Department of Pediatrics

Clinical Interests

Dr. Hunstad evaluates children with a variety of infectious diseases at St. Louis Children's Hospital. In his research laboratory in the McDonnell Pediatric Research Building, he studies the interactions of pathogenic bacteria with their hosts. He is particularly interested in mechanisms by which Gram-negative pathogens interfere with host immune responses in order to establish infection. Related projects in the laboratory are aimed at determining how bacteria assemble and utilize outer membrane protein virulence factors on their surfaces. He also participates in collaborative studies of methicillin-resistant Staph infections in children. The overarching goal of these studies is to develop new targets useful in the prevention and treatment of common bacterial infections.

Education

• BA, summa cum laude, Carleton College, 1991
• MD, Washington University School of Medicine, 1995

Training

• Intern and Resident in Pediatrics, St. Louis Children's Hospital, 1995 - 1998
• Chief Resident in Pediatrics, St. Louis Children's Hospital, 1998 - 1999
• Fellow, Pediatric Infectious Diseases, Washington University, 2000 - 2003

Licensure and Board Certification

• 1998 - PresMO, Physician and Surgeon
• 1999 - PresAmerican Board of Pediatrics
• 2003 - PresABP Sub-board of Pediatric Infectious Diseases
• 2008Neonatal Resuscitation Program

Honors and Awards

• Dean's List, Carleton College, 1987 - 1991
• CRC Press Award, Carleton College, 1988
• Phi Beta Kappa Sophomore Award, Carleton College, 1989
• Barry M. Goldwater Foundation Scholarship, 1990 - 1991
• USA Today All-USA Academic Team, 1990 - 1991
• Virgil Loeb, MD, Distinguished Alumni Scholarship, Washington University, 1991 - 1995
• Finalist, American College of Physicians Award for Excellence in Physical Diagnosis, 1994
• Fellow, Pediatric Scientist Development Program, 2001 - 2004
• NIH Pediatric Research Loan Repayment Program Award, 2002 - 2006
• Scholar, WU Child Health Research Center of Excellence, 2005 - 2008
• Wall of Honor, SOAR Program, Red Wing, MN, 2006
• Basil O'Connor Scholar Award, March of Dimes Foundation, 2009
• Residents' Lecture Award (x2), St. Louis Children's Hospital, 2010
• David Hunstad, MD, Distinguished Alumni Scholarship named by Washington University School of Medicine, 2015
• Fellow, Pediatric Infectious Diseases Society, 2015
• Residents’ Lecture Award, St. Louis Children’s Hospital, 2015
• Best Doctors in America (St. Louis Magazine), 2015 - 2018
• Featured New Member, American Pediatric Society, 2017
• Elected Member, Alpha Omega Alpha, 2018
• Faculty Achievement Award, WU Medical Center Alumni Association, 2019
• Fellow, Infectious Diseases Society of America, 2020
• Named inaugural Arnold W. Strauss, MD, Endowed Professor for Mentoring, WUSM, 2022

Recent Publications view all (56)

Publication Co-Authors

Gregory A. Storch, M.D.

Stephanie S Cabler

Duha Al-Zubeidi

Jeffrey J. Bednarski, M.D., Ph.D.

Christopher McPherson

Keith A. Hruska, M.D.

Kristine Wylie, Ph.D.

Barbara B. Warner, M.D., MSc

Andrew J. White, M.D.

Maleewan Kitcharoensakkul, MD, MSCI

Anthony R. French, MD, PhD

Rachel C. Orscheln, M.D.

Alexis M. Elward, M.D., M.P.H.

Jane M. Garbutt, M.D.

Kelleigh Briden

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

Todd N. Wylie

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

Melanie Yarbrough

Reich, Patrick

Carol Kao

Kevin Baszis, M.D.

S. Celeste Morley, M.D., Ph.D.

Washington University has a long tradition of collaboration amongst colleagues.The faculty above have co-authored publications with David A. Hunstad, M.D.

1. Godfred-Cato S, Abrams JY, Balachandran N, Jaggi P, Jones K, Rostad CA, Lu AT, Fan L, Jabbar A, Anderson EJ, Kao CM, Hunstad DA, Rosenberg RB, Zafferani MJ, Ede KC, Ballan W, Laham FR, Beltran Y, Bryant B, Meng L, Hammett TA, Oster ME, Bamrah Morris S, Belay ED. Distinguishing Multisystem Inflammatory Syndrome in Children From COVID-19, Kawasaki Disease and Toxic Shock Syndrome. Pediatr Infect Dis J. 2022;41(4):315-323. PMCID:PMC8919949  PMID:35093995 
2. Lapp SA, Abrams J, Lu AT, Hussaini L, Kao CM, Hunstad DA, Rosenberg RB, Zafferani MJ, Ede KC, Ballan W, Laham FR, Beltran Y, Hsiao HM, Sherry W, Jenkins E, Jones K, Horner A, Brooks A, Bryant B, Meng L, Hammett TA, Oster ME, Bamrah-Morris S, Godfred-Cato S, Belay E, Chahroudi A, Anderson EJ, Jaggi P, Rostad CA. Serologic and Cytokine Signatures in Children With Multisystem Inflammatory Syndrome and Coronavirus Disease 2019. Open Forum Infect Dis. 2022;9(3):ofac070. PMCID:PMC8883592  PMID:35237703 
3. Song Y, Elsabahy M, Collins CA, Khan S, Li R, Hreha TN, Shen Y, Lin YN, Letteri RA, Su L, Dong M, Zhang F, Hunstad DA, Wooley KL. Morphologic Design of Silver-Bearing Sugar-Based Polymer Nanoparticles for Uroepithelial Cell Binding and Antimicrobial Delivery. Nano Lett. 2021;21(12):4990-4998. PMCID:PMC8545462  PMID:34115938 
4. McLellan LK, McAllaster MR, Kim AS, Tóthová Ľ, Olson PD, Pinkner JS, Daugherty AL, Hreha TN, Janetka JW, Fremont DH, Hultgren SJ, Virgin HW, Hunstad DA. A host receptor enables type 1 pilus-mediated pathogenesis of Escherichia coli pyelonephritis. PLoS Pathog. 2021;17(1):e1009314. PMID:33513212 
5. McLellan LK, Daugherty AL, Hunstad DA. Sex differences in population dynamics during formation of kidney bacterial communities by uropathogenic Escherichia coli. Infect Immun. 2021. PMID:33468577 
6. Hreha TN, Collins CA, Daugherty AL, Griffith JM, Hruska KA, Hunstad DA. Androgen-Influenced Polarization of Activin A-Producing Macrophages Accompanies Post-pyelonephritic Renal Scarring. Front Immunol. 2020;11:1641. PMCID:PMC7399094  PMID:32849562 
7. Cabler SS, Hogan PG, Fritz SA, Bednarski JJ, Hunstad DA. Incidence and treatment of hemophagocytic lymphohistiocytosis in hospitalized children with Ehrlichia infection. Pediatr Blood Cancer. 2020;e28436. PMID:32706439 
8. Hogan PG, Parrish KL, Mork RL, Boyle MG, Muenks CE, Thompson RM, Morelli JJ, Sullivan ML, Hunstad DA, Wardenburg JB, Rzhetsky A, Gehlert SJ, Burnham CD, Fritz SA. HOME2: Household vs. Personalized Decolonization in Households of Children with Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infection - A Randomized Clinical Trial. Clin Infect Dis. 2020. PMID:32521007 
9. Hogan PG, Mork RL, Thompson RM, Muenks CE, Boyle MG, Sullivan ML, Morelli JJ, Williams CV, Sanchez N, Hunstad DA, Wardenburg JB, Gehlert SJ, Burnham CD, Rzhetsky A, Fritz SA. Environmental Methicillin-resistant Staphylococcus aureus Contamination, Persistent Colonization, and Subsequent Skin and Soft Tissue Infection. JAMA Pediatr. 2020;174(6):552-562. PMCID:PMC7105954  PMID:32227144 
10. Hreha TN, Collins CA, Daugherty AL, Twentyman J, Paluri N, Hunstad DA. TGFβ1 orchestrates renal fibrosis following Escherichia coli pyelonephritis. Physiol Rep. 2020;8(6):e14401. PMCID:PMC7104652  PMID:32227630 
11. Parrish KL, Wylie KM, Reich PJ, Hogan PG, Wylie TN, Kennedy CR, Lainhart W, Hunstad DA, Burnham CD, Fritz SA. Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates. J Pediatric Infect Dis Soc. 2018. PMID:30285124 
12. Kulkarni DH, McDonald KG, Knoop KA, Gustafsson JK, Kozlowski KM, Hunstad DA, Miller MJ, Newberry RD. Goblet cell associated antigen passages are inhibited during Salmonella typhimurium infection to prevent pathogen dissemination and limit responses to dietary antigens. Mucosal Immunol. 2018;11(4):1103-1113. PMCID:PMC6037413  PMID:29445136 
13. Olson PD, McLellan LK, Hreha TN, Liu A, Briden KE, Hruska KA, Hunstad DA. Androgen exposure potentiates formation of intratubular communities and renal abscesses by Escherichia coli. Kidney Int. 2018. doi:10.1016/j.kint.2018.04.023  PMID:30041870 
14. Yarbrough ML, Briden KE, Mitsios JV, Weindel AL, Terrill CM, Hunstad DA, Dietzen DJ. Mass spectrometric measurement of urinary kynurenine-to-tryptophan ratio in children with and without urinary tract infection. Clin Biochem. 2018;56:83-88. PMCID:PMC6007864  PMID:29679555 
15. Rosen DA, Twentyman J, Hunstad DA. High levels of cyclic di-GMP in Klebsiella pneumoniae attenuate virulence in the lung. Infect Immun. 2018;86(2):00647-17. doi:10.1128/IAI.00647-17  PMCID:PMC5778367  PMID:29158434 
16. Cho S, Heo GS, Khan S, Huang J, Hunstad DA, Elsabahy M, Wooley KL. A vinyl ether-functional polycarbonate as a template for multiple postpolymerization modifications. Macromolecules. 2018;51:3233-3242. doi:10.1021/acs.macromol.8b00047  PMCID:PMC6002957  PMID:29915431 
17. Olson PD, McLellan LK, Liu A, Briden KL, Tiemann KM, Daugherty AL, Hruska KA, Hunstad DA. Renal scar formation and kidney function following antibiotic-treated murine pyelonephritis. Dis Model Mech. 2017;10(11):1371-1379. PMCID:PMC5719254  PMID:28882930 
18. DeBord MA, Southerland MR, Wagers PO, Tiemann KM, Robishaw NK, Whiddon KT, Konopka MC, Tessier CA, Shriver LP, Paruchuri S, Hunstad DA, Panzner MJ, Youngs WJ. Synthesis, characterization, in vitro SAR and in vivo evaluation of N,N'bisnaphthylmethyl 2-alkyl substituted imidazolium salts against NSCLC. Bioorg Med Chem Lett. 2017;27(4):764-775. PMCID:PMC5575737  PMID:28126518 
19. Olson PD, Hruska KA, Hunstad DA. Androgens enhance male urinary tract infection severity in a new model. J Am Soc Nephrol. 2016;27(6):1625-34. PMCID:PMC4884108  PMID:26449605 
20. Loughman JA, Yarbrough ML, Tiemann KM, Hunstad DA. Local generation of kynurenines mediates inhibition of neutrophil chemotaxis by uropathogenic Escherichia coli. Infect Immun. 2016;84(4):1176-83. PMCID:PMC4807489  PMID:26857571 
21. Rosen DA, Hilliard JK, Tiemann KM, Todd EM, Morley SC, Hunstad DA. Klebsiella pneumoniae FimK promotes virulence in murine pneumonia. J Infect Dis. 2016;213(4):649-58. doi:10.1093/infdis/jiv440  PMCID:PMC4721909  PMID:26347570 
22. Wagers PO, Tiemann KM, Shelton KL, Kofron WG, Panzner MJ, Wooley KL, Youngs WJ, Hunstad DA. Imidazolium salts as small-molecule urinary bladder exfoliants in a murine model. Antimicrob Agents Chemother. 2015;59(9):5494-5502. doi:10.1128/AAC.00881-15  PMCID:PMC4538537  PMID:26124168 
23. Wang JW, Hogan PG, Hunstad DA, Fritz SA. Vitamin D sufficiency and Staphylococcus aureus infection in children. Pediatr Infect Dis J. 2015;34(5):544-5. doi:10.1097/INF.0000000000000667  PMCID:PMC4400212  PMID:25860535 
24. Danka ES, Hunstad DA. Cathelicidin augments epithelial receptivity and pathogenesis in experimental Escherichia coli cystitis. J Infect Dis. 2015;211(7):1164-73. doi:10.1093/infdis/jiu577  PMCID:PMC4366604  PMID:25336727 
25. Lim YH, Tiemann KM, Heo GS, Wagers PO, Rezenom YH, Zhang S, Zhang F, Youngs WJ, Hunstad DA, Wooley KL. Preparation and in vitro antimicrobial activity of silver-bearing degradable polymeric nanoparticles of polyphosphoester-block-poly(L-lactide). ACS Nano. 2015;9(2):1995-2008. doi:10.1021/nn507046h  PMCID:PMC4455953  PMID:25621868 
26. Lau ME, Danka ES, Tiemann KM, Hunstad DA. Bacterial lysis liberates the neutrophil migration suppressor YbcL from the periplasm of uropathogenic Escherichia coli. Infect Immun. 2014;82(12):4921-30. PMCID:PMC4249291  PMID:25183735 
27. Al-Zubeidi D, Burnham CA, Hogan PG, Collins R, Hunstad DA, Fritz SA. Molecular epidemiology of recurrent cutaneous methicillin-resistant Staphylococcus aureus infections in children. J Pediatric Infect Dis Soc. 2014;3(3):261-264. doi:10.1093/jpids/pit046  PMCID:PMC4381745  PMID:25844165 
28. Kitcharoensakkul M, Schulz CG, Kassel R, Khanna G, Liang S, Ngwube A, Baszis KW, Hunstad DA, White AJ. Scurvy revealed by difficulty walking: three cases in young children. J Clin Rheumatol. 2014;20(4):224-8. doi:10.1097/RHU.0000000000000101  PMID:24847751 
29. Heble DE Jr, McPherson C, Nelson MP, Hunstad DA. Vancomycin trough concentrations in overweight or obese pediatric patients. Pharmacotherapy. 2013;33(12):1273-7. doi:10.1002/phar.1321  PMID:23798327 
30. Lau ME, Hunstad DA. Quantitative assessment of human neutrophil migration across a cultured bladder epithelium. J Vis Exp. 2013;81:e50919. doi:10.3791/50919  PMCID:PMC3934319  PMID:24300797 
31. El Feghaly RE, Hunstad DA. A newborn with hydrops, hydrocephalus and ophthalmologic abnormalities. J Ped Infect Dis Soc. 2013;2:391-393. PMID:26619503 
32. Fritz SA, Tiemann KM, Hogan PG, Epplin EK, Rodriguez M, Al-Zubeidi DN, Bubeck Wardenburg J, Hunstad DA. A serologic correlate of protective immunity against community-onset Staphylococcus aureus infection. Clin Infect Dis. 2013;56(11):1554-61. doi:10.1093/cid/cit123  PMCID:PMC3641868  PMID:23446627 
33. Lau ME, Loughman JA, Hunstad DA. YbcL of uropathogenic Escherichia coli suppresses transepithelial neutrophil migration. Infect Immun. 2012;80(12):4123-32. doi:10.1128/IAI.00801-12  PMCID:PMC3497442  PMID:22966043 
34. 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  PMID:22807525 
35. Loughman JA, Hunstad DA. Induction of indoleamine 2,3-dioxygenase by uropathogenic bacteria attenuates innate responses to epithelial infection. J Infect Dis. 2012;205(12):1830-9. doi:10.1093/infdis/jis280  PMCID:PMC3415894  PMID:22474038 
36. Lin LY, Tiemann KM, Li Y, Pinkner JS, Walker JN, Hultgren SJ, Hunstad DA, Wooley KL. Synthetic polymer nanoparticles conjugated with FimH(A) from E. coli pili to emulate the bacterial mode of epithelial internalization. J Am Chem Soc. 2012;134(9):3938-41. doi:10.1021/ja2091917  PMCID:PMC3325780  PMID:22360307 
37. Loughman JA, Hunstad DA. Attenuation of human neutrophil migration and function by uropathogenic bacteria. Microbes Infect. 2011;13(6):555-65. doi:10.1016/j.micinf.2011.01.017  PMCID:PMC3092803  PMID:21315174 
38. Zhang B, Watts KM, Hodge D, Kemp LM, Hunstad DA, Hicks LM, Odom AR. A second target of the antimalarial and antibacterial agent fosmidomycin revealed by cellular metabolic profiling. Biochemistry. 2011;50(17):3570-7. doi:10.1021/bi200113y  PMCID:PMC3082593  PMID:21438569 
39. Horvath DJ Jr, Li B, Casper T, Partida-Sanchez S, Hunstad DA, Hultgren SJ, Justice SS. Morphological plasticity promotes resistance to phagocyte killing of uropathogenic Escherichia coli. Microbes Infect. 2011;13(5):426-37. doi:10.1016/j.micinf.2010.12.004  PMCID:PMC3071881  PMID:21182979 
40. Fritz SA, Krauss MJ, Epplin EK, Burnham CA, Garbutt J, Dunne WM, Hunstad DA, Storch GA. The natural history of contemporary Staphylococcus aureus nasal colonization in community children. Pediatr Infect Dis J. 2011;30(4):349-51. doi:10.1097/INF.0b013e3181fe075e  PMCID:PMC3077955  PMID:21412205 
41. Li Y, Hindi K, Watts KM, Taylor JB, Zhang K, Li Z, Hunstad DA, Cannon CL, Youngs WJ, Wooley KL. Shell crosslinked nanoparticles carrying silver antimicrobials as therapeutics. Chem Commun (Camb). 2010;46(1):121-3. doi:10.1039/b916559b  PMCID:PMC2978063  PMID:20024313 
42. Nicholson TF, Watts KM, Hunstad DA. OmpA of uropathogenic Escherichia coli promotes postinvasion pathogenesis of cystitis. Infect Immun. 2009;77(12):5245-51. doi:10.1128/IAI.00670-09  PMCID:PMC2786482  PMID:19797074 
43. Orscheln RC, Hunstad DA, Fritz SA, Loughman JA, Mitchell K, Storch EK, Gaudreault M, Sellenriek PL, Armstrong JR, Mardis ER, Storch GA. Contribution of genetically restricted, methicillin-susceptible strains to the ongoing epidemic of community-acquired Staphylococcus aureus infections. Clin Infect Dis. 2009;49(4):536-42. doi:10.1086/600881  PMCID:PMC2965061  PMID:19589082 
44. Loughman JA, Fritz SA, Storch GA, Hunstad DA. Virulence gene expression in human community-acquired Staphylococcus aureus infection. J Infect Dis. 2009;199(3):294-301. doi:10.1086/595982  PMCID:PMC2843142  PMID:19115951 
45. Watts KM, Hunstad DA. Components of SurA required for outer membrane biogenesis in uropathogenic Escherichia coli. PLoS One. 2008;3(10):e3359. doi:10.1371/journal.pone.0003359  PMCID:PMC2556385  PMID:18836534 
46. Justice SS, Hunstad DA, Cegelski L, Hultgren SJ. Morphological plasticity as a bacterial survival strategy. Nat Rev Microbiol. 2008;6(2):162-8. doi:10.1038/nrmicro1820  PMID:18157153 
47. Miller AS, Hunstad DA. Salmonella ovarian abscess in an adolescent. Pediatr Infect Dis J. 2007;26(6):548-9. doi:10.1097/INF.0b013e31804b21b2  PMID:17529879 
48. Hunstad DA, French AR. Histoplasmosis in a child with JRA on low-dose methotrexate. Rheumatology (Oxford). 2007;46(1):177-8. doi:10.1093/rheumatology/kel375  PMID:17114804 
49. Justice SS, Hunstad DA, Seed PC, Hultgren SJ. Filamentation by Escherichia coli subverts innate defenses during urinary tract infection. Proc Natl Acad Sci U S A. 2006;103(52):19884-9. doi:10.1073/pnas.0606329104  PMCID:PMC1750882  PMID:17172451 
50. Justice SS, Lauer SR, Hultgren SJ, Hunstad DA. Maturation of intracellular Escherichia coli communities requires SurA. Infect Immun. 2006;74(8):4793-800. doi:10.1128/IAI.00355-06  PMCID:PMC1539609  PMID:16861667 
51. Justice SS, Hunstad DA, Harper JR, Duguay AR, Pinkner JS, Bann J, Frieden C, Silhavy TJ, Hultgren SJ. Periplasmic peptidyl prolyl cis-trans isomerases are not essential for viability, but SurA is required for pilus biogenesis in Escherichia coli. J Bacteriol. 2005;187(22):7680-6. doi:10.1128/JB.187.22.7680-7686.2005  PMCID:PMC1280321  PMID:16267292 
52. Hunstad DA, Justice SS, Hung CS, Lauer SR, Hultgren SJ. Suppression of bladder epithelial cytokine responses by uropathogenic Escherichia coli. Infect Immun. 2005;73(7):3999-4006. doi:10.1128/IAI.73.7.3999-4006.2005  PMCID:PMC1168571  PMID:15972487 
53. Roberts JA, Kaack MB, Baskin G, Chapman MR, Hunstad DA, Pinkner JS, Hultgren SJ. Antibody responses and protection from pyelonephritis following vaccination with purified Escherichia coli PapDG protein. J Urol. 2004;171(4):1682-5. doi:10.1097/01.ju.0000116123.05160.43  PMCID:PMC2838480  PMID:15017266 
54. Schilling JD, Martin SM, Hunstad DA, Patel KP, Mulvey MA, Justice SS, Lorenz RG, Hultgren SJ. CD14- and Toll-like receptor-dependent activation of bladder epithelial cells by lipopolysaccharide and type 1 piliated Escherichia coli. Infect Immun. 2003;71(3):1470-80. PMCID:PMC148872  PMID:12595465 
55. Hunstad DA, Cohen AH, St Geme JW 3rd. Successful eradication of mucormycosis occurring in a pulmonary allograft. J Heart Lung Transplant. 1999;18(8):801-4. PMID:10512529 
56. Mohrig JR, Rosenberg RE, Apostol JW, Bastienaansen M, Evans JW, Franklin SJ, Frisbie CD, Fu SS, Hamm ML, Hirose CB, Hunstad DA, James TL, King RW, Larson CJ, Latham HA, Owen DA, Stein KA, Warnet R. Diastereoselectivity of enolate anion protonation: H/D exchange of beta-substituted ethyl butanoates in ethanol-d. J Am Chem Soc. 1997;119:479-486.