John Robert Perfect, MD

Professor of Medicine
James B. Duke Professor of Medicine
Chief, Division of Infectious Diseases
Professor in Molecular Genetics and Microbiology
Campus mail Duke Box 102359, Durham, NC 27710
Phone (919) 684-4016
Email address perfe001@mc.duke.edu

Research in my laboratory focuses around several aspects of medical mycology. We are investigating antifungal agents (new and old) in animal models of candida and cryptococcal infections. We have examined clinical correlation of in vitro antifungal susceptibility testing and with in vivo outcome. Our basic science project examines the molecular pathogenesis of cryptococcal infections. We have developed a molecular foundation for C. neoformans, including transformation systems, gene disruptions, differential gene expression screens, and cloning pathogenesis genes. The goal of this work is to use C. neoformans as a model yeast system to identify molecular targets for antifungal drug development. There are a series of clinical trials in fungal infections which are being coordinated through this laboratory and my work also includes a series of antibiotic trials in various aspects of infections. Finally, we have now been awarded a NIH sponsored Mycology Unit for 5 years with 6 senior investigators which is focused on C. neoformans as a pathogenic model system, but will include multiple areas of medical mycology from diagnosis to treatment.

Education and Training

  • Fellow, Infectious Diseases, Duke University School of Medicine, 1977 - 1980
  • Resident, University of Michigan at Ann Arbor, 1975 - 1977
  • Intern, Riverside Methodist Hospital, 1974 - 1975
  • M.D., University of Toledo, 1974

Publications

Alexander, B. D., M. D. Johnson, C. D. Pfeiffer, C. Jiménez-Ortigosa, J. Catania, and R. Booker. “Erratum: Increasing echinocandin resistance in Candida glabrata: Clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations (Clinical Infectious Diseases (2013) 56 (1724-32)).” Clinical Infectious Diseases 58, no. 5 (March 1, 2014). https://doi.org/10.1093/cid/cit956.

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Chen, Yuan, Dena L. Toffaletti, Jennifer L. Tenor, Anastasia P. Litvintseva, Charles Fang, Thomas G. Mitchell, Tami R. McDonald, et al. “The Cryptococcus neoformans transcriptome at the site of human meningitis..” Mbio 5, no. 1 (February 4, 2014): e01087–e01013. https://doi.org/10.1128/mBio.01087-13.

PMID
24496797
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Chen, Y., D. L. Toffaletti, J. L. Tenor, A. P. Litvintseva, C. Fang, T. G. Mitchell, T. R. McDonald, et al. “The Cryptococcus neoformans transcriptome at the site of human meningitis.” Mbio 5, no. 1 (February 4, 2014). https://doi.org/10.1128/mBio.01087-13.

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Holmer, Stephanie M., Kathy S. Evans, Yohannes G. Asfaw, Divey Saini, Wiley A. Schell, Julie G. Ledford, Richard Frothingham, Jo Rae Wright, Gregory D. Sempowski, and John R. Perfect. “Impact of surfactant protein D, interleukin-5, and eosinophilia on Cryptococcosis..” Infect Immun 82, no. 2 (February 2014): 683–93. https://doi.org/10.1128/IAI.00855-13.

PMID
24478083
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Livermore, Joanne, Susan J. Howard, Andrew D. Sharp, Joanne Goodwin, Lea Gregson, Timothy Felton, Julie A. Schwartz, et al. “Efficacy of an abbreviated induction regimen of amphotericin B deoxycholate for cryptococcal meningoencephalitis: 3 days of therapy is equivalent to 14 days..” Mbio 5, no. 1 (January 28, 2014): e00725–e00713. https://doi.org/10.1128/mBio.00725-13.

PMID
24473125
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Livermore, J., S. J. Howard, A. D. Sharp, J. Goodwin, L. Gregson, T. Felton, J. A. Schwartz, et al. “Efficacy of an abbreviated induction regimen of amphotericin B deoxycholate for cryptococcal meningoencephalitis: 3 days of therapy is equivalent to 14 days.” Mbio 5, no. 1 (January 28, 2014). https://doi.org/10.1128/mBio.00725-13.

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Spivey, J. R., R. H. Drew, and J. R. Perfect. “Future strategies for the treatment of cryptococcal meningoencephalitis in pediatric patients.” Expert Opinion on Orphan Drugs 2, no. 3 (January 1, 2014): 245–57. https://doi.org/10.1517/21678707.2014.880649.

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Oever, J. ten, E. J. Giamarellos-Bourboulis, F. L. van de Veerdonk, F. F. Stelma, A. Simon, M. Janssen, M. Johnson, et al. “Circulating galectin-3 in infections and non-infectious inflammatory diseases..” Eur J Clin Microbiol Infect Dis 32, no. 12 (December 2013): 1605–10. https://doi.org/10.1007/s10096-013-1919-4.

PMID
23828453
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Drew, Richard H., Mary L. Townsend, Melanie W. Pound, Steven W. Johnson, and John R. Perfect. “Recent advances in the treatment of life-threatening, invasive fungal infections..” Expert Opin Pharmacother 14, no. 17 (December 2013): 2361–74. https://doi.org/10.1517/14656566.2013.838217.

PMID
24050675
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