Member Spotlight: Matthew Kelly

Matthew Kelly, MD, MPH, is Professor of Pediatrics, Chief of Pediatric Infectious Diseases at Arkansas Children’s and the Associate Vice Chair of Clinical Research in the Department of Pediatrics at the University of Arkansas for Medical Sciences. He earned his medical degree at Harvard Medical School and his Master of Public Health degree at the Harvard School of Public Health. He completed his residency training in the Boston Combined Residency Program in Pediatrics and his pediatric infectious diseases fellowship training at Duke University.

Dr. Kelly currently serves as Vice Chair for the PIDS Research Affairs Subcommittee. He has taken an active role in designing the curriculum for this year’s SUMMERS scholars and is assisting in the administration of the Pichichero Award. In 2022, Dr. Kelly was recognized with the Young Investigator Award.

Why pediatric ID? During medical school and residency, I found myself drawn to the infectious diseases cases. Those were the cases that I thought about when going home and that I wanted to read more about in the morning. I found the battles between microbes and the immune system fascinating and wanted to understand why the immune response prevails in some patients while the pathogens gain the upper hand in others. After residency, I worked for a year as a hospitalist, splitting my time between Boston Children’s Hospital and the main referral hospital in Monrovia, Liberia. My experience in Liberia – practicing pediatrics in a setting with high malaria endemicity and limited access to routine childhood vaccinations – ultimately solidified my decision to pursue a career in infectious diseases with a focus on infections that disproportionately affect children in low- and middle-income countries.

Where have you taken your pediatric ID focus? Like many ID physicians, I became heavily involved in the COVID-19 response during the pandemic. This involvement took several forms, including leadership roles within the Duke University Department of Pediatrics and School of Medicine. One role that I particularly valued was serving on a COVID-19 Research Task Force that aimed to ensure research involving patients with COVID-19 was conducted safely and ethically, with clear processes for study prioritization given the large number of competing clinical trials and observational studies.

I also led several studies related to COVID-19, including the Duke BRAVE Kids Study, which enrolled over 800 children and adolescents in central North Carolina with SARS-CoV-2 infection, exposure, or recent vaccination. Through this study, we were able to provide an early, detailed characterization of the symptoms of SARS-CoV-2 in children and adolescents and, more recently, identify differences in mucosal and systemic immune responses that may explain variation in disease severity across the age spectrum. By conducting visits in participants’ homes, this study also served as a powerful reminder of how housing insecurity and limited access to resources can undermine the feasibility of public health recommendations and contribute to the disparities in infection risk and disease burden that remain so visible in our daily clinical practice.

What is a recent development in pediatric ID that you are working on? I’m particularly proud of a recent study that we conducted, the results of which will be published in an upcoming issue of Nature Communications (‘Role of the upper airway microbiota in respiratory virus and bacterial pathobiont dynamics in the first year of life’), which was the primary project funded by my NIH K23 award. In this study, we enrolled 300 mother-infant dyads in Botswana and followed them throughout the infant’s first year of life. We used PCR to test for respiratory viruses and common bacterial respiratory pathobionts and characterized the infant nasopharyngeal microbiome using 16S rRNA sequencing. We found that respiratory viral infections led to the loss of beneficial microbial species from the upper respiratory tract, which in turn was associated with an increased likelihood of acquiring Haemophilus influenzae and Streptococcus pneumoniae colonization. We were also able to predict an infant’s risk of colonization by these pathobionts using only microbiome data, with accuracy comparable to models incorporating an extensive list of established risk factors.

These findings suggest that respiratory virus-induced disruptions of the upper airway microbiome may be an underappreciated and potentially modifiable mechanism by which respiratory viruses predispose to secondary bacterial infections. We hope that findings from this study, along with other recent reports, will continue to build the evidence base for targeted modulation of the upper respiratory microbiome through nasal probiotics – a potential paradigm shift in the prevention of childhood respiratory infections.

What do you enjoy most about being a PIDS member? What keeps you renewing your membership? PIDS has truly become my professional and scientific home. It’s the community where I’ve found the most meaningful opportunities for collaboration, mentorship, friendship, and a shared sense of purpose. Through PIDS, I’ve connected with colleagues who are not only leaders in our field but who are also deeply and genuinely committed to helping others achieve similar success. I’ve appreciated the opportunity to contribute to PIDS through working groups, including my current role as Co-Chair of the PIDS Research Subcommittee. In this role, I especially enjoy exploring how we can more effectively engage trainees in pediatric ID research and support early-career investigators in our field. Finally, PIDS has consistently provided a platform to engage with colleagues on the clinical questions that matter most for the care of my patients and the challenges we face as a subspecialty.