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Charles Michael Cotten, MD

Professor of Pediatrics
Chief, Division of Pediatric Neonatology
Campus mail: 2424 Erwin Rd Suite 504, Durham, NC 27710
Phone: (919) 681-6035
Email address: michael.cotten@duke.edu

I am involved in 4 major areas of research:
1) Neuroprotection. Working with colleagues from Cell Therapies, we have added to Duke's experience participating in pivotal trials of hypothermia for term newborns with moderate to severe hypoxic-ischemic encephalopathy (HIE) by completing a phase I study of autologous cord blood cells for these infants, and developing and currently leading a multicenter, double-blind randomized clinical trial of autologous cord blood cells or placebo in term infants with moderate or severe HIE. We recently completed, w/ funding from Duke's CTSI support, the first phase I single center study of allogeneic cord tissue derived mesenchymal stromal cells for newborns with moderate or severe HIE who do not have autologous cells available.
2) Genomics. We at Duke have been in the NICHD Neonatal Research Network (NRN) since 2001. I led the NRN's development of an Anonymized DNA bank of samples collected from 1,000 extremely low birthweight infants, with phenotype information linked to the samples. This resource has been the basis for multiple candidate gene, and genome wide scan analysis, and has identified variants associated with severe retinopathy of prematurity and necrotizing enterocolitis. We are in the process of partnering with the Vermont Oxford Network-Rady Genomics collaborative to bring 48 hour turnaround Whole Genome Sequencing to patients in the Duke Intensive Care Nursery. 
3) New Technologies: I have collaborated with Drs. David Millington from Duke and Vamsee Pamula (a Duke Pratt School graduate), from BAEBIES Inc, on prototype new technology devices for use in newborn screening for lysosomal storage disease as well as multiplex chips for screening for hyperbilirubinemia and related conditions, as well as working with Dr. Pamula and Dr. Michael Freemark (Peds Endocrinology) on screening panels for hypoglycemia and hypothyroidism, and with investigators from UAB on an Acute Kidney Injury panel. Also, I am collaborating with Dr. Cynthia Toth in pediatric ophthalmology, and Pratt School investigators to develop and apply use of optical coherence tomography for retinal imaging that will assess associations between retinal neurovascular development, brain development, and neurodevelopmental outcomes. I recently worked with the Duke FORGE and multiple Pediatric subspecialists on machine-learning and deep informatics analysis of electronic health records to quantify risk for subsequent complications and on development of algorithms to identify neonatal seizures from neonatal EEG tracings. 
4)Microbiome in Micropreemies and health outcomes of periviable infants.  I have worked with multiple epidemiology researchers to assess practice variation within our center, and within the Neonatal Research Network centers, to identify how variation in practice can influence outcomes, with a particular focus on antibiotic use. This work demonstrated strong associations between high empirical antibiotic use in infants with sterile cultures and subsequent morbidities and mortality. This discovery has led to strong collaborations and new initiatives by young faculty leading studies of the evolving microbiome, leading to hypothesis generation re: the microbiome and optimal growth in extremely preterm infants.

Education and Training

  • Intern and Resident, Pediatrics, University of Miami, 1986 - 1989
  • M.H.S., Duke University School of Medicine, 2006
  • M.D., University of Miami, 1986

Selected Grants and Awards

Publications

Mukhopadhyay, Sagori, Karen M. Puopolo, Nellie I. Hansen, Scott A. Lorch, Sara B. DeMauro, Rachel G. Greenberg, C Michael Cotten, et al. “Neurodevelopmental outcomes following neonatal late-onset sepsis and blood culture-negative conditions.” Arch Dis Child Fetal Neonatal Ed 106, no. 5 (September 2021): 467–73. https://doi.org/10.1136/archdischild-2020-320664.

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Weimer, Kristin E. D., Hunter Roark, Kimberley Fisher, C Michael Cotten, David A. Kaufman, Margarita Bidegain, and Sallie R. Permar. “Breast Milk and Saliva Lactoferrin Levels and Postnatal Cytomegalovirus Infection.” Am J Perinatol 38, no. 10 (August 2021): 1070–77. https://doi.org/10.1055/s-0040-1701609.

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Adams-Chapman, Ira, Kristi L. Watterberg, Tracy L. Nolen, Shawn Hirsch, Carol A. Cole, C Michael Cotten, William Oh, et al. “Neurodevelopmental outcome of preterm infants enrolled in myo-inositol randomized controlled trial.” J Perinatol 41, no. 8 (August 2021): 2072–87. https://doi.org/10.1038/s41372-021-01018-5.

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Curtis, Samantha, Noelle Younge, Jennifer Peterson, C Michael Cotten, Samia Aleem, and Rachel G. Greenberg. “Which infants should receive indomethacin prophylaxis: moving closer to individualized medicine in the neonatal intensive care unit.” J Pediatr, July 9, 2021. https://doi.org/10.1016/j.jpeds.2021.07.006.

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Miller, Laura E., Chris DeRienzo, P Brian Smith, Carl Bose, Reese H. Clark, C Michael Cotten, Daniel K. Benjamin, Chi D. Hornik, and Rachel G. Greenberg. “Association between neonatal intensive care unit medication safety practices, adverse events, and death.” J Perinatol 41, no. 7 (July 2021): 1739–44. https://doi.org/10.1038/s41372-020-00857-y.

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Chakkarapani, Aravanan A., Hany Aly, Manon Benders, C Michael Cotten, Mohamed El-Dib, Pierre Gressens, Henrik Hagberg, et al. “Therapies for neonatal encephalopathy: Targeting the latent, secondary and tertiary phases of evolving brain injury.” Semin Fetal Neonatal Med, June 12, 2021, 101256. https://doi.org/10.1016/j.siny.2021.101256.

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Smith, Michael J., Angelique Boutzoukas, Julie Autmizguine, Mark L. Hudak, Erin Zinkhan, Barry T. Bloom, Gloria Heresi, et al. “Antibiotic Safety and Effectiveness in Premature Infants With Complicated Intraabdominal Infections.” Pediatr Infect Dis J 40, no. 6 (June 1, 2021): 550–55. https://doi.org/10.1097/INF.0000000000003034.

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Ambalavanan, Namasivayam, Seetha Shankaran, Abbot R. Laptook, Benjamin A. Carper, Abhik Das, Waldemar A. Carlo, C Michael Cotten, Andrea F. Duncan, Rosemary D. Higgins, and Rosemary D. EUNICE KENNEDY SHRIVER NICHD NEONATAL RESEARCH NETWORK. “Early Determination of Prognosis in Neonatal Moderate or Severe Hypoxic-Ischemic Encephalopathy.” Pediatrics 147, no. 6 (June 2021). https://doi.org/10.1542/peds.2020-048678.

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Mangalesh, Shwetha, Brendan McGeehan, Vincent Tai, Xi Chen, Du Tran-Viet, Lejla Vajzovic, Christian Viehland, et al. “Macular OCT Characteristics at 36 Weeks' Postmenstrual Age in Infants Examined for Retinopathy of Prematurity.” Ophthalmol Retina 5, no. 6 (June 2021): 580–92. https://doi.org/10.1016/j.oret.2020.09.004.

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Mangalesh, Shwetha, Neeru Sarin, Brendan McGeehan, S Grace Prakalapakorn, Du Tran-Viet, C Michael Cotten, Sharon F. Freedman, Maureen G. Maguire, Cynthia A. Toth, and Cynthia A. BabySTEPS Group. “Preterm Infant Stress During Handheld Optical Coherence Tomography vs Binocular Indirect Ophthalmoscopy Examination for Retinopathy of Prematurity.” Jama Ophthalmol 139, no. 5 (May 1, 2021): 567–74. https://doi.org/10.1001/jamaophthalmol.2021.0377.

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