University of Washington (kv6eonc20091225171252 )
Dr. Walter E. Stamm, whose discoveries on the diagnosis and treatment of urinary tract infections and of the relationship between chlamydia and pelvic inflammatory disease saved tens of thousands of women from infertility, died Dec. 14 at his home in Seattle. He was 64 and had been battling melanoma.
Stamm "was one of the giants . . . who really transformed diagnosis and treatment of genitourinary infections, particularly those that result in pelvic inflammatory diseases," said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, which funded much of his work. "There are a lot of happy mothers out there now because of the work of Walt Stamm."
His diagnostic and treatment recommendations "have remained the standard of care for physicians throughout the world, even now, 25 years later," said Dr. Lawrence Corey of the University of Washington, where Stamm spent most of his career.
Pelvic inflammatory disease is a generic term for an inflammation of the uterus, fallopian tubes and ovaries, typically caused by a bacterial infection. An estimated 1 million American women suffer from it each year and about 100,000 become infertile or have ectopic pregnancies. The numbers were much higher, however, before Stamm began his research.
Pelvic inflammatory disease, or PID, is particularly insidious because it can lead to infertility or other problems even in the absence of overt symptoms. Stamm demonstrated that many cases are caused by the bacterium Chlamydia trachomatis. He developed a sensitive test for the organism and, in a classic 1996 paper, demonstrated that screening women for the bacterium could sharply reduce the incidence of PID.
Such screening programs were subsequently widely introduced in the United States and Europe.
When Stamm began his research, clinicians frequently used high doses of antibiotics for long periods to cure sexually transmitted diseases. Through a series of what Fauci termed "well thought out, methodical clinical trials," Stamm demonstrated that most such infections could be cured with lower doses of drugs for shorter periods.
He showed, for example, that a single dose of the antibiotic azithromycin could cure certain chlamydia infections. He also found that a two-week course of antibiotics could cure upper urinary tract infections, compared to the six weeks that was then the standard.
Shorter treatment regimens and lower doses are crucial to minimizing the side effects of the drugs and to preventing the bacteria from becoming resistant, Fauci said.
Many women who developed urinary tract infections had both gonorrhea and chlamydia. Physicians routinely treated them with beta-lactam antibiotics, such as penicillins and cephalosporins, on the assumption that this would cure both. Many of the patients developed PID, however, and Stamm demonstrated that this was because the beta-lactams were ineffective against chlamydia.
Walter Edward Stamm was born Feb. 4, 1945, in Philadelphia but was raised in Portland, Ore. He received his bachelor's degree from Stanford University in 1967 and his medical degree, cum laude, from Harvard Medical School in 1971.
After a residency at the University of Washington Medical School, he joined what was then called the Centers for Disease Control in Atlanta, where he studied infections produced by medical devices routinely left in the body for extended periods, such as catheters and needles. While there, he investigated a cluster of urinary tract infections at a New Jersey hospital, which set the stage for his interest in the topic.
He returned to the University of Washington in 1976 and remained there for the rest of his career. During this period, he discovered two new species of campylobacter, demonstrated the importance of corynebacterium JK infections in immunocompromised people and showed the role of Bartonella quintana infections in inner-city residents with alcoholism.
He was also one of the first to note that genital ulcers made it easier for people to become infected with HIV.
Stamm was a prolific author, writing more than 350 research articles, 92 reviews, 105 book chapters and 11 books. He was a president of the Infectious Diseases Society of America and an advisor to many national and world health groups.
He was a star athlete in high school and at Stanford and had a lifelong passion for tennis. He also enjoyed traveling, fishing and skiing.
His wife of 42 years, Peggy, died in 2008. He is survived by two daughters, Hillary of Los Angeles and Lindsay of Portland; and a son, Andrew of Seattle.