Linda M. Mundy, M.D.
Assistant Professor of Medicine

Office/Lab: (314)  454-8354
FAX: (314)  454-5392
E-mail: lmundy@im.wustl.edu
Homepage: http://id.wustl.edu/docs/resintr/mundy-home.html

Office/Lab: Barnes-Jewish Hospital North, 7th Floor, Kingshighway Bldg., Box 8051

Women account for an increasing percentage of all acquired immunodeficiency syndrome (AIDS) cases, from 7% in 1986 to 18% in 1999. As a sobering statistic, AIDS has become the sixth leading cause of death in women of reproductive age. Natural history, disease progression, survival, and HIV-associated illnesses, except for those of the genital tract, seem similar for both genders. Some factors that impact differently on HIV services delivery for women are the competing priorities and challenges in their lives, such as on-going high-risk behaviors with high-risk partners, parenting responsibilities, domestic violence, poor negotiation skills, depression, substance abuse, and unmet social needs. Our work at the Helena Hatch Special Care Center has focused on characterization of these comorbid conditions for a large Midwest cohort of women and, most recently, the evaluation of a behavioral-based approach to HIV medication adherence using the Transtheoretical Model of Health Behavior Change.

My research in the area of vancomycin-resistant enterococci involves characterization of virulence, and the evaluation of prevention and control strategies. Enterococci were considered relatively innocuous gram positive bacteria prior to their development of resistance to cell wall active agents and aminoglycosides. Although the first vancomycin-resistant enterococcus (VRE) reported in the United States was isolated in St. Louis, the St. Louis hospitals rarely detected VRE prior to 1995. Subsequently, endemicity occurred. Areas of clinical investigation of VRE include: 1) the role of enteric carriage in the development of clinical disease, 2) the role of enteric eradication of VRE in asymptomatic and symptomatic hosts, 3) development of effective surveillance methods for inpatients, 4) effective infection control measures to decrease nosocomial transmission, such as scheduled rotation of antimicrobial agents and the use of gowns, and 5) the role of biotherapeutic agents for patients on multiple antibiotics in the prevention of VRE and Clostridium difficile.

Community-acquired pneumonia is the fifth leading cause of adult deaths in the United States. Focal areas of interest in this broad field of community-acquired pneumonia include: 1) determination of the role of diagnostic tests in the routine care of hospitalized adults and, 2) evaluation of the implementation of quality improvement studies in the care of both inpatients and outpatients.