About

Gina Hong, MD, MHS, is an Assistant Professor of Medicine in the Department of Pulmonary, Allergy and Critical Care at the Hospital of the University of Pennsylvania. Her educational background includes a BA from Rutgers University, an MD from Rutgers University-New Jersey Medical School, and an MHS from Johns Hopkins Bloomberg School of Public Health. Her clinical expertise focuses on cystic fibrosis and bronchiectasis, with research centered on the detection and clinical impact of bacterial and fungal infections in cystic fibrosis. Her work involves the development and application of molecular methods to detect and quantify fungal communities in cystic fibrosis airway specimens, as well as evaluating the effectiveness of antifungal treatments and diagnostic assays for Aspergillus fumigatus in cystic fibrosis patients.

Research topics

• Medicine
• Internal medicine
• Biology
• Intensive care medicine
• Microbiology

Selected publications

• Molecular Methods to Detect and Quantify Fungal Communities in Cystic Fibrosis Airway Specimens

  Pediatric Pulmonology · 2026-03-31

  article

  INTRODUCTION: Fungal pathogens are frequently detected in the cystic fibrosis (CF) airways; however, limitations exist with culture-based detection methods. Here, we apply a novel next generation sequencing (NGS) technique to identify fungal taxa in airway samples from CF and non-CF disease controls (DC), comparing the results to traditional culture. METHODS: Bronchoalveolar lavage fluid (BALF) and oropharyngeal (OP) swabs were collected concurrently from children; expectorated sputum (ES) was collected from adults with CF. Total fungal load (TFL) was quantified via quantitative polymerase chain reaction (qPCR). Fungal communities were determined using NGS (V6/V8) and assessed for relative abundance, diversity, and richness. Wilcoxon rank-sum tests compared TFL and diversity measures. RESULTS: Seventy-six samples (23 paired BALF-OP swabs, 30 ES samples) from 52 individuals (69% CF) were collected as part of two clinical research studies. Sequencing was successful in 90% of samples, including 78% of OP swabs, and identified more diverse fungal communities than culture. Predominant taxa included Agaricomycetes, Aspergillus, Candida-Lodderomyces-clade, and Cladosporium. Aspergillus was detected in all sequenced samples. Fungal richness and diversity varied by sample type with no notable difference between BALF and ES samples by culture result. Fungal community concordance, as assessed by beta diversity, between BALF-OP swab specimen pairs was low, though richness and diversity were similar. CONCLUSION: NGS identified more distinct fungi in the airways of pwCF and OP swabs show potential for reliably detecting fungi in the airway, mitigating the need for ES. Future work will assess fungal-bacterial interactions and associations with clinical outcomes.

  PublisherDOI

• Clinical features associated with self-reported food insecurity in people with cystic fibrosis

  Journal of Cystic Fibrosis · 2025-01-09 · 3 citations

  article
  PublisherDOI

• Molecular Methods Versus Culture to Detect and Quantify Fungal Communities in Airway Specimens

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01

  article

  Abstract Rationale: Fungal pathogens, like Aspergillus fumigatus, are frequently identified in the lower airways of people with cystic fibrosis (CF); however, traditional culture methods of airway specimens may not be consistently performed and can lack sensitivity and specificity. With CF transmembrane conductance regulator modulator therapies in widespread use, obtaining expectorated sputum for pathogen surveillance is becoming more challenging. Our objective was to apply a novel next generation sequencing (NGS) technique to detect and identify fungal taxa across multiple airway sample types from CF and non-CF disease controls (DC) and compare the results to traditional culture. Methods: Samples were collected as part of two studies: (1) paired BALF and OP swab specimens from clinically indicated bronchoscopies performed in pediatric CF and DC subjects; and (2) sputum samples from adult CF subjects were analyzed. Total fungal load (TFL) was measured by quantitative polymerase chain reaction. Fungal communities were determined using NGS (V6/V8), and relative abundance, diversity, and richness were determined. Paired and two-sample t-tests were used to compare TFL and diversity. Results: Our dataset included 23 paired BALF and OP swab samples from children with and without CF and 29 sputum samples from adults with CF (n=75 samples). NGS was successful in 69 samples, including 78% (18/23) of OP swabs. The four most prevalent fungi in all sample types were Agaricomycetes, Aspergillus, Candida-Lodderomyces, and Cladosporium. Low levels of Aspergillus were detected in all samples. The number of distinct fungal communities varied by sample type and NGS detected more fungi than culture. Median (inter-quartile range, IQR) richness from NGS in the negative fungal culture samples (n=16) was 31 (29-34). In BALF and sputum, TFL between fungal culture positive (n=21) and negative (n=20) showed no significant difference. TFL was significantly lower in OP swabs compared to the paired BALF samples (p<0.01), and richness and diversity were not significantly different (p=0.43, p=0.76). Paired BALF and OP swabs showed low community concordance [median (IQR) Morisita-Horn similarity 0.13 (0.04-0.44)]. Conclusions: NGS shows potential for reliably detecting fungi in various airway specimens and OP swabs are a potentially effective and valuable tool for identifying fungal communities. Further study is needed to better define relevant, pathogenic fungal communities and to determine thresholds of clinical importance. Next steps include analyses integrating biomarkers of inflammation, determining relationships with NGS of bacterial communities, and investigating correlations with clinical metadata. This work is key for better understanding infection in the CF airway.

  PublisherDOI

• Home sputum collection for Aspergillus fumigatus detection in adults with cystic fibrosis

  UNC Libraries · 2025-12-19

  articleOpen access

  Background Elexacaftor/tezacaftor/ivacaftor (ETI) has impacted the ability for people with cystic fibrosis (PwCF) to spontaneously expectorate sputum, leading to lower respiratory sampling rates and infection detection challenges. Home sampling may permit a potential strategy for fungal detection in PwCF. Methods We conducted a prospective decentralised cohort study of PwCF to test the feasibility of home sputum collection and ambient temperature transport for Aspergillus fumigatus (Af) detection. Participants collected and shipped weekly sputum samples from home to the laboratory for fungal culture and completed electronic questionnaires. Descriptive statistics were calculated for patient factors, sputum characteristics and Af-positive cultures. We used a generalised estimating equations model to determine the association between highly effective modulator therapy (HEMT) and sputum volume. Results We enrolled 76 adults with cystic fibrosis (CF) with a median (interquartile range) forced expiratory volume in 1 s (FEV1) % predicted of 72.5% (53.8–86.3). 60 (79%) were on ETI and 44 (58%) had a history of Aspergillus. 70 (92%) successfully collected and shipped three or more sputum samples. Of 284 samples received, 83% arrived within one day. Sputum collection was reported as easy in 83 (29%) and somewhat easy in 114 (40%) collection events. Sputum volume from PwCF on HEMT was 36% lower than those not on HEMT (36%, 95% CI 3–58; p=0.03), adjusting for covariates. Af was detected in 205 (73%) of home sputum samples. Conclusion Home sputum collection is feasible in adults with CF. Af was detected in remotely collected sputum samples. Further work to assess the validity of home sputum samples in PwCF is necessary to determine the value of remote specimens in clinical and research settings.

  PublisherDOI

• 791 Expanded use of remote objective monitoring during telehealth visits for people with CF experiencing acute symptoms: The EUROPA Project

  Journal of Cystic Fibrosis · 2025-10-01

  article
  PublisherDOI

• Home sputum collection for <i>Aspergillus fumigatus</i> detection in adults with cystic fibrosis

  ERJ Open Research · 2025-06-19

  articleOpen access1st authorCorresponding

  Background Elexacaftor/tezacaftor/ivacaftor (ETI) has impacted the ability for people with cystic fibrosis (PwCF) to spontaneously expectorate sputum, leading to lower respiratory sampling rates and infection detection challenges. Home sampling may permit a potential strategy for fungal detection in PwCF. Methods We conducted a prospective decentralised cohort study of PwCF to test the feasibility of home sputum collection and ambient temperature transport for Aspergillus fumigatus ( Af ) detection. Participants collected and shipped weekly sputum samples from home to the laboratory for fungal culture and completed electronic questionnaires. Descriptive statistics were calculated for patient factors, sputum characteristics and Af -positive cultures. We used a generalised estimating equations model to determine the association between highly effective modulator therapy (HEMT) and sputum volume. Results We enrolled 76 adults with cystic fibrosis (CF) with a median (interquartile range) forced expiratory volume in 1 s (FEV 1 ) % predicted of 72.5% (53.8–86.3). 60 (79%) were on ETI and 44 (58%) had a history of Aspergillus . 70 (92%) successfully collected and shipped three or more sputum samples. Of 284 samples received, 83% arrived within one day. Sputum collection was reported as easy in 83 (29%) and somewhat easy in 114 (40%) collection events. Sputum volume from PwCF on HEMT was 36% lower than those not on HEMT (36%, 95% CI 3–58; p=0.03), adjusting for covariates. Af was detected in 205 (73%) of home sputum samples. Conclusion Home sputum collection is feasible in adults with CF. Af was detected in remotely collected sputum samples. Further work to assess the validity of home sputum samples in PwCF is necessary to determine the value of remote specimens in clinical and research settings.

  PublisherDOI

• Standards for the care of people with cystic fibrosis (CF); recognising and addressing CF health issues

  Journal of Cystic Fibrosis · 2024-01-16 · 75 citations

  articleOpen access

  This is the third in a series of four papers updating the European Cystic Fibrosis Society (ECFS) standards for the care of people with CF. This paper focuses on recognising and addressing CF health issues. The guidance was produced with wide stakeholder engagement, including people from the CF community, using an evidence-based framework. Authors contributed sections, and summary statements which were reviewed by a Delphi consultation. Monitoring and treating airway infection, inflammation and pulmonary exacerbations remains important, despite the widespread availability of CFTR modulators and their accompanying health improvements. Extrapulmonary CF-specific health issues persist, such as diabetes, liver disease, bone disease, stones and other renal issues, and intestinal obstruction. These health issues require multidisciplinary care with input from the relevant specialists. Cancer is more common in people with CF compared to the general population, and requires regular screening. The CF life journey requires mental and emotional adaptation to psychosocial and physical challenges, with support from the CF team and the CF psychologist. This is particularly important when life gets challenging, with disease progression requiring increased treatments, breathing support and potentially transplantation. Planning for end of life remains a necessary aspect of care and should be discussed openly, honestly, with sensitivity and compassion for the person with CF and their family. CF teams should proactively recognise and address CF-specific health issues, and support mental and emotional wellbeing while accompanying people with CF and their families on their life journey.

  PublisherOA PDFDOI

• 741 Expanded use of remote objective monitoring during telehealth visits for people with CF experiencing acute symptoms: the EUROPA Study

  Journal of Cystic Fibrosis · 2024-09-01 · 1 citations

  article
  PublisherDOI

• The Real-World Effectiveness of Antifungals in People with Cystic Fibrosis and <i>Aspergillus</i> -Positive Cultures

  Annals of the American Thoracic Society · 2024-10-10 · 1 citations

  articleOpen accessSenior author

  Abstract Rationale The pathogenicity of Aspergillus in the cystic fibrosis (CF) airway is debated, leading to unclear clinical benefit of antifungal therapy for Aspergillus infection. Objective To determine the real-world effectiveness of antifungal use in people with CF (PwCF) with Aspergillus species in the United States. Methods We conducted a retrospective cohort study evaluating the association of antifungal use and respiratory outcomes in PwCF and Aspergillus-positive cultures using the Cystic Fibrosis Foundation Patient Registry. Marginal structural models using inverse-probability treatment weighted estimators were used to test whether antifungal exposure was associated with forced expiratory volume in 1 second percent predicted (FEV1pp) and pulmonary exacerbation rate while controlling for fixed and time-varying confounders. We conducted sensitivity analyses on individuals with persistent Aspergillus and without concomitant allergic bronchopulmonary aspergillosis (ABPA). Results A total of 14,754 individuals with Aspergillus-positive cultures between 2006 and 2019 were identified. Antifungals were prescribed to 3,575 (24.2%) unique PwCF during the study period. Antifungal use was not associated with FEV1pp (adjusted estimate = −0.96 percentage points; 95% confidence interval [CI] = −2.21, 0.29). Antifungal use was associated with 29% increased rate of pulmonary exacerbations requiring intravenous (i.v.) antibiotics (adjusted incidence rate ratio = 1.29, 95% CI = 1.22, 1.37). In sensitivity analyses limited to individuals without ABPA, antifungals were associated with 1.88 lower FEV1pp (95% CI = −3.35, −0.41) and an increased rate of pulmonary exacerbations (adjusted incidence rate ratio = 1.30; 95% CI = 1.21, 1.40), whereas in patients with persistent Aspergillus and persistent Aspergillus without concomitant ABPA, antifungals were not associated with FEV1pp. Conclusions Antifungal therapy in PwCF and Aspergillus-positive cultures was not associated with improvements in FEV1pp, suggesting no observed benefit. Although antifungal therapy was associated with increased risk for pulmonary exacerbations, this could reflect confounding by severity of disease. Randomized clinical trials examining the clinical efficacy of antifungals in Aspergillus infections in CF are warranted.

  PublisherOA PDFDOI

• Elexacaftor/Tezacaftor/Ivacaftor Markedly Reduces <i>Aspergillus fumigatus</i> in Cystic Fibrosis

  American Journal of Respiratory and Critical Care Medicine · 2024-08-27 · 20 citations

  letterOpen access
  PublisherOA PDFDOI

Recent grants

• The impact of Aspergillus species in cystic fibrosis

  NIH · $1.0M · 2019–2025

Frequent coauthors

• Raymond C. Koehler

  Johns Hopkins Medicine

  12 shared

• Noah Lechtzin

  12 shared

• Steven M. Kawut

  University of Pennsylvania

  8 shared

• Zeng-Jin Yang

  Kaohsiung Veterans General Hospital

  8 shared

• Yue Zhang

  First Hospital of China Medical University

  8 shared

• Herman Kwansa

  Johns Hopkins University

  8 shared

• Denis Hadjiliadis

  University of Pennsylvania

  8 shared

• Daniel Dorgan

  7 shared