, Clinical Course and Outcome in a Prospective Multicenter Study of Cases and Their Matched Controls. BMC Infectious Disease. 2014 Jun 12(14):327
Schwartz KL, Richardson SE, Ward KN, Donaldson C, MacGregor D, Banwell B, Mahant S, Bitnun A. Delayed Primary HHV-7 Infection and Neurologic Disease. Pediatrics. 2014 Jun;133(6):e1541-e1547.
Amin R, Ford-Jones E, Richardson SE, MacGregor D, Tellier R, Heurter H, Fearon M, Bitnun A. Acute childhood encephalitis and encephalopathy associated with influenza: a prospective 11-year review. Pediatric Infectious Disease Journal 2008; 27(5):390-395
Cameron MJ, Ran L, Xu L, Danesh A, Bermejo-Martin JF, Cameron CF, Muller MP, Gold WL, Richardson SE, Poutanen SM, Willey BM, DeVries ME, Fang Y, Seneviratne C, Bosinger SE, Persad D, Wilkinson P, Greller LD, Somogyi R, Humar A, Louie M, Loeb MB, Brunton J, McGeer AJ and Kelvin DJ, for the Canadian SARS Research Network. Interferon-mediated immunopathological events are associated with atypical innate and adaptive immune responses in severe acute respiratory syndrome (SARS) patients. J Virol 2007; 81(16):8692-8706
Elbers JM, Bitnun A, Richardson SE, Ford-Jones EL, Tellier R, Wald RM, Petric M, Kolski H, Heurter H, MacGregor D. A 12-year prospective study of childhood herpes simplex encephalitis: is there a broader spectrum of disease? Pediatrics 2007; 119:399-407