William Rehrauer
· Associate Professor (CHS) - Director of Molecular DiagnosticsUniversity of Wisconsin-Madison · Pathology and Laboratory Medicine
Active 1993–2024
About
William Rehrauer is an Associate Professor (CHS) and the Director of Molecular Diagnostics at the Department of Pathology and Laboratory Medicine at the University of Wisconsin School of Medicine and Public Health. His research interests focus on molecular diagnostic techniques, contributing to the advancement of diagnostic methods in pathology. Rehrauer holds a PhD and is actively involved in both research and clinical applications within his department, supporting the integration of molecular diagnostics into patient care and pathology practice.
Research topics
- Medicine
- Biology
- Virology
- Intensive care medicine
- Microbiology
- Computer Science
- Internal medicine
- Computer Security
- Immunology
- Anesthesia
- Evolutionary biology
- Oncology
- Genetics
- Pathology
- Geography
- Telecommunications
Selected publications
2023
- Medicine
- Intensive care medicine
- Microbiology
A patient suffered a non-fatal wet drowning in a freshwater lake and developed bacteremia several days later. Blood culture grew a Gram-negative rod that could not be identified by MALDI-TOF MS. 16S ribosomal RNA sequencing of the isolate identified the microbe as Hydrogenophaga laconesensis––an environmental microbe commonly found in freshwater. The recovery of multiple pathogenic microorganisms (although not Hydrogenophaga laconesensis) from culture of respiratory specimens prompted the initiation of antibiotic therapy with cefepime and, later, vancomycin. The patient’s clinical course gradually improved over the course of two weeks and she was ultimately discharged home with minimal sequelae. To our knowledge, this is the first evidence of human infection with bacteria in the Hydrogenophaga genus. Hydrogenophaga may be considered in cases of freshwater near-drowning, and MALDI-TOF MS databases should be updated to include Hydrogenophaga laconesensis.
Access Microbiology · 2023 · 3 citations
- Microbiology
- Medicine
- Anesthesia
.
Cancer Cytopathology · 2022 · 7 citations
- Medicine
- Pathology
- Oncology
BACKGROUND: Fine-needle aspiration is used as a diagnostic tool in head and neck oropharyngeal squamous cell carcinoma and its metastases. Prognosis and treatment rely on the presence or absence of the human papilloma virus. The purpose of this study was to validate the performance of the Aptima HPV assay using Hema-Diff stained fine-needle aspiration smears in the diagnosis of human papilloma virus-related oropharyngeal squamous cell carcinoma using a simplified method to obtain tumor cells for testing. METHODS: Patients with a diagnosis of squamous cell carcinoma and positive p16 immunohistochemical staining were identified. Aptima Specimen Transport Media was used to remove tumor cells from the Hema-Diff stained slides using a moistened swab. The selected cells were tested for high risk-human papilloma virus using the Aptima HPV assay and Aptima HPV 16 18/45 genotype assay. The results were compared with the p16 immunohistochemical staining of the related cell block and surgical specimens. RESULTS: Twenty-one of the 21 (100%) p16-positive cases were found to be positive for high risk-human papilloma virus, whereas 20 of 21 (95%) negative cases were found to be negative for high risk-human papilloma virus using the Aptima HPV assay. CONCLUSION: The Aptima HPV assay can be used to detect high-risk human papilloma virus in Hema-Diff stained fine-needle aspiration smears of oropharyngeal squamous cell carcinoma with a sensitivity of 100% and a specificity of 95%. This provides a valuable alternative to p16 immunohistochemical staining of cell block sections that often lack appropriate numbers of tumor cells.
2022
- Medicine
- Intensive care medicine
- Microbiology
A patient suffered a non-fatal wet drowning in a freshwater lake and developed bacteremia several days later. Blood culture grew a Gram-negative rod that could not be identified by MALDI-TOF MS. 16S ribosomal RNA sequencing of the isolate identified the microbe as Hydrogenophaga laconesensis––an environmental microbe commonly found in freshwater. The recovery of multiple pathogenic microorganisms (although not Hydrogenophaga laconesensis) from culture of respiratory specimens prompted the initiation of antibiotic therapy with cefepime and, later, vancomycin. The patient’s clinical course gradually improved over the course of two weeks and she was ultimately discharged home with minimal sequelae. To our knowledge, this is the first evidence of human infection with bacteria in the Hydrogenophaga genus. Hydrogenophaga may be considered in cases of freshwater near-drowning, and MALDI-TOF MS databases should be updated to include Hydrogenophaga laconesensis.
Viral Sequencing to Investigate Sources of SARS-CoV-2 Infection in US Healthcare Personnel
Clinical Infectious Diseases · 2021 · 57 citations
- Medicine
- Virology
- Intensive care medicine
BACKGROUND: Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We posit that current infection control guidelines generally protect HCP from SARS-CoV-2 infection in a healthcare setting. METHODS: In this retrospective case series, we used viral genomics to investigate the likely source of SARS-CoV-2 infection in HCP at a major academic medical institution in the Upper Midwest of the United States between 25 March and 27 December 2020. We obtained limited epidemiological data through informal interviews and review of the electronic health record and combined this information with healthcare-associated viral sequences and viral sequences collected in the broader community to infer the most likely source of infection in HCP. RESULTS: We investigated SARS-CoV-2 infection clusters involving 95 HCP and 137 possible patient contact sequences. The majority of HCP infections could not be linked to a patient or coworker (55 of 95 [57.9%]) and were genetically similar to viruses circulating concurrently in the community. We found that 10.5% of HCP infections (10 of 95) could be traced to a coworker. Strikingly, only 4.2% (4 of 95) could be traced to a patient source. CONCLUSIONS: Infections among HCP add further strain to the healthcare system and put patients, HCP, and communities at risk. We found no evidence for healthcare-associated transmission in the majority of HCP infections evaluated. Although we cannot rule out the possibility of cryptic healthcare-associated transmission, it appears that HCP most commonly become infected with SARS-CoV-2 via community exposure. This emphasizes the ongoing importance of mask wearing, physical distancing, robust testing programs, and rapid distribution of vaccines.
PLoS Pathogens · 2021 · 123 citations
- Biology
- Evolutionary biology
- Virology
The emergence of divergent SARS-CoV-2 lineages has raised concern that novel variants eliciting immune escape or the ability to displace circulating lineages could emerge within individual hosts. Though growing evidence suggests that novel variants arise during prolonged infections, most infections are acute. Understanding how efficiently variants emerge and transmit among acutely-infected hosts is therefore critical for predicting the pace of long-term SARS-CoV-2 evolution. To characterize how within-host diversity is generated and propagated, we combine extensive laboratory and bioinformatic controls with metrics of within- and between-host diversity to 133 SARS-CoV-2 genomes from acutely-infected individuals. We find that within-host diversity is low and transmission bottlenecks are narrow, with very few viruses founding most infections. Within-host variants are rarely transmitted, even among individuals within the same household, and are rarely detected along phylogenetically linked infections in the broader community. These findings suggest that most variation generated within-host is lost during transmission.
Revealing fine-scale spatiotemporal differences in SARS-CoV-2 introduction and spread
Nature Communications · 2020 · 47 citations
- Computer Science
- Computer Security
- Geography
known introduction of SARS-CoV-2 in the United States, but this did not lead to descendant community spread. Instead, the Dane County outbreak was seeded by multiple later introductions, followed by limited community spread. In contrast, relatively few introductions in Milwaukee County led to extensive community spread. We present evidence for reduced viral spread in both counties following the statewide "Safer at Home" order, which went into effect 25 March 2020. Our results suggest patterns of SARS-CoV-2 transmission may vary substantially even in nearby communities. Understanding these local patterns will enable better targeting of public health interventions.
Frequent coauthors
- 83 shared
Molly A. Accola
University of Wisconsin–Madison
- 32 shared
Yoshihiro Kawaoka
- 24 shared
David H. O’Connor
University of Wisconsin–Madison
- 21 shared
Thomas C. Friedrich
University of Wisconsin–Madison
- 18 shared
Derrick J. Chen
University of Wisconsin–Madison
- 17 shared
Peter Halfmann
University of Wisconsin–Madison
- 16 shared
Adam L. Bailey
- 15 shared
Daniel R. Matson
University of Wisconsin–Madison
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