Lakshmi Srinivasan, MD, FAAP
Areas of expertise: Biomarkers in neonatal inflammation, Neonatal sepsis, Novel diagnostic tools in neonatal infection
Locations: Main Building
About Lakshmi Srinivasan, MD, FAAP
Dr. Lakshmi Srinivasan is an attending physician in the Division of Neonatology and the Pediatric Sepsis Program at Children’s Hospital of Philadelphia, and the Neonatal Intensive Care Units (NICUs) at Children’s Hospital of Philadelphia and Hospital of University of Pennsylvania.
Dr. Srinivasan attended medical school at Madras Medical College in Chennai, India. After receiving training in Pediatrics at Children’s Hospital of Michigan, she completed her neonatal-perinatal medicine fellowship at Children’s Hospital of Philadelphia. She joined the faculty of the Division of Neonatology after graduation from fellowship, and went on to complete a Masters in Translational Research with an emphasis on design and conduct of patient oriented research studies. Her specific areas of interest include improving sepsis recognition and response in the NICU discovery of biomarker signatures for neonatal sepsis.
Dr. Srinivasan is the CHOP physician leader hospital-wide for prevention of Central Line Associated Bloodstream infections (CLABSI). She also heads the CHOP NICU sepsis quality improvement workgroup, and has successfully led improvement work standardizing the response to sepsis and timely antibiotic administration in the NICU. She is currently guiding the development of a sepsis pathway to improve recognition and management of late-onset sepsis in the CHOP NICU. Along with Dr. Harris, she co-leads the NICU sepsis registry project (an ongoing automated repository of clinical data surrounding sepsis evaluations in the NICU), and is a co-investigator on the project led by Drs. Harris and Grundmeier to develop an early warning system utilizing the NICU sepsis registry.
Her translational research investigations of biomarkers have included testing of broad range 16s rRNA bacterial PCR for diagnosis of neonatal infections, and development of diagnostic signatures using cytokines and Damage Associated Molecular Patterns. She has performed a pilot gene expression profiling study to better understand genetic risk and expression in neonatal sepsis. She was the lead investigator of the first genome-wide-association study of neonatal sepsis, performed through the NICHD Neonatal Research Network. She is presently performed a metaHer current research involves the investigation of integrated “omics” approaches for identification of diagnostic and prognostic tools in neonatal diseases. To this end, she is validating pilot data on transcriptomic profiles in neonatal sepsis, and embarking on a concurrent investigation of the metabolome in neonatal sepsis.
Titles
Attending Neonatologist
Certifications
Neonatal-Perinatal Medicine – American Board of Pediatrics
Pediatrics – American Board of Pediatrics
Awards and Honors
2017, Young Investigator Travel grant award, Perinatal Research Society
2016, Inducted as member, Society for Pediatric Research
2014, Faculty Honor Roll, Children’s Hospital of Philadelphia
2013, Faculty Honor Roll, Children’s Hospital of Philadelphia
2011, Junior Investigator Pilot Grant Award, Clinical and Translational Research Center and Institute for Translational Medicine and Therapeutics, Perelman School of Medicine at the University of Pennsylvania
2011, Foerderer Awards for Excellence, Children's Hospital of Philadelphia
2010, Institute for Translational Medicine and Therapeutics scholarship, University of Pennsylvania
2010, Travel Grant, American Academy of Pediatrics
2009, Travel Grant, Pediatric Academic Societies
2009, Travel Grant, Eastern Society for Pediatric Research
2007, Best Graduating Pediatric Critical Care Medicine Resident, Children's Hospital of Michigan, Detroit, MI
2006, Outstanding Pediatric Critical Care Medicine Resident, Children's Hospital of Michigan, Detroit, MI
2005, Travel Grant as AAP Resident Representative for the Children's Hospital of Michigan, American Academy of Pediatrics
2005, Tina Kelley Award for Pediatric Intern of the Year, Children's Hospital of Michigan, Detroit, MI
2002, Balfour Memorial Medal for Excellence in Obstetrics and Gynecology, Madras Medical College, Chennai, India
2002, Gangadram Prize in Obstetrics and Gynecology, Madras Medical College, Chennai, India
2001, Dr. Venugopal Silver Medal in Urology, Madras Medical College, Chennai, India
2000, Dr. Govindareddy Gold Medal in Pathology, Madras Medical College, Chennai, India
2000, Dr. Govindarajan Prize in Microbiology, Madras Medical College, Chennai, India
1999, Biochemistry Prize, Madras Medical College, Chennai, India
1997, Department of Biotechnology Award, Government of India
1996-1998, National Talent Scholarship, Government of India
Leadership and Memberships
Memberships in Professional Organizations
2017, Member, Perinatal Research Society
2016, Member, Society for Pediatric Research
2015, Member, Eastern Society for Pediatric Research
2011-present, Associate member, Institute for Translational Medicine and Therapeutics, University of Pennsylvania.
2007-present, Fellow, American Academy of Pediatrics
Editorial and Academic Positions
Editorial Positions
Ad hoc Reviewer
British Medical Journal
Pediatrics
Journal of the Pediatric Infectious Diseases Society
Journal of Perinatology
Pediatric Research
Academic and Institutional Committees
2017-present, Member, Lines indicator harmonization committee
2015-present, Member and CLABSI indicator leader, Harm Prevention Program, Children's Hospital of Philadelphia
2015-present, Hospital-wide physician leader, Central Line Associated Bloodstream Infections Steering Committee, Children's Hospital of Philadelphia
2015-present, NICU team leader, CHOP Sepsis Outcomes Advisory Committee
2015-present, Member, Infection Prevention and Control Committee, The Children's Hospital of Philadelphia
2014-present, Leader, NICU Sepsis Workgroup, CHOP
2014-2017, Member, Institutional Review Board (Committee 6), University of Pennsylvania
2014-2015, NICU Fellowship Clinical Competency Committee
2012-present, Member, CHOP Sepsis Governance Committee
Education & training
Graduate Degree
Masters in Translational Research - Institute for Translational Medicine and Therapeutics, University of Pennsylvania
Medical Degree
MBBS - Madras Medical College, Chennai, India
Internship
Rotating Internship - Government General Hospital, Chennai, India
Residency
Pediatrics - Children's Hospital of Michigan, Detroit, MI
Fellowship
Neonatal-Perinatal Medicine - The Children's Hospital of Philadelphia, Philadelphia, PA
Additional Training
Clinical Research Certificate, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Patient Oriented Research Training Program - Institute for Translational Medicine and Therapeutics, University of Pennsylvania
Publications
Publications
2022
Karavite D, Harris MC, Grundmeier RW, Srinivasan L, Shaeffer G, Muthu N: Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Neonates. ACI Open 00: 1-15, 2022
2021
Coggins SA, Harris MC, Srinivasan L.: Dual-site blood culture yield and time to positivity in neonatal late-onset sepsis. 2021 Nov 9:fetalneonatal-2021-322844. doi: 10.1136/archdischild-2021-322844.Epub ahead of print. PMID: 34753783. Arch Dis Child Fetal Neonatal Ed. Nov 2021.
Balasubramanian H, Atyalgade M, Garg B, Srinivasan L, Kabra NS, Khapekar S.: Effects of blood sampling stewardship and erythropoietin administration in extremely low birth weight infants-a quality improvement non-controlled before-and-after retrospective study. Eur J Pediatr, 2021.
Coggins SA, Laskin B, Harris MC, Grundmeier RW, Passarella M, McKenna KJ, Srinivasan L.: Acute Kidney Injury Associated with Late-Onset Neonatal Sepsis: A Matched Cohort Study. J Pediatr. 2021 Apr;231:185-192.e4.
2020
Gordon SM, Srinivasan L, Taylor DM, Master SR, Tremoglie, MA, Hankeova A, Flannery DD, Abbasi S, Fitzgerald JC, Harris MC. Derivation of a metabolic signature associated with bacterial meningitis in infants. 2020. Pediatr Res. 88, 184–191. https://doi.org/10.1038/s41390-020-0816-7
Gordon SM, Srinivasan L and Harris MC. Neonatal Meningitis: Overcoming Challenges in Diagnosis, Prognosis, and Treatment with Omics. 2017. Front. Pediatr. 5:139. https://doi.org/10.3389/fped.2017.00139
Coggins S, Harris MC, Grundmeier R, Kalb E, Nawab U, Srinivasan L. Performance of Pediatric Systemic Inflammatory Response Syndrome and Organ Dysfunction Criteria in Late-Onset Sepsis in a Quaternary Neonatal Intensive Care Unit: A Case-Control Study. J Pediatr. 2020 Feb 6. pii: S0022-3476(19)31743-3. doi: 10.1016/j.jpeds.2019.12.064. PMID: 32037153.
Balasubramanian H, Sindhur M, Doshi A, Srinivasan L, Kabra NS, Malpani A, Agashe P.: Predictors and ocular outcomes of rescue treatment in preterm infants with treated retinopathy of prematurity-a retrospective study. Eye (Lond), 2020.
2019
Ostapenko S, Schmatz M, Srinivasan L, Elci OU, Weiss SL, Masino AJ, Tremoglie M, Harris MC, Grundmeier RW. Neonatal sepsis registry: Time to antibiotic dataset. Data Brief. 2019 Nov 11;27:104788. doi: 10.1016/j.dib.2019.104788. eCollection 2019 Dec. PMID: 31799346
Schmatz M, Srinivasan L, Grundmeier RW, Elci OU, Weiss SL, Masino AJ, Tremoglie M, Ostapenko S, Harris MC. Surviving Sepsis in a Referral Neonatal Intensive Care Unit: Association between Time to Antibiotic Administration and In-Hospital Outcomes. J Pediatr. 2019 Oct 8. pii: S0022-3476(19)31081-9. doi: 10.1016/j.jpeds.2019.08.023. [Epub ahead of print] PMID: 31604632 [PubMed - as supplied by publisher]
Masino AJ, Harris MC, Forsyth D, Ostapenko S, Srinivasan L, Bonafide CP, Balamuth F, Schmatz M, Grundmeier RW. Machine learning models for early sepsis recognition in the neonatal intensive care unit using readily available electronic health record data. PLoS One. 2019 Feb 22;14(2):e0212665. doi: 10.1371/journal.pone.0212665. eCollection 2019.
2018
Srinivasan L, Kilpatrick L, Shah SS, Abbasi S, Harris MC. Elevations of novel cytokines in bacterial meningitis in infants. PLoS One. 2018 Feb; 13(2):e0181449.
2017
Gordon SM, Srinivasan L, Harris MC. Neonatal Meningitis: Overcoming Challenges in Diagnosis, Prognosis, and Treatment with Omics. Front Pediatr. 2017 Jun; 5:139.
Srinivasan L, Page G, Kirpalani H, Murray JC, Das A, Higgins RD, Carlo WA, Bell EF, Goldberg RN, Schibler K, Sood BG, Stevenson DK, Stoll BJ, Van Meurs KP, Johnson KJ, Levy J, McDonald SA, Zaterka-Baxter KM, Kennedy KA, Sánchez PJ, Duara S, Walsh MC, Shankaran S, Wynn JL, Cotten CM; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Genome-wide association study of sepsis in extremely premature infants. Arch Dis Child Fetal Neonatal Ed. 2017 Mar 10. pii: fetalneonatal-2016-311545. [Epub ahead of print]
Srinivasan L, Swarr DT, Sharma M, Cotten CM, Kirpalani H.: Systematic Review and Meta-analysis: Gene Association Studies in Neonatal Sepsis. Am J Perinatol. 2017 Jun; 34(7):684-692.
2016
Srinivasan L, Kilpatrick L, Shah SS, Abbasi S, Harris MC. Cerebrospinal fluid cytokines in the diagnosis of bacterial meningitis in infants. Pediatr Res. 2016 Oct;80(4):566-72. doi: 10.1038/pr.2016.117. Epub 2016 May 26.
2014
Padula, MA; Dewan, ML; Shah, SS; Padula, AM; Srinivasan, L; McGowan, KL; Mahoney, KR; Harris, MC. Risk Factors Associated with Laboratory-confirmed Bloodstream Infections in a Tertiary Neonatal Intensive Care Unit. Pediatr Infect Dis J. 2014 Oct. 33 (10):1027-1032.
2013
Sen P, Yang Y, Navarro C, Silva I, Szafranski P, Kolodziejska KE, Dharmadhikari AV, et a. Novel FOXF1 Mutations in Sporadic and Familial Cases of Alveolar Capillary Dysplasia with Misaligned Pulmonary Veins Imply a Role for its DNA Binding Domain. Hum Mutat. 2013 Jun;34(6)801-11.
Srinivasan L, Shah SS, Abbasi S, Padula MA, Harris MC. Traumatic Lumbar Punctures in Infants Hospitalized in the Neonatal Intensive Care Unit. Pediatr Infect Dis J. 2013 Apr 25.
Srinivasan L, Harris MC, Shah SS. Lumbar puncture in the neonate: challenges in decision-making and interpretation. Semin Perinatol. 2012 Dec;36(6):445-53.
2012
Srinivasan L, Harris MC, Shah SS. Lumbar puncture in the neonate: challenges in decision-making and interpretation. Semin Perinatol 2012. Dec; 36(6): 445-453.
Srinivasan L, Pisapia JM, Shah SS, Halpern CH, Harris MC.
Can broad-range 16S ribosomal ribonucleic acid gene polymerase chain reactions improve the diagnosis of bacterial meningitis? A systematic review and meta-analysis. Ann Emerg Med. 2012 Nov; 60(5):609-620.e2.
Srinivasan L, Shah SS, Padula MA, Abbasi S, McGowan KL, Harris MC. Cerebrospinal fluid reference ranges in term and preterm infants in the neonatal intensive care unit. J Pediatr. 2012 Oct; 161(4):729-34.
Srinivasan L, Harris MC: New technologies for the rapid diagnosis of neonatal sepsis. Curr Opin Pediatr. 2012 Apr; 24(2): 165-171.
2011
Lorch SA, Srinivasan L, Escobar GJ. Epidemiology of apnea and bradycardia resolution in premature infants. Pediatrics. 2011 Aug; 128(2):e366-73.
Abstracts (includes Posters and Scientific Presentations)
2020
Fleiss N, Coggins SA, Srinivasan L, Visser DH, Polin R, Dejong BS, Wynn J.: The utility of the nSOFA score to predict late-onset sepsis mortality risk among VLBW infants: A retrospective international multi-center and single-center prospective study. Pediatric Academic Societies. 2020 Notes: Accepted for platform presentation. However, conference was cancelled due to COVID pandemic.
Coggins SA, Harris MC, Grundmeier RW, Srinivasan L.: Acute Kidney Injury Associated with Late-Onset Neonatal Sepsis: A Matched Cohort Study. Eastern Society for Pediatric Research 2020 Notes: Accepted for platform presentation. However, conference was cancelled due to COVID pandemic.
Coggins SA, Harris MC, Grundmeier RW, Srinivasan L.: Acute Kidney Injury Associated with Late-Onset Neonatal Sepsis: A Matched Cohort Study. Pediatric Academic Societies 2020 Notes: Accepted for poster presentation. However, conference was cancelled due to COVID pandemic.
Coggins SA, Gibbs KA, Harris MC, Srinivasan L.: Sepsis Huddle Implementation in the Neonatal Intensive Care Unit (NICU). Pediatric Academic Societies 2020 Notes: Accepted for poster presentation. However, conference was cancelled due to COVID pandemic.
Coggins SA, Gibbs KA, Harris MC, Srinivasan L: Sepsis Huddle Implementation in the Neonatal Intensive Care Unit (NICU. Eastern Society for Pediatric Research 2020 Notes: Accepted for platform presentation. However, conference was cancelled due to COVID pandemic.
2019
Nithya Sivakumar, Lakshmi Srinivasan, Robert Grundmeier, Melissa Schmatz,Mary Catherine Harris: Demystifying "Culture-negative sepsis": Reasons for prolonged antibiotic administration in the NICU Pediatric Academic Societies, Baltimore MD May 2019.
Leigh Finnegan, Mary C Harris, Sarah Coggins, Melissa Schmatz, Marissa Tremoglie, Lakshmi Srinivasan MBBS2: Suspected Sepsis in the NICU: Leveraging Staff Perceptions of Delays in Antibiotic Delivery to Drive Improvement Pediatric Academic Societies, Baltimore MD May 2019.
Coggins S, Harris M, Grundmeier R, Nawab U, Srinivasan L: Pediatric SIRS and organ dysfunction criteria in late-onset sepsis in a quaternary NICU: a case-control study. Pediatric Academic Societies, Baltimore MD May 2019.
Charlotte Z Woods-Hill, Lakshmi Srinivasan, Emily Schriver, Tanya Haj-Hassan, Orysia Bezpalko, Julia S. Sammons: Novel Risk Factors for Central-Line Associated Bloodstream Infections in Critically Ill Children. Society for Healthcare Epidemiology of America, Boston, MA Apr 2019.
Nithya Sivakumar, Lakshmi Srinivasan MBBS MTR, Robert Grundmeier, Melissa Schmatz,Mary Catherine Harris: Demystifying "Culture-negative sepsis": Reasons for prolonged antibiotic administration in the NICU Eastern Society for Pediatric Research, Philadelphia PA Mar 2019.
Coggins S, Harris MC, Grundmeier R, Nawab U, Srinivasan L.: Pediatric SIRS and organ dysfunction criteria in late-onset sepsis in a quaternary NICU: a case-control study. Eastern Society for Pediatric Research, Philadelphia PA Mar 2019.
Leigh Finnegan, Mary C Harris, Sarah Coggins, Melissa Schmatz, Marissa Tremoglie, Lakshmi Srinivasan: Suspected Sepsis in the NICU: Leveraging Staff Perceptions of Delays in Antibiotic Delivery to Drive Improvement Eastern Society for Pediatric Research, Philadelphia PA Mar 2019.
2018
Kalb E, Coggins S, Harris MC, Ursula Nawab, Grundmeier R, Srinivasan L: Applicability of systemic inflammatory response syndrome (SIRS) and severe sepsis definitions to late onset infections in a quaternary NICU. (Poster presentations at Society for Pediatric Research, Toronto, Canada 2018 and Eastern Society for Pediatric Research, Philadelphia 2018).
Schmatz M, Srinivasan L, Grundmeier R, Ostapenko S, Chilutti M, Harris MC: Surviving Sepsis in the NICU: Delayed Antimicrobial Therapy Worsens Outcomes. (Poster presentations at Society for Pediatric Research, Toronto, Canada 2018 and Eastern Society for Pediatric Research, Philadelphia 2018).
Coggins S, Kalb E, Harris MC, Nawab U, Grundmeier R, Srinivasan L: Factors associated with delayed recognition of sepsis in a quarternary NICU. (Poster presentation at Eastern Society for Pediatric Research, Philadelphia 2018).
Srinivasan, Lakshmi, Morris, Kelly, Shanahan, Amanda, Bezpalko, Orysia, Frye, Anna Powell, Stephanie, Sammons, Julia S. : Leveraging High Reliability to Identify Special Cause Factors and Reduce Central Line-Associated Bloodstream Infections. Institute For Healthcare Improvement, Orlando, FL 2018.
Srinivasan L, Rowan H, Kaminski S, Harris M, Nawab U.: Development of a NICU specific sepsis pathway. Improving Pediatric Sepsis Outcomes, Children's Hospitals Associations, Atlanta, GA Dec 2018.
Sarah Coggins, Elizabeth Kalb, Mary C Harris, Ursula Nawab, Robert Grundmeier, Lakshmi Srinivasan: Factors associated with delayed recognition of sepsis in a quarternary NICU. Children's Hospitals Neonatal Consortium, Columbus, OH Oct 2018.
Elizabeth Kalb, Sarah Coggins, Mary Harris, Ursula Nawab, Robert Grundheimer, Lakshmi Srinivasan: Applicability of systemic inflammatory response syndrome (SIRS) and severe sepsis definitions to late onset infections in a quaternary NICU. Children's Hospitals Neonatal Consortium, Columbus, OH Oct 2018.
Melissa Schmatz, Lakshmi Srinivasan, Robert Grundheimer, Svetlana Chilutti, Mary Harris: Surviving Sepsis in the NICU: Delayed Antimicrobial Therapy Worsens Outcomes. Society for Pediatric Research, Toronto, Canada May 2018 Notes: Poster presentation.
Elizabeth Kalb, Sarah Coggins, Mary Harris, Ursula Nawab, Robert Grundheimer, Lakshmi Srinivasan: Applicability of systemic inflammatory response syndrome (SIRS) and severe sepsis definitions to late onset infections in a quaternary NICU Society for Pediatric Research, Toronto, Canada May 2018 Notes: Poster presentation.
Lectures by Invitation
2020
Srinivasan, L. “Developing Context-Specific Prediction Tools for Central Line Associated Bloodstream Infections (CLABSIs)”, Maternal and Child Health Research Symposium, University of Pennsylvania. 2020.
2019
Srinivasan, L. "Neonatal sepsis", IRIS (Penn Sepsis Working Group), University of Pennsylvania. 2019.
2018
Srinivasan, L. “Sepsis Management in the NICU: adopting a culture of urgency”. Invited presentation (webinar) to New Jersey Health Association and the New Jersey Sepsis Learning Action Collaborative, Jan 2018.
Srinivasan, L. "Approach to Sepsis Related Quality Improvement in the NICU", Invited speaker and leader of breakout session, Improving Pediatric Sepsis Outcomes collaborative, Children's Hospitals Association. 2018.
Srinivasan, L. "Preventing CLABSI: Where We've Been; Where We're Going", Pediatric Grand Rounds, Children's Hospital of Philadelphia. 2018.
Editorials, Reviews, Chapters
2017
Srinivasan L, Evans JE.: Healthcare Associated Infections in the Nursery. Avery's Diseases of the Newborn 10th ed. 2017.
Srinivasan L, Harris MC, Kilpatrick L.: Cytokines and Inflammatory Response in the Fetus and Neonate. Polin, Abman, Rowitch, Benitz and Fox, Fetal and Neonatal Physiology 5th ed. 2017.