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Last Name

profileMaha Reda Farhat, M.D.,C.M., M.D.

TitleAssistant Professor of Biomedical Informatics
InstitutionHarvard Medical School
DepartmentBiomedical Informatics
AddressHarvard Medical School
Countway Lib #307
10 Shattuck St
Boston MA 02115
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Available: 06/01/17, Expires: 06/01/19

Non-tuberculous Mycobacterial (NTM) infections are an increasing source of patient morbidity and health care cost. Recent estimates of Mycobacterium avium complex (MAC) disease burden report an annual prevalence increase by 36% in the last 10 years. NTM pulmonary disease is associated with high rates of morbidity and mortality, yet available treatment regimens are reported to result in no clinical or microbiological response in an estimated 8-41% of patients with MAC, and is much higher for patients with Mycobacterium abscessus where the rate is as high as 72%. Currently a limited number of patient and bacterial factors predict the poor response to therapy but include cavitary lung disease, high disease burden as indicated by positive AFB smears at baseline, isolates resistant or with inducible resistance to macrolides, a history of previous treatment among a few others. Due to the limited efficacy of medical therapy and the significant associated morbidity and mortality for some patients with pulmonary NTM disease, surgical resection of affected lung has been suggested as an adjunct to medical therapy. However data on the timing and the actual magnitude of benefit offered by surgery is limited. Most studies have been small case series that reported on outcomes of surgery without comparing these outcomes with outcomes of medical therapy alone. Macrolide resistant NTM carries a significantly worse prognosis than NTM that is sensitive to the drug as determined by in vitro drug susceptibility testing. To date it is not known how the rates of macrolide resistance for NTM are evolving over time. It is likely that with the more prevalent use of these antibiotics for treatment of other respiratory infections, and for the prophylaxis of chronic obstructive pulmonary disease and bronchiectasis exacerbations, that the rates will increase and this may pose an increasing public health threat. Here, the student will carry out a retrospective cohort study of MAC patients through the electronic review of medical records in the Partners HealthCare system. The mentor will apply for and secure IRB approval for the work before the student starts. The student will learn about NTM disease natural history, treatment and outcomes, retrospective study design and elements of how to think about and control for confounding. She will also learn how to search medical records, collect data using an abstraction form, develop an organize a database, and basics or more advanced training on biostatistical data analysis depending on the student's comfort level. The student will also gain experience in the scientific writing of the results.

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Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
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  1. Farhat MR, Jacobson KR, Franke MF, Kaur D, Murray M, Mitnick CD. Fluoroquinolone Resistance Mutation Detection Is Equivalent to Culture-Based Drug Sensitivity Testing for Predicting Multidrug-Resistant Tuberculosis Treatment Outcome: A Retrospective Cohort Study. Clin Infect Dis. 2017 Oct 15; 65(8):1364-1370. PMID: 29017248.
    View in: PubMed
  2. Nebenzahl-Guimaraes H, van Laarhoven A, Farhat MR, Koeken VACM, Mandemakers JJ, Zomer A, van Hijum SAFT, Netea MG, Murray M, van Crevel R, van Soolingen D. Transmissible Mycobacterium tuberculosis Strains Share Genetic Markers and Immune Phenotypes. Am J Respir Crit Care Med. 2017 Jun 01; 195(11):1519-1527. PMID: 27997216.
    View in: PubMed
  3. Farhat MR, Sultana R, Iartchouk O, Bozeman S, Galagan J, Sisk P, Stolte C, Nebenzahl-Guimaraes H, Jacobson K, Sloutsky A, Kaur D, Posey J, Kreiswirth BN, Kurepina N, Rigouts L, Streicher EM, Victor TC, Warren RM, van Soolingen D, Murray M. Genetic Determinants of Drug Resistance in Mycobacterium tuberculosis and Their Diagnostic Value. Am J Respir Crit Care Med. 2016 Sep 01; 194(5):621-30. PMID: 26910495; PMCID: PMC5027209 [Available on 09/01/17].
  4. Andre E, Isaacs C, Affolabi D, Alagna R, Brockmann D, de Jong BC, Cambau E, Churchyard G, Cohen T, Delmee M, Delvenne JC, Farhat M, Habib A, Holme P, Keshavjee S, Khan A, Lightfoot P, Moore D, Moreno Y, Mundade Y, Pai M, Patel S, Nyaruhirira AU, Rocha LE, Takle J, Trébucq A, Creswell J, Boehme C. Connectivity of diagnostic technologies: improving surveillance and accelerating tuberculosis elimination. Int J Tuberc Lung Dis. 2016 Aug; 20(8):999-1003. PMID: 27393530; PMCID: PMC4937753.
  5. Farhat MR, Jacobson KR, Franke MF, Kaur D, Sloutsky A, Mitnick CD, Murray M. Gyrase Mutations Are Associated with Variable Levels of Fluoroquinolone Resistance in Mycobacterium tuberculosis. J Clin Microbiol. 2016 Mar; 54(3):727-33. PMID: 26763957; PMCID: PMC4767988.
  6. Ramly EP, Bohnen JD, Farhat MR, Razmdjou S, Mavros MN, Yeh DD, Lee J, Butler K, De Moya M, Velmahos GC, Kaafarani HM. The nature, patterns, clinical outcomes, and financial impact of intraoperative adverse events in emergency surgery. Am J Surg. 2016 Jul; 212(1):16-23. PMID: 26601649.
    View in: PubMed
  7. Farhat MR, Mitnick CD, Franke MF, Kaur D, Sloutsky A, Murray M, Jacobson KR. Concordance of Mycobacterium tuberculosis fluoroquinolone resistance testing: implications for treatment. Int J Tuberc Lung Dis. 2015 Mar; 19(3):339-41. PMID: 25686144; PMCID: PMC4486051.
  8. Farhat MR, Shapiro BJ, Sheppard SK, Colijn C, Murray M. A phylogeny-based sampling strategy and power calculator informs genome-wide associations study design for microbial pathogens. Genome Med. 2014; 6(11):101. PMID: 25484920; PMCID: PMC4256898.
  9. Nebenzahl-Guimaraes H, Jacobson KR, Farhat MR, Murray MB. Systematic review of allelic exchange experiments aimed at identifying mutations that confer drug resistance in Mycobacterium tuberculosis. J Antimicrob Chemother. 2014 Feb; 69(2):331-42. PMID: 24055765; PMCID: PMC3886931.
  10. Farhat MR, Shapiro BJ, Kieser KJ, Sultana R, Jacobson KR, Victor TC, Warren RM, Streicher EM, Calver A, Sloutsky A, Kaur D, Posey JE, Plikaytis B, Oggioni MR, Gardy JL, Johnston JC, Rodrigues M, Tang PK, Kato-Maeda M, Borowsky ML, Muddukrishna B, Kreiswirth BN, Kurepina N, Galagan J, Gagneux S, Birren B, Rubin EJ, Lander ES, Sabeti PC, Murray M. Genomic analysis identifies targets of convergent positive selection in drug-resistant Mycobacterium tuberculosis. Nat Genet. 2013 Oct; 45(10):1183-9. PMID: 23995135; PMCID: PMC3887553.
  11. Farhat MR, Loring SH, Riskind P, Weinhouse G. Disturbance of respiratory muscle control in a patient with early-stage multiple sclerosis. Eur Respir J. 2013 Jun; 41(6):1454-6. PMID: 23728406.
    View in: PubMed
  12. Karvellas CJ, Farhat MR, Sajjad I, Mogensen SS, Leung AA, Wald R, Bagshaw SM. A comparison of early versus late initiation of renal replacement therapy in critically ill patients with acute kidney injury: a systematic review and meta-analysis. Crit Care. 2011; 15(1):R72. PMID: 21352532; PMCID: PMC3222005.
  13. Colijn C, Brandes A, Zucker J, Lun DS, Weiner B, Farhat MR, Cheng TY, Moody DB, Murray M, Galagan JE. Interpreting expression data with metabolic flux models: predicting Mycobacterium tuberculosis mycolic acid production. PLoS Comput Biol. 2009 Aug; 5(8):e1000489. PMID: 19714220; PMCID: PMC2726785.
  14. Menzies D, Gardiner G, Farhat M, Greenaway C, Pai M. Thinking in three dimensions: a web-based algorithm to aid the interpretation of tuberculin skin test results. Int J Tuberc Lung Dis. 2008 May; 12(5):498-505. PMID: 18419884.
    View in: PubMed
  15. Cobelens FG, Menzies D, Farhat M. False-positive tuberculin reactions due to non-tuberculous mycobacterial infections. Int J Tuberc Lung Dis. 2007 Aug; 11(8):934-5;author reply 935. PMID: 17705966.
    View in: PubMed
  16. Farhat M, Greenaway C, Pai M, Menzies D. False-positive tuberculin skin tests: what is the absolute effect of BCG and non-tuberculous mycobacteria? Int J Tuberc Lung Dis. 2006 Nov; 10(11):1192-204. PMID: 17131776.
    View in: PubMed
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