Department of Pediatrics

Clinical Interests

Dr. Elward is the Medical Director of Infection Control for Saint Louis Children's Hospital. She also serves on the Centers for Disease Control and Prevention's Hospital Infection Control Practice Advisory Committee (HICPAC) and is the HICPAC liaison to the Advisory Committee on Immunization Practices. Dr. Elward's research interests center around the epidemiology and outcomes of nosocomial infections in children, including hospital-acquired bloodstream infections, ventilator-associated pneumonia and antibiotic resistant organisms.

Education

• BA, Loyola College, 1988
• MD, University of Maryland School of Medicine, 1994
• MPH, St. Louis University School of Public Health, 2006

Training

• Resident, St. Louis Children's Hospital, 1994 - 1997
• Chief Resident, St. Louis Children's Hospital, 1997 - 1998
• Fellow, Washington Uniersity School of Medicine, 1998 - 2001
• Lean Six Sigma Yellow Belt Certification, 2006

Licensure and Board Certification

• 1996 - PresMO, Physician and Surgeon
• 1998American Board of Pediatrics (recertified 2005 and 2012)
• 2001Pediatric Infectious Diseases Subspecialy Certificaton (recertified 2008)

Honors and Awards

• National Merit Scholarship Finalist, 1984
• Valedictorian, Martin Spalding High School, Glen Burnie, MD, 1984
• Marion Burke Knott Full Tuition Scholarship, Loyola College, Baltimore, MD, 1984 - 1988
• Ayers Philosophy Award, 1988
• Pediatric Infectious Diseases Society Fellowship Award, 1999
• Saint Louis University School of Public Health Academic Achievement Award, 2006
• Quality Award, Neonatal Intensive Care Unit Bloodstream Infection Prevention Team Co-leader, St. Louis Children’s Hospital, 2007
• Synergy Award, Association for Professionals in Infection Control, St. Louis Chapter 73 “For Outstanding and Dedicated Service in Preventing Disease.”, 2007
• Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention, 2008
• Hospital Infection Control Practice Advisory Committee (HICPAC), Centers for Disease Control and Prevention, 2008
• Quality Award, Hand Hygiene Team, St. Louis Children’s Hospital, 2008
• Charles C. Shephard Science Award nominee, Centers for Disease Control and Prevention, 2009
• Society for Healthcare Epidemiology of America, Fellow status, 2009
• Top 10 percent Washington University Physicians Patient Satisfaction Survey, 2013
• Outstanding Commitment to Teaching Award, SLCH Pediatric Housestaff, 2014
• Acadamy of Educators, 2021
• Outstanding Commitment to Teaching Award, 2021

Recent Publications view all (50)

Publication Co-Authors

Ericka V. Hayes, M.D.

Gregory A. Storch, M.D.

Drew Schwartz, M.D., Ph.D.

Christopher McPherson

Jason Newland, M.D., M.Ed.

David A. Hunstad, M.D.

Kristine Wylie, Ph.D.

Barbara B. Warner, M.D., MSc

Neil H. White, M.D.

Rachel C. Orscheln, M.D.

Daniel Willis, MD MPHS

Jane M. Garbutt, M.D.

David A. Rosen, M.D., Ph.D.

Frederick S. Huang, M.D.

Janet Scheel

William Brinson Orr, MD, FAAP, FACC

Stephanie A. Fritz, M.D., M.S.C.I.

Nikoleta S. Kolovos, M.D.

Kevin T. Barton, M.D.

Neeta Vachharajani

Reich, Patrick

Victoria Fraser

John C. Lin, M.D.

Robert J. Hayashi, M.D.

Washington University has a long tradition of collaboration amongst colleagues.The faculty above have co-authored publications with Alexis M. Elward, M.D., M.P.H.

1. 1. Bryant K, Brady M, Cox K, Fauerbach L, Guzman-Cottrill J, Hogges M, Huskins WC, Iwamoto M, Leas B, Milstone A, Oliver C, Roberts K, Singh N, Okasako-Schmucker D,So C, Stone E, Umscheid C, Elward A and the Hospital Infection Control and Prevention Advisory Committee

   . Recommendations for Prevention and Control of Infections in NICU Patients: CLABSI. CDC. 2022. doi:https://www.cdc.gov/infectioncontrol/guidelines/nicu-clabsi.   
2. Reich, Patrick, Elward, Alexis. Infection Prevention during the COVID-19 Pandemic Infectious Diseases Clinics of North America. 2022;36(1):15-37. 
3. Willis DN, Huang FS, Elward AM, Wu N, Magnusen B, Dubberke ER, Hayashi RJ. Clostridioides difficile Infections in Inpatient Pediatric Oncology Patients: A Cohort Study Evaluating Risk Factors and Associated Outcomes. J Pediatric Infect Dis Soc. 2021;10(3):302-308. PMCID:PMC8023311  PMID:32766672 
4. Orr WB, Elward AM, Lin JC, Reich PJ, Scheel JN, Hayes EV, Remy KE. Delayed Development of Coronary Artery Dilitation in Suspected Severe Acute Respiratory Syndrome Coronavirus 2 Multisystem Inflammatory Syndrome: More Research Needed. Crit Care Explor. 2020;2(10):e0236. PMCID:PMC7531755  PMID:33063036 
5. Milstone AM, Elward A, Brady MT, et al.. Centers for Disease Control and Prevention Recommendations for the Prevention and Control of Infections in Neonatal Intensive Care Unit Patients: Staphylococcus aureus, 2020. Centers for Disease Control and Prevention, Infection Control Guidelines Website. Published September 14, 2020. Accessed: [DATE] https://www.cdc.gov/infectioncontrol/guidelines/nicu-saureus/index.html. https://www.cdc.gov/infectioncontrol/guidelines/nicu-saureus/index.html. . 2020. 
6. Schwartz DJ, Elward A, Storch GA, Rosen DA. Ureaplasma urealyticum pyelonephritis presenting with progressive dysuria, renal failure, and neurologic symptoms in an immunocompromised patient. Transpl Infect Dis. 2019;21(2):e13032. PMCID:PMC6542459  PMID:30472777 
7. Barton K, Davis TK, Marshall B, Elward A, White NH. Posaconazole-induced hypertension and hypokalemia due to inhibition of the 11β-hydroxylase enzyme. Clin Kidney J. 2018;11(5):691-693. PMCID:PMC6165748  PMID:30289132 
8. Sandora TJ, Bryant KK, Cantey JB, Elward AM, Yokoe DS, Bartlett AH. SHEA neonatal intensive care unit (NICU) white paper series: Practical approaches to Clostridioides difficile prevention. Infect Control Hosp Epidemiol. 2018;39(10):1149-1153. PMID:30160646 
9. Gregory JR, Smith JC, Brown-Riley SM, Elward AM, Luhmann SJ. Vancomycin Concentrations in Paraspinal Muscles During Posterior Spinal Fusions for Neuromuscular Scoliosis. Spine Deform. 2018;6(6):736-740. PMID:30348352 
10. Pierce R, Bryant K, Elward A, Lessler J, Milstone AM. Bacterial Infections in Neonates Following Mupirocin-Based MRSA Decolonization: A Multicenter Cohort Study. Infect Control Hosp Epidemiol. 2017;1-7. PMID:28578731 
11. Das S, Adler AL, Miles-Jay A, Kronman MP, Qin X, Weissman SJ, Burnham CA, Elward A, Newland JG, Selvarangan R, Sullivan KV, Zaoutis T, Zerr DM. Antibiotic Prophylaxis Is Associated with Subsequent Resistant Infections in Children with an Initial Extended-Spectrum-Cephalosporin-Resistant Enterobacteriaceae Infection. Antimicrob Agents Chemother. 2017;61(5). PMCID:PMC5404513  PMID:28289030 
12. Vachharajani AJ, Vachharajani NA, Morris H, Niesen A, Elward A, Linck DA, Mathur AM. Reducing peripherally inserted central catheters in the neonatal intensive care unit. J Perinatol. 2017;37(4):409-413. PMID:28079867 
13. Zerr DM, Weissman SJ, Zhou C, Kronman MP, Adler AL, Berry JE, Rayar J, Myers J, Haaland WL, Burnham CD, Elward A, Newland J, Selvarangan R, Sullivan KV, Zaoutis T, Qin X. The Molecular and Clinical Epidemiology of Extended-Spectrum Cephalosporin- and Carbapenem-Resistant Enterobacteriaceae at 4 US Pediatric Hospitals. J Pediatric Infect Dis Soc. 2017. PMID:28339623 
14. Reich PJ, Boyle MG, Hogan PG, Johnson AJ, Wallace MA, Elward AM, Warner BB, Burnham CA, Fritz SA. Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge. Clin Microbiol Infect. 2016;22(7):645.e1-8. PMCID:PMC4987169  PMID:27126609 
15. Zerr DM, Miles-Jay A, Kronman MP, Zhou C, Adler AL, Haaland W, Weissman SJ, Elward A, Newland JG, Zaoutis T, Qin X. Previous Antibiotic Exposure Increases Risk of Infection with Extended-Spectrum-β-Lactamase- and AmpC-Producing Escherichia coli and Klebsiella pneumoniae in Pediatric Patients. Antimicrob Agents Chemother. 2016;60(7):4237-43. PMCID:PMC4914666  PMID:27139486 
16. Zhou Y, Wylie KM, El Feghaly RE, Mihindukulasuriya KA, Elward A, Haslam DB, Storch GA, Weinstock GM. Metagenomic Approach for Identification of the Pathogens Associated with Diarrhea in Stool Specimens. J Clin Microbiol. 2016;54(2):368-75. PMCID:PMC4733167  PMID:26637379 
17. Elward A, Yegge J, Recktenwald A, Jadwisiak L, Kieffer P, Hohrein M, Hopkins-Broyles D, Woeltje KF. Risk Factors for Craniotomy or Spinal Fusion Surgical Site Infection. Pediatr Infect Dis J. 2015;34(12):1323-8. PMID:26353030 
18. Rodriguez M, Nelson M, Kelly JE, Elward A, Morley SC. Successful use of temocillin as salvage therapy for cervical osteomyelitis secondary to multi-drug resistant Burkholderia cepacia J Pediar Infect Dis Soc. 2014;3(1):77-80. 
19. Rodriguez M, Nelson M, Kelly JE, Elward A, Morley SC. Successful Use of Temocillin as Salvage Therapy for Cervical Osteomyelitis Secondary to Multidrug-Resistant Burkholderia cepacia. J Pediatric Infect Dis Soc. 2014;3(1):77-80. PMID:26624908 
20. Milstone AM, Elward A, Song X, Zerr DM, Orscheln R, Speck K, Obeng D, Reich NG, Coffin SE, Perl TM, Pediatric SCRUB Trial Study Group. Daily chlorhexidine bathing to reduce bacteraemia in critically ill children: a multicentre, cluster-randomised, crossover trial. Lancet. 2013;381(9872):1099-106. doi:10.1016/S0140-6736(12)61687-0  PMID:23363666 
21. Feemster KA, Leckerman KH, Middleton M, Zerr DM, Elward AM, Newland JG, Asti L, Guth RM, Selvarangan R, Coffin SE. Use of Administrative Data for the Identificationof Laboratory-Confirmed Influenza Infection: The Validity ofInfluenza-Specific ICD-9 Codes. J Pediatric Infect Dis Soc. 2013;2(1):63-6. PMID:26619444 
22. McPherson C, Warner B, Hunstad DA, Elward A, Acosta EP. Oseltamivir dosing in premature infants. J Infect Dis. 2012;206(6):847-50. doi:10.1093/infdis/jis471  PMCID:PMC3572879  PMID:22807525 
23. MacCannell T, Umscheid CA, Agarwal RK, Lee I, Kuntz G, Stevenson KB, Healthcare Infection Control Practices Advisory Committee-HICPAC. Guideline for the prevention and control of norovirus gastroenteritis outbreaks in healthcare settings. Infect Control Hosp Epidemiol. 2011;32(10):939-69. doi:10.1086/662025  PMID:21931246 
24. Bucher BT, Guth RM, Elward AM, Hamilton NA, Dillon PA, Warner BW, Keller MS. Risk factors and outcomes of surgical site infection in children. J Am Coll Surg. 2011;212(6):1033-1038.e1. doi:10.1016/j.jamcollsurg.2011.01.065  PMID:21398150 
25. O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S, Healthcare Infection Control Practices Advisory Committee (HICPAC) (Appendix 1).. Summary of recommendations: Guidelines for the Prevention of Intravascular Catheter-related Infections. Clin Infect Dis. 2011;52(9):1087-99. PMCID:PMC3106267  PMID:21467014 
26. O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S, Healthcare Infection Control Practices Advisory Committee (HICPAC).. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162-93. PMCID:PMC3106269  PMID:21460264 
27. Toltzis P, Elward A, Davis D, Helfaer M, Smathers S, Zaoutis T. Opportunities for antibiotic reduction in mechanically ventilated children. Pediatr Crit Care Med. 2011;12(3):282-5. doi:10.1097/PCC.0b013e3181f39f0e  PMID:20921920 
28. O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S, Healthcare Infection Control Practices Advisory Committee. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4 Suppl 1):S1-34. doi:10.1016/j.ajic.2011.01.003  PMID:21511081 
29. Shaklee J, Zerr DM, Elward A, Newland J, Leckerman K, Asti L, Guth R, Bass J, Selvarangan R, Coffin S, Zaoutis T. Improving surveillance for pediatric Clostridium difficile infection: derivation and validation of an accurate case-finding tool. Pediatr Infect Dis J. 2011;30(3):e38-40. doi:10.1097/INF.0b013e3182027c22  PMID:21079527 
30. National Center for Immunization and Respiratory Diseases.. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60(2):1-64. PMID:21293327 
31. Milstone AM, Song X, Coffin S, Elward A, Society for Healthcare Epidemiology of America's Pediatric Special Interest Group. Identification and eradication of methicillin-resistant Staphylococcus aureus colonization in the neonatal intensive care unit: results of a national survey. Infect Control Hosp Epidemiol. 2010;31(7):766-8. doi:10.1086/653615  PMCID:PMC2881181  PMID:20470034 
32. Umscheid CA, Agarwal RK, Brennan PJ, Healthcare Infection Control Practices Advisory Committee.. Updating the guideline development methodology of the Healthcare Infection Control Practices Advisory Committee (HICPAC). Am J Infect Control. 2010;38(4):264-73. PMID:20116133 
33. Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol. 2010;31(4):319-26. doi:10.1086/651091  PMID:20156062 
34. Elward AM, McAndrews JM, Young VL. Methicillin-sensitive and methicillin-resistant Staphylococcus aureus: preventing surgical site infections following plastic surgery. Aesthet Surg J. 2009;29(3):232-44. doi:10.1016/j.asj.2009.01.010  PMID:19608074 
35. Blossom DB, Kallen AJ, Patel PR, Elward A, Robinson L, Gao G, Langer R, Perkins KM, Jaeger JL, Kurkjian KM, Jones M, Schillie SF, Shehab N, Ketterer D, Venkataraman G, Kishimoto TK, Shriver Z, McMahon AW, Austen KF, Kozlowski S, Srinivasan A, Turabelidze G, Gould CV, Arduino MJ, Sasisekharan R. Outbreak of adverse reactions associated with contaminated heparin. N Engl J Med. 2008;359(25):2674-84. doi:10.1056/NEJMoa0806450  PMID:19052120 
36. Fritz SA, Garbutt J, Elward A, Shannon W, Storch GA. Prevalence of and risk factors for community-acquired methicillin-resistant and methicillin-sensitive staphylococcus aureus colonization in children seen in a practice-based research network. Pediatrics. 2008;121(6):1090-8. doi:10.1542/peds.2007-2104  PMID:18519477 
37. Turabelidze G, Elward A, Jones M, Patel PR, Arduino M, Gould C, Shehab N, Sunkavalli K, Schillie S, Blossom D, Kallen A, Jaeger J. Acute Allergic-Type Reactions Among Patients Undergoing Hemodialysis—Multiple States 2007-2008 MMWR. 2008;57. 
38. Foglia E, Meier MD, Elward A. Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients. Clin Microbiol Rev. 2007;20(3):409-25, table of contents. doi:10.1128/CMR.00041-06  PMCID:PMC1932752  PMID:17630332 
39. Foglia EE, Fraser VJ, Elward AM. Effect of nosocomial infections due to antibiotic-resistant organisms on length of stay and mortality in the pediatric intensive care unit. Infect Control Hosp Epidemiol. 2007;28(3):299-306. doi:10.1086/512628  PMID:17326020 
40. Warren DK, Quadir WW, Hollenbeak CS, Elward AM, Cox MJ, Fraser VJ. Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital. Crit Care Med. 2006;34(8):2084-9. doi:10.1097/01.CCM.0000227648.15804.2D  PMID:16763511 
41. Elward A, Grim A, Schroeder P, Kieffer P, Sellenriek P, Ferrett R, Adams HC, Phillips V, Bartow R, Mays D, Lawrence S, Seed P, Holzmann-Pazgal G, Polish L, Leet T, Fraser V. Outbreak of Salmonella javiana infection at a children's hospital. Infect Control Hosp Epidemiol. 2006;27(6):586-92. doi:10.1086/504935  PMID:16755478 
42. Elward AM, Fraser VJ. Risk factors for nosocomial primary bloodstream infection in pediatric intensive care unit patients: a 2-year prospective cohort study. Infect Control Hosp Epidemiol. 2006;27(6):553-60. doi:10.1086/505096  PMID:16755473 
43. Elward AM, Hollenbeak CS, Warren DK, Fraser VJ. Attributable cost of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics. 2005;115(4):868-72. doi:10.1542/peds.2004-0256  PMID:15805357 
44. Kennedy AM, Elward AM, Fraser VJ. Survey of knowledge, beliefs, and practices of neonatal intensive care unit healthcare workers regarding nosocomial infections, central venous catheter care, and hand hygiene. Infect Control Hosp Epidemiol. 2004;25(9):747-52. doi:10.1086/502471  PMID:15484799 
45. Elward AM. Pediatric ventilator-associated pneumonia. Pediatr Infect Dis J. 2003;22(5):445-6. doi:10.1097/01.inf.0000069000.67615.bd  PMID:12792388 
46. Yogaraj JS, Elward AM, Fraser VJ. Rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics. 2002;110(3):481-5. PMID:12205248 
47. Elward AM, Warren DK, Fraser VJ. Ventilator-associated pneumonia in pediatric intensive care unit patients: risk factors and outcomes. Pediatrics. 2002;109(5):758-64. PMID:11986433 
48. Elward AM, McGann KA. Steps to Prevent Nosocomial Infections in Children Infections in Medicine. 2002;19:414-419. 
49. Warren DK, Zack JE, Elward AM, Cox MJ, Fraser VJ. Nosocomial primary bloodstream infections in intensive care unit patients in a nonteaching community medical center: a 21-month prospective study. Clin Infect Dis. 2001;33(8):1329-35. doi:10.1086/322483  PMID:11550117 
50. Janowski, Andrew, Kao, Carol, Elward, Alexis. Pediatric Infectious Diseases Washington Manual.