Lisa Winston, MD

Professor

Lisa Winston received her MD from Johns Hopkins University School of Medicine in 1994. She completed her residency in Internal Medicine at UCSF and was Chief Resident at San Francisco General Hospital. Dr. Winston then completed fellowships in Infectious Diseases and Clinical Pharmacology at UCSF.

She is the Associate Chief Medical Officer for Medical Surgical Services and Hospital Epidemiologist at Zuckerberg San Francisco General Hospital and Trauma Center. Her research interests are infection control and prevention and antimicrobial resistant bacterial pathogens.

Education:
• AB, Harvard University, 1990
• MD, Johns Hopkins University School of Medicine, 1994

Training:
• Internal Medicine Residency, University of California, San Francisco, 1994-1997
• Chief Resident, University of California, San Francisco, 1997-1998
• Infectious Diseases Fellowship, University of California, San Francisco, 1998 – 2001
• Clinical Pharmacology Fellowship, University of California, San Francisco, 1999-2001

Certification:
• American Board of Internal Medicine, certified 1997, recertified 2007 and 2017
• American Board of Internal Medicine, subspecialty Infectious Diseases, certified 2000, recertified 2010 and 2020

Memberships & Affiliations:
• Infectious Diseases Society of America, fellow
• Society for Healthcare Epidemiology of America

Education

2017 - Diversity, Equity, and Inclusion Champion Training, University of California, San Francisco

Residency, 1997 - Internal Medicine, University of California, San Francisco

Publications

Guh AY, Li R, Korhonen L, Winston LG, Parker E, Czaja CA, Johnston H, Basiliere E, Meek J, Olson D, Fridkin SK, Wilson LE, Perlmutter R, Holzbauer SM, D'Heilly P, Phipps EC, Flores KG, Dumyati GK, Pierce R, Ocampo VLS, Wilson CD, Watkins JJ, Gerding DN, McDonald LC. Characteristics of Patients With Initial Clostridioides difficile Infection (CDI) That Are Associated With Increased Risk of Multiple CDI Recurrences. 2024. PMID: 38577028
Guh AY, Fridkin S, Goodenough D, Winston LG, Johnston H, Basiliere E, Olson D, Wilson CD, Watkins JJ, Korhonen L, Gerding DN. Potential underreporting of treated patients using a Clostridioides difficile testing algorithm that screens with a nucleic acid amplification test. 2024. PMID: 38268440
Alice Guh, Rongxia Li, Lauren C Korhonen, Lisa Gail Winston, Erin Parker, Christopher A Czaja, Helen Johnston, Elizabeth Basiliere, James Meek, Danyel M Olson, Scott Fridkin, Lucy E Wilson, Rebecca Perlmutter, Stacy Holzbauer, Paige D’Heilly, Erin Phipps, Kristina Flores, Ghinwa Dumyati, Rebecca Pierce, Valerie Ocampo, Christopher Wilson, Jasmine Watkins, Dale Gerding, L Clifford McDonald. 684. Characteristics of Patients with Initial Clostridioides difficile Infection (CDI) That Are Associated With Increased Risk of Multiple CDI Recurrences. 2023. PMID:
Alice Guh, Lisa Gail Winston, Helen Johnston, Elizabeth Basiliere, Danyel M Olson, Scott Fridkin, Dana Goodenough, Christopher Wilson, Jasmine Watkins, Lauren C Korhonen, Dale N Gerding. 1665. Potential underreporting of treated patients using a Clostridioides difficile testing algorithm that screens with a nucleic acid amplification test. 2022. PMID:
Guh AY, Yi SH, Baggs J, Winston L, Parker E, Johnston H, Basiliere E, Olson D, Fridkin SK, Mehta N, Wilson L, Perlmutter R, Holzbauer SM, D'Heilly P, Phipps EC, Flores KG, Dumyati GK, Hatwar T, Pierce R, Ocampo VLS, Wilson CD, Watkins JJ, Korhonen L, Paulick A, Adamczyk M, Gerding DN, Reddy SC. Comparison of the Risk of Recurrent Clostridioides Difficile Infections Among Patients in 2018 Versus 2013. 2022. PMID: 36072699
Appa A, Adamo M, Le S, Davis J, Winston L, Doernberg SB, Chambers H, Martin M, Hills NK, Coffin PO, Jain V. Comparative one-year outcomes of invasive Staphylococcus aureus infections among persons with and without drug use: an observational cohort study. 2021. PMID: 33904900
Dana Freiser, Merjo Roca, Tony Chung, Tanvi Bhakta, Lisa G. Winston, Gabriel M. Ortiz. The Evolution of a Hospital-Based Covid-19 Vaccination Program for Inpatients. 2022. PMID:
Winston LG, Winkler ML, Kheterpal A, Villalba JA. Case 36-2021: A 22-Year-Old Man with Pain and Erythema of the Left Hand. 2021. PMID: 34818483
Dietz BW, Winston LG, Koehler JE, Margaretten M. Copycat. 2021. PMID: 34731540
Appa A, Adamo M, Le S, Davis J, Winston L, Doernberg SB, Chambers H, Martin M, Hills NK, Coffin P, Jain V. Patient-Directed Discharges Among Persons Who Use Drugs Hospitalized with Invasive S. aureus Infections: Opportunities for Improvement. 2021. PMID: 34508704
Skrobarcek KA, Mu Y, Ahern J, Basiliere E, Beldavs ZG, Brousseau G, Dumyati G, Fridkin S, Holzbauer SM, Johnston H, Kainer MA, Meek J, Ocampo VLS, Parker E, Perlmutter R, Phipps EC, Winston L, Guh A. Association between Socioeconomic Status and Incidence of Community-Associated Clostridioides difficile Infection - United States, 2014-2015. 2021. PMID: 33462596
Whitman JD, Pham P, Bern C, Dekker EM, Haller BL, Jain V, Winston LG. Significant and sustained decrease in non-SARS-CoV-2 respiratory viral infections during COVID-19 public health interventions. 2021. PMID: 34013283
Ayesha Ashley Appa, Meredith Adamo, Stephenie Le, Jennifer Davis, Lisa Gail Winston, Sarah B Doernberg, Henry Chambers, Marlene Martin, Phillip Coffin, Vivek Jain. 39. Comparative One-year Outcomes of Invasive staphylococcus Aureus infections Among Persons with and Without Drug Use in an Urban West Coast Cohort. 2020. PMID:
Vivek Jain, Lillian B Brown, Carina Marquez, Luis Rubio, Natasha Spottiswoode, Bethlehem Churnet, Katherine Brooks, Mengyu Zhou, Timothy Muldoon, Carolyn Hendrickson, Adithya Cattamanchi, Antonio Gomez, Brian Haas, Edwin Charlebois, Annie Luetkemeyer, Annie Luetkemeyer, Monica Gandhi, Diane Havlir, Sumant Ranji, Lisa Gail Winston. 448. Disproportionate Burden of COVID-19 on Latinx Residents among Hospitalized Patients at San Francisco’s Public Health Hospital. 2020. PMID:
Lillian B Brown, Lisa Gail Winston, Barbara Haller, Phong Pham, Beatrice Marcelo, Wendy Cheung, Kara Lynch, Vivek Jain. 496. Higher SARS-CoV-2 RT-PCR Cycle Threshold (Ct) Values Associated with Longer Symptom Duration Among Patients Hospitalized with COVID-19. 2020. PMID:
Alice Guh, Lauren C Korhonen, Lisa Gail Winston, Brittany Martin, Helen Johnston, Geoffrey Brousseau, Elizabeth Basiliere, Danyel M Olson, Scott Fridkin, Lucy E Wilson, Rebecca Perlmutter, Stacy Holzbauer, Maria Bye, Erin C Phipps, Kristina Flores, Ghinwa Dumyati, Deborah Nelson, Trupti Hatwar, Valerie Ocampo, Marion Kainer, Clifford McDonald. 780. How Much Does Prior Hospitalization Contribute to Readmission with Community-onset Clostridioides difficile Infection?. 2020. PMID:
Guh AY, Mu Y, Winston LG, Johnston H, Olson D, Farley MM, Wilson LE, Holzbauer SM, Phipps EC, Dumyati GK, Beldavs ZG, Kainer MA, Karlsson M, Gerding DN, McDonald LC, Emerging Infections Program Clostridioides difficile Infection Working Group. Trends in U.S. Burden of Clostridioides difficile Infection and Outcomes. 2020. PMID: 32242357
Novosad SA, Mu Y, Winston LG, Johnston H, Basiliere E, Olson DM, Farley MM, Revis A, Wilson L, Perlmutter R, Holzbauer SM, Whitten T, Phipps EC, Dumyati GK, Beldavs ZG, Ocampo VLS, Davis CM, Kainer M, Gerding DN, Guh AY. Treatment of Clostridioides difficile Infection and Non-compliance with Treatment Guidelines in Adults in 10 US Geographical Locations, 2013-2015. 2019. PMID: 31768906
Guh AY, Hatfield KM, Winston LG, Martin B, Johnston H, Brousseau G, Farley MM, Wilson L, Perlmutter R, Phipps EC, Dumyati GK, Nelson D, Hatwar T, Kainer MA, Paulick AL, Karlsson M, Gerding DN, McDonald LC. Toxin Enzyme Immunoassays Detect Clostridioides difficile Infection With Greater Severity and Higher Recurrence Rates. 2019. PMID: 30615074
Kelly M Hatfield, James Baggs, Lisa Gail Winston, Erin Parker, Helen Johnston, Geoff Brousseau, Danyel M Olson, Scott Fridkin, Lucy Wilson, Rebecca Perlmuter, Stacy Holzbauer, Erin C Phipps, Emily B Hancock, Ghinwa Dumyati, Valerie Ocampo, Marion A Kainer, Lauren C Korhonen, John A Jernigan, L Clifford McDonald, Alice Guh. 837. Prior Hospitalizations Among Cases of Community-Associated Clostridioides difficile Infection—10 US States, 2014–2015. 2019. PMID:
Aronowitz PB, Williams DM, Henderson MC, Winston LG. Mind the Base Rate: an Exercise in Clinical Reasoning. 2019. PMID: 31270792
Geha RM, Dhaliwal G, Winston LG, Kickler TS, Manesh R. Overcoming the Barrier. 2018. PMID: 30575451
Alon Vaisman, Henry F Chambers, Lisa G Winston, Dhruv Kazi. 1788. Cost-Effectiveness of Penicillin Skin Testing Among Patients With Methicillin-Sensitive Staphylococcus aureus Bacteremia and Reported Penicillin Allergy. 2018. PMID:
Kimberly Skrobarcek, Yi Mu, Jennifer Ahern, Zintars Beldavs, Geoff Brousseau, Ghinwa Dumyati, Monica M Farley, Stacy Holzbauer, Marion A Kainer, James I Meek, Rebecca Perlmutter, Erin C Phipps, Lisa G Winston, Alice Y Guh. 482. Association between Socioeconomic Status Factors and Incidence of Community-Associated Clostridium difficile Infection Utilizing Factor Analysis—United States, 2014–2015. 2018. PMID:
Alice Guh, Kelly Hatfield, Lisa G Winston, Brittany Martin, Helen Johnston, Geoff Brousseau, Monica M Farley, Lucy E Wilson, Rebecca Perlmutter, Erin C Phipps, Ghinwa Dumyati, Deborah Nelson, Trupti Hatwar, Marion A Kainer, L Clifford McDonald. 490. Comparison of Clostridium difficile Infection Outcomes by Diagnostic Testing Method. 2018. PMID:
Kelly M Hatfield, James Baggs, Lisa G Winston, Erin Parker, Brittany Martin, James I Meek, Danyel Olson, Monica M Farley, Andrew Revis, Stacy Holzbauer, Maria Bye, Lucy Wilson, Rebecca Perlmutter, Erin C Phipps, Rebecca Pierce, Valerie L S Ocampo, Marion A Kainer, Miranda Smith, L Clifford McDonald, John A Jernigan, Alice Guh. 492. Long-Term Outcomes of Clostridium difficile Infection Among Medicare Beneficiaries. 2018. PMID:
Chaisson LH, Duong D, Cattamanchi A, Roemer M, Handley MA, Schillinger D, Sur M, Pham P, Lin MA, Goldman LE, Quan J, Perez S, Healy M, Higashi J, Winston L, Haller B, Luetkemeyer AF, Davis JL. Association of Rapid Molecular Testing With Duration of Respiratory Isolation for Patients With Possible Tuberculosis in a US Hospital. 2018. PMID: 30178007
Vaisman A, Jula M, Wagner J, Winston LG. Examining the association between hospital-onset Clostridium difficile infection and multiple-bed room exposure: a case-control study. 2018. PMID: 30060776
Guh AY, Mu Y, Baggs J, Winston LG, Bamberg W, Lyons C, Farley MM, Wilson LE, Holzbauer SM, Phipps EC, Beldavs ZG, Kainer MA, Karlsson M, Gerding DN, Dumyati G. Trends in incidence of long-term-care facility onset Clostridium difficile infections in 10 US geographic locations during 2011-2015. 2018. PMID: 29329918
Guh AY, Adkins SH, Li Q, Bulens SN, Farley MM, Smith Z, Holzbauer SM, Whitten T, Phipps EC, Hancock EB, Dumyati G, Concannon C, Kainer MA, Rue B, Lyons C, Olson DM, Wilson L, Perlmutter R, Winston LG, Parker E, Bamberg W, Beldavs ZG, Ocampo V, Karlsson M, Gerding DN, McDonald LC. Risk Factors for Community-Associated Clostridium difficile Infection in Adults: A Case-Control Study. 2017. PMID: 29732377
Alon Vaisman, Michael Jula, Jessica Wagner, Lisa G Winston. Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study. 2017. PMID:
Kimberly Skrobarcek, Yi Mu, Lisa G Winston, Geoff Brousseau, Carol Lyons, Monica Farley, Rebecca Perlmutter, Stacy Holzbauer, Erin C Phipps, Ghinwa Dumyati, Zintars G Beldavs, Marion Kainer, Alice Guh. Socioeconomic Status Factors Associated with Increased Incidence of Community-Associated Clostridium difficile Infection. 2017. PMID:
Shannon Novosad, Lisa G. Winston, Helen Johnston, Elizabeth Badolato, Carol Lyons, Monica Farley, Andrew Revis, Lucy Wilson, Rebecca Perlmutter, Stacy M. Holzbauer, Tory Whitten, Erin C. Phipps, Ghinwa Dumyati, Zintars G. Beldaversus, Valerie L.S. Ocampo, Marion Kainer, Corinne M. Davis, Jamie Barnes, Dale Gerding, Alice Guh. Treatment of Clostridium difficile Infection in 10 US Geographical Locations, 2013–2014. 2016. PMID:
Hunter JC, Mu Y, Dumyati GK, Farley MM, Winston LG, Johnston HL, Meek JI, Perlmutter R, Holzbauer SM, Beldavs ZG, Phipps EC, Dunn JR, Cohen JA, Avillan J, Stone ND, Gerding DN, McDonald LC, Lessa FC. Burden of Nursing Home-Onset Clostridium difficile Infection in the United States: Estimates of Incidence and Patient Outcomes. 2016. PMID: 26798767
Sujan C. Reddy, Alice Guh, Fernanda C. Lessa, Yi Mu, Zintars G. Beldavs, Corinne M. Davis, Ghinwa Dumyati, Stacy M. Holzbauer, Helen L. Johnston, Carol Lyons, Erin C. Phipps, Lucy E. Wilson, Lisa G. Winston, Dale N. Gerding, L. Clifford McDonald, Monica M. Farley. Risk Factors for Clostridium difficile Infection Recurrence. 2015. PMID:
Dantes R, Mu Y, Hicks LA, Cohen J, Bamberg W, Beldavs ZG, Dumyati G, Farley MM, Holzbauer S, Meek J, Phipps E, Wilson L, Winston LG, McDonald LC, Lessa FC. Association Between Outpatient Antibiotic Prescribing Practices and Community-Associated Clostridium difficile Infection. 2015. PMID: 26509182
Lessa FC, Winston LG, McDonald LC, Emerging Infections Program C. difficile Surveillance Team. Burden of Clostridium difficile infection in the United States. 2015. PMID: 26061850
Isaacson D, Haller B, Leslie H, Roemer M, Winston L. Novel handwashes are superior to soap and water in removal of Clostridium difficile spores from the hands. Volume 43 of Issue 5. 2015. PMID: 25952050
Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, Farley MM, Holzbauer SM, Meek JI, Phipps EC, Wilson LE, Winston LG, Cohen JA, Limbago BM, Fridkin SK, Gerding DN, McDonald LC. Burden of Clostridium difficile infection in the United States. 2015. PMID: 25714160
Rita P. Nguyen, Lisa G. Winston. A Critical Evaluation of Healthcare-Associated Pneumonia and the Need for Anti-pseudomonal Therapy, Including Double Coverage. 2014. PMID:
Lessa FC, Mu Y, Winston LG, Dumyati GK, Farley MM, Beldavs ZG, Kast K, Holzbauer SM, Meek JI, Cohen J, McDonald LC, Fridkin SK. Determinants of Clostridium difficile Infection Incidence Across Diverse United States Geographic Locations. 2014. PMID: 25734120
See I, Mu Y, Cohen J, Beldavs ZG, Winston LG, Dumyati G, Holzbauer S, Dunn J, Farley MM, Lyons C, Johnston H, Phipps E, Perlmutter R, Anderson L, Gerding DN, Lessa FC. NAP1 strain type predicts outcomes from Clostridium difficile infection. 2014. PMID: 24604900
Wendt JM, Cohen JA, Mu Y, Dumyati GK, Dunn JR, Holzbauer SM, Winston LG, Johnston HL, Meek JI, Farley MM, Wilson LE, Phipps EC, Beldavs ZG, Gerding DN, McDonald LC, Gould CV, Lessa FC. Clostridium difficile infection among children across diverse US geographic locations. 2014. PMID: 24590748
Jennifer C. Hunter, Yi Mu, Ghinwa K. Dumyati, Monica M. Farley, Lisa G. Winston, Helen L. Johnston, James I. Meek, Lucy E. Wilson, M Stacy, Zintars G. Beldavs, Erin C. Phipps, John R. Dunn, Jessica a. Cohen, Nimalie D. Stone, L. Clifford Mcdonald, Fernanda C. Lessa. 524National estimates of incidence, recurrence, hospitalization, and death of nursing home-onset Clostridium difficile infections — United States, 2012. 2014. PMID:
Gould CV, Edwards JR, Cohen J, Bamberg WM, Clark LA, Farley MM, Johnston H, Nadle J, Winston L, Gerding DN, McDonald LC, Lessa FC, Clostridium difficile Infection Surveillance Investigators, Centers for Disease Control and Preventi. Effect of nucleic acid amplification testing on population-based incidence rates of Clostridium difficile infection. 2013. PMID: 23899677
Chitnis AS, Holzbauer SM, Belflower RM, Winston LG, Bamberg WM, Lyons C, Farley MM, Dumyati GK, Wilson LE, Beldavs ZG, Dunn JR, Gould LH, MacCannell DR, Gerding DN, McDonald LC, Lessa FC. Epidemiology of community-associated Clostridium difficile infection, 2009 through 2011. 2013. PMID: 23780507
Wooten DA, Winston LG. Risk factors for methicillin-resistant Staphylococcus aureus in patients with community-onset and hospital-onset pneumonia. 2013. PMID: 23756035
Doernberg SB, Winston LG, Deck DH, Chambers HF. Does doxycycline protect against development of Clostridium difficile infection? 2012. PMID: 22563022
Doernberg SB, Winston LG. Risk factors for acquisition of extended-spectrum β-lactamase-producing Escherichia coli in an urban county hospital. 2011. PMID: 21775020
Chew KW, Yen IH, Li JZ, Winston LG. Predictors of pneumonia severity in HIV-infected adults admitted to an Urban public hospital. 2011. PMID: 21488749
Winston L, Chambers H. Coming home with MRSA. 2009. PMID: 19667300
Lisa G. Winston, Henry F. Chambers. Antimicrobial Resistance in Staphylococci: Mechanisms of Resistance and Clinical Implications. 2009. PMID:
Lisa G. Winston, Daniel Deck, Ann F. Bolger. CHAPTER 81 ENDOCARDITIS. 2009. PMID:
Jain V, Yang MH, Kovacicova-Lezcano G, Juhle LS, Bolger AF, Winston LG. Infective endocarditis in an urban medical center: association of individual drugs with valvular involvement. 2008. PMID: 18597851
Dombrowski JC, Winston LG. Clinical failures of appropriately-treated methicillin-resistant Staphylococcus aureus infections. 2008. PMID: 18533269
Li JZ, Winston LG, Moore DH, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. 2007. PMID: 17765048
Winston LG, Roemer M, Goodman C, Haller B. False-positive culture results from patient tissue specimens due to contamination of RPMI medium with Cryptococcus albidus. Volume 45 of Issue 5. 2007. PMID: 17314221
Young LS, Winston LG. Preoperative use of mupirocin for the prevention of healthcare-associated Staphylococcus aureus infections: a cost-effectiveness analysis. 2006. PMID: 17152027
Weems JJ, Steinberg JP, Filler S, Baddley JW, Corey GR, Sampathkumar P, Winston L, John JF, Kubin CJ, Talwani R, Moore T, Patti JM, Hetherington S, Texter M, Wenzel E, Kelley VA, Fowler VG. Phase II, randomized, double-blind, multicenter study comparing the safety and pharmacokinetics of tefibazumab to placebo for treatment of Staphylococcus aureus bacteremia. 2006. PMID: 16870768
Winston LG, Bolger AF. Modern epidemiology, prophylaxis, and diagnosis and therapy for infective endocarditis. 2006. PMID: 16524536
Mendez MN, Gibbs L, Jacobs RA, McCulloch CE, Winston L, Guglielmo BJ. Impact of a piperacillin-tazobactam shortage on antimicrobial prescribing and the rate of vancomycin-resistant enterococci and Clostridium difficile infections. 2006. PMID: 16509027
Winston LG, Charlebois ED, Pang S, Bangsberg DR, Perdreau-Remington F, Chambers HF. Impact of a formulary switch from ticarcillin-clavulanate to piperacillin-tazobactam on colonization with vancomycin-resistant enterococci. 2004. PMID: 15573053
Winston LG, Felt SC, Huang WH, Chambers HF. Introduction of a waterless hand gel was associated with a reduced rate of ventilator-associated pneumonia in a surgical intensive care unit. 2004. PMID: 15636285
Young LS, Perdreau-Remington F, Winston LG. Clinical, epidemiologic, and molecular evaluation of a clonal outbreak of methicillin-resistant Staphylococcus aureus infection. 2004. PMID: 15095210
Winston LG, Pang S, Haller BL, Wong M, Chambers HF, Perdreau-Remington F. API 20 strep identification system may incorrectly speciate enterococci with low level resistance to vancomycin. Volume 48 of Issue 4. 2004. PMID: 15062923
Chambers HF, Winston LG. Mupirocin prophylaxis misses by a nose. 2004. PMID: 15023716
Winston L, Benowitz N. Once-daily dosing of aminoglycosides: how much monitoring is truly required? 2003. PMID: 12637142
Winston LG, Bangsberg DR, Chambers HF, Felt SC, Rosen JI, Charlebois ED, Wong M, Steele L, Gerberding JL, Perdreau-Remington F. Epidemiology of vancomycin-resistant Enterococcus faecium under a selective isolation policy at an urban county hospital. 2002. PMID: 12410216
Winston LG, Perlman JL, Rose DA, Gerberding JL. Penicillin-nonsusceptible Streptococcus pneumoniae at San Francisco General Hospital. 1999. PMID: 10530451