Alfred Luk's Avatar

Alfred Luk

@alukmd.bsky.social

Transplant Infectious Disease physician at Tulane via NYU ID and SUNY Downstate IM. #IDSky #TxID

1,181 Followers  |  131 Following  |  20 Posts  |  Joined: 12.11.2024  |  2.3231

Latest posts by alukmd.bsky.social on Bluesky

Random Education: Aspergillus
YouTube video by Dr. Glaucomflecken Random Education: Aspergillus

Aspergillus by @glaucomflecken.bsky.social

19.08.2025 05:43 β€” πŸ‘ 2    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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For the awake and dedicated. 7am session - top papers in transplant ID. #TxID #WTC2025

05.08.2025 14:04 β€” πŸ‘ 6    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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AJT Transplant ID Exchange

Don't miss the new @amjtransplant.bsky.social #TxID blog led by Emily Blumberg ajt-transplant-id-exchange.squarespace.com #wtc2025 @ast-idcop.bsky.social @ast-tyfcop.bsky.social @astinfo.bsky.social

03.08.2025 20:01 β€” πŸ‘ 13    πŸ” 6    πŸ’¬ 0    πŸ“Œ 0
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Dr. Robert (Bob) Rubin Transplant ID Award Recipient for 2025 is the amazing @kottonnelson.bsky.social !!! #TxID #MedEd @astinfo.bsky.social

04.08.2025 18:35 β€” πŸ‘ 29    πŸ” 8    πŸ’¬ 0    πŸ“Œ 1
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Packed house at talk on #MDR challenging cases at #WTC2025 - clearly a growing concern in #TxID #IDSky discussion of ceftaz avi plus aztreonam v cefidericol for CRE @ast-idcop.bsky.social @txidfellows.bsky.social @astinfo.bsky.social @ttsorg.bsky.social

03.08.2025 15:36 β€” πŸ‘ 15    πŸ” 4    πŸ’¬ 0    πŸ“Œ 0
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Accuracy of plasma cell-free DNA PCR for non-invasive diagnosis of mucormycosis | Journal of Clinical Microbiology Mucormycosis is an invasive mold infection associated with high morbidity and mortality. Early diagnosis and effective antifungal treatment are critical for improving clinical outcomes. However, diagn...

Accuracy of plasma cell-free DNA PCR for non-invasive diagnosis of mucormycosis

@jordan1990.bsky.social and colleagues at Stanford

journals.asm.org/doi/10.1128/...

22.07.2025 15:22 β€” πŸ‘ 18    πŸ” 10    πŸ’¬ 0    πŸ“Œ 1
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Lack of Association Between Histoplasma Urine Antigen Values and Clinical Response in Persons without HIV AbstractBackground. Histoplasma urine antigen detection, a valuable diagnostic tool, is often used to monitor response to antifungal therapy, but persisten

Lack of Association Between Histoplasma Urine Antigen Values and Clinical Response in Persons without HIV

Marisa Miceli and colleagues

academic.oup.com/ofid/advance...

29.07.2025 13:33 β€” πŸ‘ 11    πŸ” 6    πŸ’¬ 2    πŸ“Œ 1
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Outcomes of Invasive Aspergillosis in Liver Transplant Recipients From an Institution Using Targeted Antifungal Prophylaxis and an Antifungal Stewardship Program Background Recent evidence suggests liver transplant recipients (LiTRs) with invasive aspergillosis (IA) have lower rates of dissemination and mortality compared to historical data. However, contemp...

Outcomes of Invasive Aspergillosis in Liver Transplant Recipients From an Institution Using Targeted Antifungal Prophylaxis and an Antifungal Stewardship Program

Duke TxID fellow Brennan Collis and co from Melbourne

IA was uncommon, mortality low in LiTx

onlinelibrary.wiley.com/doi/10.1111/...

13.05.2025 16:05 β€” πŸ‘ 9    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0

Register @ cmvstream.com

23.04.2025 13:34 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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CMV Stream 2025 - CMV STREAM Live Online! CMV Management in Solid Organ Transplantation Insights and Challenges from the New 4th Consensus Guidelines Friday, April 25th, 2025 3:00 PM EST REGISTER NOW Register Now Days Hours Minut...

Registration link: cmvstream.com

23.04.2025 13:34 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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πŸ„πŸ„Happy to share the link to free full text version of our new article in press: Current Antifungals and the Developing Pipeline with the fantastic @moorewjustin.bsky.social. #IDSky #PharmSky Thank you to the editors @drluiso.bsky.social @alukmd.bsky.social & Dr. Helen Boucher for the opportunity.

24.03.2025 15:18 β€” πŸ‘ 11    πŸ” 7    πŸ’¬ 1    πŸ“Œ 0
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Histoplasmosis (2025)

Update on the Clinical Practice Guidelines for treatment of Histoplasmosis. Thank you to all the authors @fungaldoc.bsky.social @germhuntermd.bsky.social @jobadd.bsky.social @iddoc4kids.bsky.social Nathan Bahr

www.idsociety.org/practice-gui...

10.03.2025 12:59 β€” πŸ‘ 19    πŸ” 3    πŸ’¬ 1    πŸ“Œ 0
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Facts and myths about measles It seems ironic that Robert F Kennedy Jr, one of the most prominent antivaccine activists, has been made Secretary of Health and Human Services in the USA while one of the largest recent measles outbr...

Facts and myths about measles

@thelancetinfdis.bsky.social @hoferu.bsky.social

www.thelancet.com/journals/lan...

07.03.2025 16:17 β€” πŸ‘ 24    πŸ” 10    πŸ’¬ 0    πŸ“Œ 1
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New upcoming seminar from TTS to address a growing concern in the immunocompromised community: Measles

tts.org/116-tts/educ...

05.03.2025 23:53 β€” πŸ‘ 6    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0

😱

06.03.2025 22:13 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

Was an honor to work with @drluiso.bsky.social and all the amazing authors who contributed to this issue!

05.03.2025 01:52 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
SCIENCE IN PERIL

Research funding at risk

UNDERSTANDING RESEARCH COSTS

Research requires funding for both direct costs (like lab supplies) and Facilities & Administrative (F&A) costs.

F&A covers essential expenses that support research but aren't tied to a single project, such as...

IT and cybersecurity for data protection

Laboratory space and utilities

Administrative support for grants and operations

WHAT WILL HAPPEN IF F&A COST REIMBURSEMENT RATES ARE CUT?

Research institutions will lose millions of dollars to do critical research

THE IMPACTS WOULD BE DEVASTATING.

Fewer clinical trials, delaying new treatments

Slowed scientific discovery and innovation

Weakened local economies and research-driven industries

Job cuts and fewer opportunities to train future leaders

SCIENCE IN PERIL Research funding at risk UNDERSTANDING RESEARCH COSTS Research requires funding for both direct costs (like lab supplies) and Facilities & Administrative (F&A) costs. F&A covers essential expenses that support research but aren't tied to a single project, such as... IT and cybersecurity for data protection Laboratory space and utilities Administrative support for grants and operations WHAT WILL HAPPEN IF F&A COST REIMBURSEMENT RATES ARE CUT? Research institutions will lose millions of dollars to do critical research THE IMPACTS WOULD BE DEVASTATING. Fewer clinical trials, delaying new treatments Slowed scientific discovery and innovation Weakened local economies and research-driven industries Job cuts and fewer opportunities to train future leaders

Previous F&A cost reimbursement rates varied by institution. Rates averaged around 28%, but some organizations had negotiated rates over 60%.

Costs vary widely, with rates set based on factors like institution size, location, and rent or utility costs.

HOW IS RESEARCH AT RISK?

The National Institutes of Health (NIH) announced a policy change that limits F&A cost funding to 15% for both new and existing grants.

The policy drastically cuts essential federal support for biomedical research.

A group of universities and states filed a lawsuit claiming the funding cuts are illegal.

A federal judge temporarily paused the funding cuts, but F&A costs remain at risk.

Scientists and the public are speaking out to share how important it is to maintain funding for research and innovation.

RESEARCH SAVES LIVES.

NOW, WE MUST SAVE RESEARCH

Previous F&A cost reimbursement rates varied by institution. Rates averaged around 28%, but some organizations had negotiated rates over 60%. Costs vary widely, with rates set based on factors like institution size, location, and rent or utility costs. HOW IS RESEARCH AT RISK? The National Institutes of Health (NIH) announced a policy change that limits F&A cost funding to 15% for both new and existing grants. The policy drastically cuts essential federal support for biomedical research. A group of universities and states filed a lawsuit claiming the funding cuts are illegal. A federal judge temporarily paused the funding cuts, but F&A costs remain at risk. Scientists and the public are speaking out to share how important it is to maintain funding for research and innovation. RESEARCH SAVES LIVES. NOW, WE MUST SAVE RESEARCH

What’s at stake with proposed health research funding cuts?

Good explainer by Lizzy Knippler, Community Engagement Coordinator at the Duke CFAR. Please share these graphics widely!

04.03.2025 22:19 β€” πŸ‘ 19    πŸ” 14    πŸ’¬ 1    πŸ“Œ 0

The link doesn’t seem to be working?

09.02.2025 01:07 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
Unfortunately and unsurprisingly, the administration continues to charge ahead, running roughshod over norms, laws, and the dignity of and most basic protections for the people most vulnerable to infections. Many of the changes are summarized here, up to date as of Feb 4. Who will speak up, or better still, ACT UP for these individuals?

The National Science Foundation has reportedly shared with program officers a list of forbidden "DEI"-related words that will result in grants being flagged. These include routinely used terms like "female", "biased", "systemic", "inclusion" and "exclusion" along with other words that specifically target vulnerable populations. While few clinical researchers rely on NSF grants, it can be reasonably expected that similar censorship with grants from NIH, CDC, etc is inevitable.
USAID funding remains frozen, and in fact there are reports of efforts underway to eliminate the entire agency. The effects have already been devastating for programs dedicated to controlling TB, malaria, and HIV, among others. Despite claims that these would be exempt, distribution of antiretrovirals remains frozen.
The Senate Finance committee advanced RFK Jr for confirmation as HHS Secretary. Kennedy's disdain for evidence-based medicine is no secret. He is a conspiracy theorist who engages in dangerous race-based pseudoscience. The IDSA has fallen short of other professional societies (e.g. the American Public Health Association, which represents 25,000 public health professionals) in calling for the outright rejection of RFK Jr's nomination.
The CDC and NIH remain muzzled, unable to communicate with interstate or international agencies or the public. They have been instructed to recall submitted or accepted manuscripts to scrub objectionable language. They remain barred from traveling until at least the end of April. How will these actions affect our ability to detect and respond to infectious disease outbreaks?

Unfortunately and unsurprisingly, the administration continues to charge ahead, running roughshod over norms, laws, and the dignity of and most basic protections for the people most vulnerable to infections. Many of the changes are summarized here, up to date as of Feb 4. Who will speak up, or better still, ACT UP for these individuals? The National Science Foundation has reportedly shared with program officers a list of forbidden "DEI"-related words that will result in grants being flagged. These include routinely used terms like "female", "biased", "systemic", "inclusion" and "exclusion" along with other words that specifically target vulnerable populations. While few clinical researchers rely on NSF grants, it can be reasonably expected that similar censorship with grants from NIH, CDC, etc is inevitable. USAID funding remains frozen, and in fact there are reports of efforts underway to eliminate the entire agency. The effects have already been devastating for programs dedicated to controlling TB, malaria, and HIV, among others. Despite claims that these would be exempt, distribution of antiretrovirals remains frozen. The Senate Finance committee advanced RFK Jr for confirmation as HHS Secretary. Kennedy's disdain for evidence-based medicine is no secret. He is a conspiracy theorist who engages in dangerous race-based pseudoscience. The IDSA has fallen short of other professional societies (e.g. the American Public Health Association, which represents 25,000 public health professionals) in calling for the outright rejection of RFK Jr's nomination. The CDC and NIH remain muzzled, unable to communicate with interstate or international agencies or the public. They have been instructed to recall submitted or accepted manuscripts to scrub objectionable language. They remain barred from traveling until at least the end of April. How will these actions affect our ability to detect and respond to infectious disease outbreaks?

Meanwhile, our members are experiencing significant moral injury, and some have expressed levels of morale that rival the nadirs felt during the worst of COVID19. Every day it is a new insult, the cumulative effect being the disassembly of public health protections and further marginalization of the most vulnerable in society. 

Reticence to call attention to ourselves, potentially putting our work in the administration's cross hairs, is entirely understandable. After all, we don't want to imperil existing and ongoing advocacy efforts, including those related to bolstering the ID workforce. A sober analysis would concede that the likelihood of any potential actions moving the needle on any of these issues is low. I would argue, however, that standing up for what is right is the most important thing we can do to reinforce our commitment to social justice and to our members and the patients in our care. 

What we can do and how we can do it is up for debate; some bold ideas have already been presented in the IDea exchange forum and I welcome further input from colleagues. What is certain is that as rank-and-file individuals, our voices can easily be dismissed, but as a trusted, bipartisan professional organization that represents >13,000 infectious diseases experts, we cannot be ignored, and we must not allow ourselves to cower in silence. The reality is that things are going to get worse, and standing up to the assault on public health will only get more difficult as the administration becomes further emboldened and the actions set in motion gather steam. 

In the words of John Lewis, "If not us, then who? If not now, then when?"

Meanwhile, our members are experiencing significant moral injury, and some have expressed levels of morale that rival the nadirs felt during the worst of COVID19. Every day it is a new insult, the cumulative effect being the disassembly of public health protections and further marginalization of the most vulnerable in society. Reticence to call attention to ourselves, potentially putting our work in the administration's cross hairs, is entirely understandable. After all, we don't want to imperil existing and ongoing advocacy efforts, including those related to bolstering the ID workforce. A sober analysis would concede that the likelihood of any potential actions moving the needle on any of these issues is low. I would argue, however, that standing up for what is right is the most important thing we can do to reinforce our commitment to social justice and to our members and the patients in our care. What we can do and how we can do it is up for debate; some bold ideas have already been presented in the IDea exchange forum and I welcome further input from colleagues. What is certain is that as rank-and-file individuals, our voices can easily be dismissed, but as a trusted, bipartisan professional organization that represents >13,000 infectious diseases experts, we cannot be ignored, and we must not allow ourselves to cower in silence. The reality is that things are going to get worse, and standing up to the assault on public health will only get more difficult as the administration becomes further emboldened and the actions set in motion gather steam. In the words of John Lewis, "If not us, then who? If not now, then when?"

I am deeply disappointed by the subdued response of the Infectious Diseases Society of America (@idsainfo.bsky.social) to the dismantling of public health structures, both in the US & globally

Here's what I wrote in the closed listserv (response: πŸ¦—) in hopes of stimulating discussion here #IDSky

07.02.2025 18:32 β€” πŸ‘ 309    πŸ” 90    πŸ’¬ 14    πŸ“Œ 2
Visual Abstract

Visual Abstract

Would global warming bring an increase of invertebrate-associated cutaneous invasive fungal infections?

Kontoyiannis & Casadevall

journals.asm.org/doi/10.1128/...

05.02.2025 20:56 β€” πŸ‘ 19    πŸ” 7    πŸ’¬ 1    πŸ“Œ 0

Congratulations πŸŽ‰

29.01.2025 22:08 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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Impact of fluconazole on outcomes of patients with primary pulmonary coccidioidomycosis: a commercial health insurance claims-based, propensity score matched analysis AbstractBackground. Patients with pulmonary coccidioidomycosis often experience prolonged symptoms lasting weeks to months. Limited data exist regarding wh

Great work by CDC (Mycotic Diseases Branch) and @grthompsonmd.bsky.social. Healthcare data analysis evaluating fluc efficacy on pulmonary #coccidioidomycosis in immunocompetent patients. Again, fluc is not effective.
#IDSky #MedMyco

25.01.2025 21:27 β€” πŸ‘ 9    πŸ” 2    πŸ’¬ 2    πŸ“Œ 0
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The ACIP 2025 vaccine schedule for adults by medical condition (as well as age) is now available - with some great updates www.cdc.gov/vaccines/hcp...

02.12.2024 03:13 β€” πŸ‘ 15    πŸ” 9    πŸ’¬ 0    πŸ“Œ 0
Figure 1. Study flow diagram.

Figure 1. Study flow diagram.

Figure 2. Patients with proven or probable invasive pulmonary Aspergillus by diagnosis methods.

Figure 2. Patients with proven or probable invasive pulmonary Aspergillus by diagnosis methods.

Evaluation of Viracor Fungal Plus PCR Profile I @MSKCC

"In our cohort, PCR targeting Mucorales and Nocardia can improve the early detection of invasive pulmonary infection, whereas Aspergillus PCR has a low added value"

@fungalspore.bsky.social @ebabady.bsky.social
journals.asm.org/doi/10.1128/...

17.01.2025 15:10 β€” πŸ‘ 16    πŸ” 5    πŸ’¬ 2    πŸ“Œ 0
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Summary of new antibiotic agents for the treatment of MDR Gram negative bacterial infections

doi.org/10.1016/S014...

#IDSky

17.01.2025 12:46 β€” πŸ‘ 29    πŸ” 13    πŸ’¬ 4    πŸ“Œ 2
Mortality risk according to antiretroviral therapy (ART) status at the time of presentation with cryptococcal meningitis. The dynamic relationship between time on ART at cryptococcal meningitis presentation and mortality risk in the combined Ambisome Therapy Induction Optimisation (AMBITION) and Antifungal Combinations for Treatment of Cryptococcal Meningitis in Africa (ACTA) cohort was determined using univariable logistic regression models with days on ART as the single predictor (using restricted cubic splines with 3 knots) and mortality as the outcome for (A) 2-week and (B) 10-week mortality, restricted to participants on ART for up to 6 months. The gray shading represents 95% confidence intervals. Mortality risk in those on ART for more than 6 months and those not on ART at the time of cryptococcal meningitis diagnosis are shown for comparison, with error bars representing 95% confidence intervals, and the dotted line indicating the mortality risk estimate in those not on ART.

Mortality risk according to antiretroviral therapy (ART) status at the time of presentation with cryptococcal meningitis. The dynamic relationship between time on ART at cryptococcal meningitis presentation and mortality risk in the combined Ambisome Therapy Induction Optimisation (AMBITION) and Antifungal Combinations for Treatment of Cryptococcal Meningitis in Africa (ACTA) cohort was determined using univariable logistic regression models with days on ART as the single predictor (using restricted cubic splines with 3 knots) and mortality as the outcome for (A) 2-week and (B) 10-week mortality, restricted to participants on ART for up to 6 months. The gray shading represents 95% confidence intervals. Mortality risk in those on ART for more than 6 months and those not on ART at the time of cryptococcal meningitis diagnosis are shown for comparison, with error bars representing 95% confidence intervals, and the dotted line indicating the mortality risk estimate in those not on ART.

We know that in ART-naive patients with Cryptococcal meningitis, ART initiation should be delayed, but what about those already on ART?

In this retrospective analysis, higher mortality observed w recent ART (<2 wks), and with ART continuation vs interruption

academic.oup.com/cid/advance-...

15.01.2025 19:50 β€” πŸ‘ 28    πŸ” 8    πŸ’¬ 1    πŸ“Œ 0
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#idboardreview Pt pricked his thumb w/ wood splinter. 1 wk later, painless papule at injury site & over next weeks, tender lymphangitis developed. No improvement w/oral cephalexin or amox-clavulanate. No fever nor systemic sx, no travel/water exposure #IDSky #idmeded #meded #dermsky

16.01.2025 01:41 β€” πŸ‘ 15    πŸ” 2    πŸ’¬ 1    πŸ“Œ 0
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Influenza Vaccination Strategies in Patients with Hematologic Cancer | NEJM In this trial involving patients with hematologic cancers, the immune responses that were elicited were similar for adjuvanted-dose and standard-dose influenza vaccines.

Practice affirming results from our team @victoriahall.bsky.social @ncicancer.bsky.social - No additional benefit from second influenza vaccine dose/adjuvant vaccines in non-HCT haematology patients. #TxID #IDsky #medsky

www.nejm.org/doi/full/10....

16.01.2025 11:13 β€” πŸ‘ 17    πŸ” 7    πŸ’¬ 0    πŸ“Œ 0
Pie charts of whether mold isolates were represented in Bruker and VITEK databases, respectively

Pie charts of whether mold isolates were represented in Bruker and VITEK databases, respectively

Evaluation of two MALDI-TOF MS systems and extraction methods for identification of filamentous fungi recovered from clinical specimens

Eric Ransom, Carey-Ann Burnham and colleagues

journals.asm.org/doi/10.1128/...

14.01.2025 15:50 β€” πŸ‘ 13    πŸ” 4    πŸ’¬ 1    πŸ“Œ 1
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Epidemiology and Prognostic Factors Associated With Mold-Positive Blood Cultures: 10-Year Data From a French Prospective Surveillance Program (2012–2022) Fusarium species were the most common cause of mold-related fungemia. Patients’ underlying conditions and clinical presentation differed between genera. Pu

Great paper to review and reference when encountering Mould fungemia (like Fusarium, Aspergillus, Mucor).
#MedMyc #IDSky #InfectiousDiseases

10.01.2025 18:16 β€” πŸ‘ 11    πŸ” 4    πŸ’¬ 1    πŸ“Œ 0

@alukmd is following 19 prominent accounts