Rachel Wattier, MD, MHS

Rachel Wattier, M.D., M.H.S. is a physician in the Department of Pediatrics, Division of Infectious Diseases and Global Health. She started the Antimicrobial Stewardship Program at Benioff Chidren's Hospital San Francisco and has conducted collaborative research to improve judicious antimicrobial and diagnostic test use in children. Her current research as a scholar in the UCSF-KPNC Urologic Epidemiology K12 program focuses on improving evidence uptake and application in diagnosis of urinary tract infections.
Education
Fellowship, 06/2015 - Clinical Pharmacology, University of California, San Francisco
Fellowship, 06/2015 - Pediatric Infectious Diseases, University of California, San Francisco
Certificate Program, 05/2015 - Advanced Training in Clinical Research, University of California, San Francisco
Residency, 06/2012 - Pediatrics, University of California, San Francisco
M.D., M.H.S., 05/2009 - School of Medicine, Yale University
B.S., 05/2004 - Biology, Agricultural Biotechnology, University of Kentucky

  1. Rachel L Wattier, Daniel J Shapiro, Sunitha V Kaiser, Adam L Hersh. Urine Testing in Children with Respiratory or Other Viral Illness Symptoms: a National Analysis of Ambulatory Encounters. Journal of the Pediatric Infectious Diseases Society 2024. PMID:


  2. Bucayu RFT, Boge CLK, Yildirim I, Avilés-Robles M, Vora SB, Berman DM, Sharma TS, Sung L, Castagnola E, Palazzi DL, Danziger-Isakov L, Yin DE, Roilides E, Maron G, Tribble AC, Soler-Palacin P, López-Medina E, Romero J, Belani K, Arrieta AC, Carlesse F, Nolt D, Halasa N, Dulek D, Rajan S, Muller WJ, Ardura MI, Pong A, Gonzalez BE, Salvatore CM, Huppler AR, Aftandilian C, Abzug MJ, Chakrabarti A, Green M, Lutsar I, Knackstedt ED, Johnson SK, Steinbach WJ, Fisher BT, Wattier RL. Transition to Enteral Triazole Antifungal Therapy for Pediatric Invasive Candidiasis: Secondary Analysis of a Multicenter Cohort Study Conducted by the Pediatric Fungal Network. Journal of the Pediatric Infectious Diseases Society 2024. PMID: 39513400


  3. Zhong D, Dong SW, Chu VT, Gabriel N, Lusardi K, Searns JB, Wattier RL, Ristagno EH, Bhimraj A, Boguniewicz J, Pottinger P. Out-BREAK!: An IDWeek 2023 Escape Room to Break Out of the Educational Mold. Open forum infectious diseases 2024. PMID: 39411221


  4. Bahakel H, Spieker AJ, Hayek H, Schuster JE, Hamdan L, Dulek DE, Kitko CL, Stopczynski T, Batarseh E, Haddadin Z, Stewart LS, Stahl A, Potter M, Rahman H, Amarin J, Kalams SA, Bocchini CE, Moulton EA, Coffin SE, Ardura MI, Wattier RL, Maron G, Grimley M, Paulsen G, Harrison CJ, Freedman J, Carpenter PA, Englund JA, Munoz FM, Danziger-Isakov L, Halasa N, Pediatric HCT Flu Study. Immunogenicity and Reactogenicity of High-dose or Standard-dose Influenza Vaccine in a Second Consecutive Influenza Season. The Journal of infectious diseases 2024. PMID: 39279435


  5. Rachel Wattier, Prachi Singh, Israel Green-Hopkins, Adam Hersh, Andrew Auerbach, Sunitha Kaiser. Diagnostic Stewardship Opportunities for Emergency Department Evaluation of Children with Suspected Urinary Tract Infection. Antimicrobial Stewardship & Healthcare Epidemiology 2024. PMID:


  6. Amarin JZ, Dulek DE, Simmons J, Hayek H, Chappell JD, Nochowicz CH, Kitko CL, Schuster JE, Muñoz FM, Bocchini CE, Moulton EA, Coffin SE, Freedman JL, Ardura MI, Wattier RL, Maron G, Grimley M, Paulsen G, Danziger-Isakov L, Carpenter PA, Englund JA, Halasa NB, Spieker AJ, Kalams SA. Immunophenotypic predictors of influenza vaccine immunogenicity in pediatric hematopoietic cell transplant recipients. Blood advances 2024. PMID: 38386973


  7. Schuster JE, Hamdan L, Dulek DE, Kitko CL, Batarseh E, Haddadin Z, Stewart LS, Stahl A, Potter M, Rahman H, Kalams SA, Bocchini CE, Moulton EA, Coffin SE, Ardura MI, Wattier RL, Maron G, Grimley M, Paulsen G, Harrison CJ, Freedman JL, Carpenter PA, Englund JA, Munoz FM, Danziger-Isakov L, Spieker AJ, Halasa NB, Pediatric HCT Flu Study. The Durability of Antibody Responses of Two Doses of High-Dose Relative to Two Doses of Standard-Dose Inactivated Influenza Vaccine in Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2023. PMID: 37800415


  8. Hannah Bahakel, Andrew J Spieker, Anna Stahl, Herdi Rahman, Justin Amarin, Lubna Hamdan, Daniel E Dulek, Carrie L Kitko, Einas Batarseh, Zaid Haddadin, Laura S Stewart, Molly Potter, Spyros A Kalams, Jennifer E Schuster, Susan Coffin, Monica I Ardura, Rachel L Wattier, Gabriela Maron, Claire E Bocchini, Elizabeth A Moulton, Michael Grimley, Grant Paulsen, Christopher J Harrison, Jason Freedman, Paul A Carpenter, Janet A Englund, Flor M Munoz, Lara Danziger-Isakov, Natasha Halasa. Immunogenicity and Safety of Alternative Influenza Vaccination Strategies in Repeated Seasons in Pediatric Hematopoietic-Cell Transplant Recipients. Journal of the Pediatric Infectious Diseases Society 2023. PMID:


  9. Wattier RL, Bucayu RFT, Boge CLK, Ross RK, Yildirim I, Zaoutis TE, Palazzi DL, Vora SB, Castagnola E, Avilés-Robles M, Danziger-Isakov L, Tribble AC, Sharma TS, Arrieta AC, Maron G, Berman DM, Yin DE, Sung L, Green M, Roilides E, Belani K, Romero J, Soler-Palacin P, López-Medina E, Nolt D, Bin Hussain IZ, Muller WJ, Hauger SB, Halasa N, Dulek D, Pong A, Gonzalez BE, Abzug MJ, Carlesse F, Huppler AR, Rajan S, Aftandilian C, Ardura MI, Chakrabarti A, Hanisch B, Salvatore CM, Klingspor L, Knackstedt ED, Lutsar I, Santolaya ME, Shuster S, Johnson SK, Steinbach WJ, Fisher BT. Adjunctive Diagnostic Studies Completed Following Detection of Candidemia in Children: Secondary Analysis of Observed Practice from a Multicenter Cohort Study Conducted by the Pediatric Fungal Network. Journal of the Pediatric Infectious Diseases Society 2023. PMID: 37589394


  10. Otani IM, Tang M, Wang L, Anstey KM, Hilts-Horeczko A, Li F, Le VP, Lee M, Bystritsky R, Mulliken JS, Wattier RL, Blumenthal KG, Doernberg SB. Impact of an Inpatient Allergy Guideline on β-Lactam and Alternative Antibiotic Use. The journal of allergy and clinical immunology. In practice 2023. PMID: 37182569


  11. Cooch PB, Kim MO, Swami N, Tamma PD, Tabbutt S, Steurer MA, Wattier RL. Broad- Versus Narrow-Spectrum Perioperative Antibiotics and Outcomes in Pediatric Congenital Heart Disease Surgery: Analysis of the Vizient Clinical Data Base. Journal of the Pediatric Infectious Diseases Society 2023. PMID: 37018466


  12. Schuster JE, Hamdan L, Dulek DE, Kitko CL, Batarseh E, Haddadin Z, Stewart LS, Stahl A, Potter M, Rahman H, Kalams SA, Coffin S, Ardura MI, Wattier RL, Maron G, Bocchini CE, Moulton EA, Grimley M, Paulsen G, Harrison CJ, Freedman J, Carpenter PA, Englund JA, Munoz FM, Danziger-Isakov L, Spieker AJ, Halasa N, Pediatric HCT Flu Study Group. Influenza Vaccine in Pediatric Recipients of Hematopoietic-Cell Transplants. The New England journal of medicine 2023. PMID: 36630610


  13. Prinzi AM, Wattier RL, Curtis DJ, Ziniel SI, Fitzgerald A, Pearce K, Parker SK. Impact of Organism Reporting from Endotracheal Aspirate Cultures on Antimicrobial Prescribing Practices in Mechanically Ventilated Pediatric Patients. Journal of clinical microbiology 2022. PMID: 36218349


  14. Fisher BT, Boge CLK, Xiao R, Shuster S, Chin-Quee D, Allen J, Shaheen S, Hayden R, Suganda S, Zaoutis TE, Chang YC, Yin DE, Huppler AR, Danziger-Isakov L, Muller WJ, Roilides E, Romero J, Sue PK, Berman D, Wattier RL, Halasa N, Pong A, Maron G, Soler-Palacin P, Hutto SC, Gonzalez BE, Salvatore CM, Rajan S, Green M, Doby Knackstedt E, Hauger SB, Steinbach WJ. Multicenter Prospective Study of Biomarkers for Diagnosis of Invasive Candidiasis in Children and Adolescents. 2022. PMID: 35134165


  15. Essakow J, Jin L, Marupudi N, Wattier R, McQuillen P, Franzon D. Serotonin Syndrome in an Infant Associated With Linezolid and Opioid Use. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG 2022. PMID: 36988981


  16. Wattier RL, Esbenshade AJ. From "More is Better" to "Less is More": A Commentary on Antimicrobial Use in Pediatric Oncology. 2022. PMID: 35099542


  17. Wolf J, Abzug MJ, Anosike BI, Vora SB, Waghmare A, Sue PK, Olivero RM, Oliveira CR, James SH, Morton TH, Maron GM, Young JL, Orscheln RC, Schwenk HT, Bio LL, Willis ZI, Lloyd EC, Hersh AL, Huskins CW, Soma VL, Ratner AJ, Hayes M, Downes K, Chiotos K, Grapentine SP, Wattier RL, Lamb GS, Zachariah P, Nakamura MM. Updated Guidance on Use and Prioritization of Monoclonal Antibody Therapy for Treatment of COVID-19 in Adolescents. 2022. PMID: 35107571


  18. Wattier RL, Thurm CW, Parker SK, Banerjee R, Hersh AL, Pediatric Health Information System Antimicrobial Stewardship Research Group. Indirect Standardization as a Case Mix Adjustment Method to Improve Comparison of Children's Hospitals' Antimicrobial Use. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2021. PMID: 33320178


  19. Fisher BT, Zaoutis TE, Xiao R, Wattier RL, Castagnola E, Pana ZD, Fullenkamp A, Boge CLK, Ross RK, Yildirim I, Palazzi DL, Danziger-Isakov L, Vora SB, Arrieta A, Yin DE, Avilés-Robles M, Sharma T, Tribble AC, Maron G, Berman D, Green M, Sung L, Romero J, Hauger SB, Roilides E, Belani K, Nolt D, Soler-Palacin P, López-Medina E, Muller WJ, Halasa N, Dulek D, Hussain IZB, Pong A, Hoffman J, Rajan S, Gonzalez BE, Hanisch B, Aftandilian C, Carlesse F, Abzug MJ, Huppler AR, Salvatore CM, Ardura MI, Chakrabarti A, Santolaya ME, Localio AR, Steinbach WJ. Comparative Effectiveness of Echinocandins vs Triazoles or Amphotericin B Formulations as Initial Directed Therapy for Invasive Candidiasis in Children and Adolescents. Journal of the Pediatric Infectious Diseases Society 2021. PMID: 34374424


  20. Wolf J, Abzug MJ, Wattier RL, Sue PK, Vora SB, Zachariah P, Dulek DE, Waghmare A, Olivero R, Downes KJ, James SH, Pinninti SG, Yarbrough A, Aldrich ML, MacBrayne CE, Soma VL, Grapentine SP, Oliveira CR, Hayes M, Kimberlin DW, Jones SB, Bio LL, Morton TH, Hankins JS, Maron GM, Timberlake K, Young JL, Orscheln RC, Schwenk HT, Goldman DL, Groves HE, Huskins WC, Rajapakse NS, Lamb GS, Tribble AC, Lloyd EC, Hersh AL, Thorell EA, Ratner AJ, Chiotos K, Nakamura MM. Initial Guidance on Use of Monoclonal Antibody Therapy for Treatment of Coronavirus Disease 2019 in Children and Adolescents. Journal of the Pediatric Infectious Diseases Society 2021. PMID: 33388760


  21. Chiotos K, Hayes M, Kimberlin DW, Jones SB, James SH, Pinninti SG, Yarbrough A, Abzug MJ, MacBrayne CE, Soma VL, Dulek DE, Vora SB, Waghmare A, Wolf J, Olivero R, Grapentine S, Wattier RL, Bio L, Cross SJ, Dillman NO, Downes KJ, Oliveira CR, Timberlake K, Young J, Orscheln RC, Tamma PD, Schwenk HT, Zachariah P, Aldrich ML, Goldman DL, Groves HE, Rajapakse NS, Lamb GS, Tribble AC, Hersh AL, Thorell EA, Denison MR, Ratner AJ, Newland JG, Nakamura MM. Multicenter Interim Guidance on Use of Antivirals for Children With Coronavirus Disease 2019/Severe Acute Respiratory Syndrome Coronavirus 2. Journal of the Pediatric Infectious Diseases Society 2021. PMID: 32918548


  22. Rachel L. Wattier, William J. Steinbach. 25 Mucormycosis, fusariosis, scedosporiasis, and other invasive mold diseases. 2021. PMID:


  23. Rachel Wattier, Cary Thurm, Ritu Banerjee, Ritu Banerjee, Adam Hersh. 1348. Indirect Standardization to Improve Comparison of Children’s Hospitals’ Antimicrobial Use. 2020. PMID:


  24. Peter B Cooch, Rachel Wattier, Martina Steurer-Muller. 1361. Variation in Perioperative Antibiotic Use for Children Undergoing Congenital Heart Disease Surgery in U.S. Academically Affiliated Centers. 2020. PMID:


  25. Singh P, Steurer MA, Cantey JB, Wattier RL. Hospital-level Antibiotic Use and Complexity of Care Among Neonates. Journal of the Pediatric Infectious Diseases Society 2020. PMID: 31879765


  26. Chiotos K, Hayes M, Kimberlin DW, Jones SB, James SH, Pinninti SG, Yarbrough A, Abzug MJ, MacBrayne CE, Soma VL, Dulek DE, Vora SB, Waghmare A, Wolf J, Olivero R, Grapentine S, Wattier RL, Bio L, Cross SJ, Dillman NO, Downes KJ, Timberlake K, Young J, Orscheln RC, Tamma PD, Schwenk HT, Zachariah P, Aldrich M, Goldman DL, Groves HE, Lamb GS, Tribble AC, Hersh AL, Thorell EA, Denison MR, Ratner AJ, Newland JG, Nakamura MM. Multicenter Initial Guidance on Use of Antivirals for Children With Coronavirus Disease 2019/Severe Acute Respiratory Syndrome Coronavirus 2. 2020. PMID: 32318706


  27. Downes KJ, Danziger-Isakov LA, Cousino MK, Green M, Michaels MG, Muller WJ, Orscheln RC, Sharma TS, Statler VA, Wattier RL, Ardura MI. Return to School for Pediatric Solid Organ Transplant Recipients in the United States During the Coronavirus Disease 2019 Pandemic: Expert Opinion on Key Considerations and Best Practices. 2020. PMID: 32750142


  28. Cordoro KM, Reynolds SD, Wattier R, McCalmont TH. Clustered cases of acral perniosis: Clinical features, histopathology, and relationship to COVID-19. 2020. PMID: 32396999


  29. Jennifer E Schuster, Jennifer E Schuster, Andrew Speaker, Lubna Hamdan, Einas Batarseh, Laura S Stewart, Daniel Dulek, Carrie L Kitko, Flor M Munoz, Flor M Munoz, Claire Bocchini, Lara Danziger-Isakov, Michael Grimley, Rakesh Goyal, Susan E Coffin, Jason L Freedman, Janet A Englund, Paul A Carpenter, Monica I Ardura, Jeffrey Auletta, Rachel Wattier, Kenny Truong, Gabriela Maron, Kim J Allison, Natasha B Halasa. 2759. Immunogenicity of Inactivated Influenza Vaccines Given Early vs. Late After Pediatric Allogeneic Hematopoietic Cell Transplantation. 2019. PMID:


  30. Benjamin T, Wattier R, Dominic W. Allograft of Primary Cutaneous Mucormycosis in a Preterm Neonate: A Case Report. 2019. PMID: 31373557


  31. Prachi Singh, Rachel Wattier. 258. Variation in Antibiotic Use Among Neonates Hospitalized in United States Academically Affiliated Centers. 2018. PMID:


  32. Rachel L. Wattier, William J. Steinbach. 293 Antifungal Agents. 2018. PMID:


  33. Wattier RL, Levy ER, Sabnis AJ, Dvorak CC, Auerbach AD. Reducing Second Gram-Negative Antibiotic Therapy on Pediatric Oncology and Hematopoietic Stem Cell Transplantation Services. Infection control and hospital epidemiology 2017. PMID: 28758610


  34. Esbenshade AJ, Zhao Z, Aftandilian C, Saab R, Wattier RL, Beauchemin M, Miller TP, Wilkes JJ, Kelly MJ, Fernbach A, Jeng M, Schwartz CL, Dvorak CC, Shyr Y, Moons KGM, Sulis ML, Friedman DL. Multisite external validation of a risk prediction model for the diagnosis of blood stream infections in febrile pediatric oncology patients without severe neutropenia. Cancer 2017. PMID: 28542918


  35. Wattier RL, Ramirez-Avila L. Pediatric Invasive Aspergillosis. 2016. PMID: 29376936


  36. Wattier RL, Ramirez-Avila L. Pediatric invasive aspergillosis 2016. PMID:


  37. Horn B, O'Kane S, Wattier RL, Wahlstrom JT, Melton A, Cowan MJ, Dvorak CC. Risk of serious bloodstream infections is low in pediatric hematopoietic stem cell transplant (HSCT) recipients with fevers due to antithymocyte globulins and alemtuzumab. Bone marrow transplantation 2016. PMID: 27272452


  38. Biljana Horn, Sara O'Kane, Rachel Wattier, Justin T. Wahlstrom, Alexis Melton, Morton J. Cowan, Christopher C. Dvorak. Serotherapy-Related Fevers, Blood Stream Infections (BSI), and Antibiotic Use in Pediatric Allogeneic Hematopoietic Cell Transplant (HCT) Recipients. Biology of Blood and Marrow Transplantation 2016. PMID:


  39. Wattier RL, Dvorak CC, Auerbach AD, Weintrub PS. Repeat blood cultures in children with persistent fever and neutropenia: Diagnostic and clinical implications. Pediatric blood & cancer 2015. PMID: 25728605


  40. Wattier RL, Dvorak CC, Hoffman JA, Brozovich AA, Bin-Hussain I, Groll AH, Castagnola E, Knapp KM, Zaoutis TE, Gustafsson B, Sung L, Berman D, Halasa NB, Abzug MJ, Velegraki A, Sharma TS, Fisher BT, Steinbach WJ. A Prospective, International Cohort Study of Invasive Mold Infections in Children. Journal of the Pediatric Infectious Diseases Society 2014. PMID: 26582870


  41. Levitz R, Wattier R, Phillips P, Solomon A, Lawler J, Lazar I, Weibel C, Kahn JS. Induction of IL-6 and CCL5 (RANTES) in human respiratory epithelial (A549) cells by clinical isolates of respiratory syncytial virus is strain specific. 2012. PMID: 22962966


  42. Wattier RL, Vázquez M, Weibel C, Shapiro ED, Ferguson D, Landry ML, Kahn JS. Role of human polyomaviruses in respiratory tract disease in young children. 2008. PMID: 18976566


  43. von Lackum K, Babb K, Riley SP, Wattier RL, Bykowski T, Stevenson B. Functionality of Borrelia burgdorferi LuxS: the Lyme disease spirochete produces and responds to the pheromone autoinducer-2 and lacks a complete activated-methyl cycle. 2006. PMID: 16530477


  44. Babb K, von Lackum K, Wattier RL, Riley SP, Stevenson B. Synthesis of autoinducer 2 by the lyme disease spirochete, Borrelia burgdorferi. 2005. PMID: 15838035


  45. Stevenson B, von Lackum K, Wattier RL, McAlister JD, Miller JC, Babb K. Quorum sensing by the Lyme disease spirochete. 2003. PMID: 12941391