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@theodorevrouchos.bsky.social

Consultant Medical Microbiologist (UK) Consultant Medical Biopathologist (Greece) Views my own

212 Followers  |  1,634 Following  |  14 Posts  |  Joined: 29.10.2025
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Posts by (@theodorevrouchos.bsky.social)

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Weighted-incidence syndromic combination antibiogram (WISCA) to guide antibiotic regimens for empiric treatment of prosthetic joint infections: A retrospective cohort study Prosthetic joint infections (PJIs) are now routinely treated with oral antibiotics, but selecting empiric regimens is challenging, including for treatment of culture-negative PJIs. Although antibiogra...

πŸ“£ What is a #WISCA?

It's something you should probably use for culture-negative prosthetic joint infections. Local antibiograms alone can be misleading.

This WISCA showed that doxycycline + a fluoroquinolone offer best coverage for #PJI

#IDSky #clinmicro #ortho
www.cmi-comms.org/article/S295...

12.02.2026 10:10 β€” πŸ‘ 12    πŸ” 7    πŸ’¬ 0    πŸ“Œ 5
Research in context panel for Lancet paper "Adult obesity and risk of severe infections: a multicohort study with global burden estimates". Copyright: 2025 The Author(s). Published by Elsevier Ltd. CC BY 4.0.

Research in context panel for Lancet paper "Adult obesity and risk of severe infections: a multicohort study with global burden estimates". Copyright: 2025 The Author(s). Published by Elsevier Ltd. CC BY 4.0.

People with obesity at 70% higher risk of serious infection with one in ten infectious disease deaths globally potentially linked to obesity, study suggests.

Find out more πŸ‘‰ spkl.io/63323AtTtt

11.02.2026 17:03 β€” πŸ‘ 9    πŸ” 5    πŸ’¬ 1    πŸ“Œ 2
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Preventing Long COVID With Metformin Chaichana et al conducted a sequential trial emulation to assess whether starting metformin after severe acute respiratory syndrome coronavirus 2 (SARS-CoV

#MedskyπŸ§ͺ #IDsky #endosky #immunosky #pharmasky #publichealth Repurposing a chronic diabetes medication for acute viral infection may seem counterintuitive, so the briefly review the rationale
@cidjournal.bsky.social
academic.oup.com/cid/advance-...

05.02.2026 05:45 β€” πŸ‘ 11    πŸ” 4    πŸ’¬ 1    πŸ“Œ 0
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Preventing Long COVID With Metformin Chaichana et al conducted a sequential trial emulation to assess whether starting metformin after severe acute respiratory syndrome coronavirus 2 (SARS-CoV

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

04.02.2026 12:17 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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Fedora Pharmaceuticals Highlights First-in-Class Antibiotic at Conference | Contagion Live Fedora Pharmaceuticals is presenting new preclinical data at the IMARI conference demonstrating that its lead candidate, FPI-2119, shows strong activity against some of the most dangerous drug-resista...

Fedora Pharmaceuticals is presenting new preclinical data at the IMARI conference demonstrating that its lead candidate, FPI-2119, shows strong activity against some of the most dangerous drug-resistant Gram-negative infections, supporting its advancement toward clinical trials. #IDsky #Medsky

29.01.2026 15:21 β€” πŸ‘ 1    πŸ” 1    πŸ’¬ 1    πŸ“Œ 0
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ONE ANTIBIOTIC PK TABLE TO RULE THEM ALL

Absorption takes drug into blood from GI,
Vd spreads drug out to where bug calls home.
And after bacteria are doomed to die,
The drug’s eliminated on the porcelain throne

In the Land of Notion where this table doth lie…

#idSky #microsky #pharmsky #medsky

26.01.2025 19:48 β€” πŸ‘ 109    πŸ” 28    πŸ’¬ 12    πŸ“Œ 3
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Goodbye 2025, hello 2026!🦠 As the year comes to a close, here's all of the incredible microbes that were discovered this year and featured as our Microbe of the Month. We're so glad to see you all enjoying this series as much as we do, and we hope you're as excited to see what 2026 has in storeπŸ”¬πŸ”Ž

31.12.2025 11:01 β€” πŸ‘ 10    πŸ” 3    πŸ’¬ 1    πŸ“Œ 0
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Oral vancomycin use and incidence of vancomycin-resistant enterococci: time-series analysis - PubMed There was a significant association between institutional oral vancomycin use and hospital-acquired VRE incidence, highlighting the need for antibiotic stewardship for oral vancomycin use to contain the nosocomial spread of VRE in addition to infection control measures.

pubmed.ncbi.nlm.nih.gov/39617941/

www.mendeley.com/catalogue/2c...

pubmed.ncbi.nlm.nih.gov/33441409/

pubmed.ncbi.nlm.nih.gov/40601321/

31.12.2025 11:24 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

I'm sure some confounding in this retrospective study. But more evidence that gentamicin probably isn't doing anything in Staph PVE.
Rifampin still an open question

#IDSky

17.12.2025 15:54 β€” πŸ‘ 7    πŸ” 2    πŸ’¬ 3    πŸ“Œ 0

The real edge is decreased recurrence. That itself is important and financially shown to be cost effective. But fidaxo is also narrower spectrum compared to vanc, and doesn't promote resistance (especially VRE). Finally the sporicidal effect might be useful in reducing transmission in outbreaks.

12.12.2025 16:33 β€” πŸ‘ 2    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

TAPER-V's primary outcome was standard vs tapered vanc. Comparisons with fidaxo were from other studies on fidaxo, not TAPER-V.

12.12.2025 16:31 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

In comparison to what, im ceftriaxone? If so, reasons include higher resistance compared to ceftriaxone, penetration to relevant sites (especially rectal/throat) and most importantly, clinical failure rates.

12.12.2025 16:13 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0
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COVID-19 mRNA Vaccination and 4-Year All-Cause Mortality Among Adults in France This cohort study uses the data from all adults aged 18 to 59 years living in France on November 1, 2021, to evaluate whether there is an association of receipt of an mRNA COVID-19 vaccine with long-t...

β€’ Vaccinated people had lower risk of death from any cause.
In short: mRNA vaccines weren’t just safe β€” they were protective across the board. πŸ”₯πŸ“‰ shorturl.at/GcZeK #EMSky

05.12.2025 02:50 β€” πŸ‘ 133    πŸ” 40    πŸ’¬ 3    πŸ“Œ 3
Ceftobiprole alone versus ampicillin-ceftriaxone against borderline-penicillin-resistant, ampicillin-susceptible, and vancomycin-resistant Enterococcus faecalis isolates ABSTRACTDespite the use of recommended treatments against Enterococcus faecalis infective endocarditis, mortality rates remain at 30%. Penicillin-resistant, ampicillin-susceptible E. faecalis (PRASEF) has been associated with worsened clinical outcomes; however, a more common phenotype, borderline-PRASEF (penicillin minimum inhibitory concentration [MIC] 4–8 Β΅g/mL), decreases the activity of ampicillin-ceftriaxone in vitro. Ceftobiprole presents a promising alternative against borderline-PRASEF and also has shown activity against vancomycin-resistant E. faecalis (VREfs). The ceftobiprole MIC distribution was determined via broth microdilution for 78 E. faecalis clinical blood isolates, including 71 borderline-PRASEF. Ceftobiprole activity alone was compared to ampicillin-ceftriaxone via in vitro 24-hour time-kill assays against 30 E. faecalis isolates, 24 of which were borderline-PRASEF and 15 were VREfs. Ceftobiprole and ceftriaxone were tested at physiologic concentrations (fCpss 13.9 Β΅g/mL and 17.2 mcg/mL, respectively) and ampicillin at subinhibitory concentrations (0.25 Γ— MIC and 0.5 Γ— MIC). Isolates where ceftobiprole alone had limited activity were tested against ceftobiprole-ampicillin. Ceftobiprole maintained activity against borderline-PRASEF compared to ampicillin-ceftriaxone. Ceftobiprole also demonstrated more activity against VREfs isolates and isolates with an elevated ceftobiprole MIC β‰₯16 Β΅g/mL, compared to ampicillin-ceftriaxone. Ceftobiprole did not achieve β‰₯2 log10 CFU/mL kill in six isolates but was able to achieve this once combined with ampicillin. When tested at ampicillin inhibitory concentrations, ceftobiprole-ampicillin activity trended towards antagonism in two isolates. Overall, ceftobiprole alone had greater activity compared to ampicillin-ceftriaxone, and there may be a potential role of ceftobiprole combination therapy in certain isolates.

30% mortality in E. faecalis endocarditis persists. Ceftobiprole showed better activity vs borderline-PRASEF & VREfs than ampicillin-ceftriaxone in 78 isolates. Combo helps some.⚑🦠

#idsky

05.12.2025 06:00 β€” πŸ‘ 2    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0

πŸ‘‰ Evidence is limited, but reducing Ξ²-lactam doses too early in AKI may underdose critically ill patients at the worst possible time.
πŸ›‘οΈ Delayed dose reduction (after reassessing kidney recovery ~48H) might improve mortalityβ€”but better prospective studies are urgently needed #idsky #EMIMCC

05.12.2025 09:51 β€” πŸ‘ 7    πŸ” 2    πŸ’¬ 0    πŸ“Œ 0
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Beta-lactam dose reductions in critically ill patients with acute kidney injury: a scoping review - Critical Care Background Acute kidney injury is a common complication in critically ill patients, often coinciding with the need for antibiotic therapy. The dose of beta-lactam antibiotics is frequently adjusted an...

βš‘πŸ’‰Are We Jumping the Gun? Early Beta-Lactam Dose Cuts Risk Underdosing in AKI, Critical Care, 2025

link.springer.com/article/10.1...

Link to X post:
x.com/ABsteward/st...
#idsky #EMIMCC

03.12.2025 18:53 β€” πŸ‘ 7    πŸ” 2    πŸ’¬ 0    πŸ“Œ 2
IDSA and PIDS statement on 2025 infectious diseases fellowship Match results

This year’s US ID Fellowship Match saw 272 adult ID and 44 pediatric ID matches - but overall fewer physicians are entering the field and over half of fellowship programs went unfilled.
www.idsociety.org/news--public...

04.12.2025 00:00 β€” πŸ‘ 5    πŸ” 3    πŸ’¬ 0    πŸ“Œ 2
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Breaking down the Desirability of Outcome Ranking (DOOR): unpacking the methodology behind the Dalbavancin as an Option for Treatment of Staphylococcus aureus Bacteremia (DOTS) trial Desirability of Outcome Ranking (DOOR) outcomes such as the primary outcome of the DOTS (Dalbavancin as an Option for Treatment of Staphylococcus aure…

πŸ€” I’ll admit β€” I’m still wrapping my head around DOOR in clinical trials. I’m used to P-values and classic non-inferiority, but DOOR feels different.
Breaking down the DOOR in DOTS RCT @cmicomms.bsky.social
#idsky #EMIMCC
www.sciencedirect.com/science/arti...

03.12.2025 20:57 β€” πŸ‘ 9    πŸ” 4    πŸ’¬ 0    πŸ“Œ 0
Tuberculosis with Drug-Induced Hepatitis: A Narrative Literature Review - Consensus Key takeaway: 'Tuberculosis treatment can cause drug-induced hepatitis in 5-28% of patients, with symptoms varying from asymptomatic to symptomatic, and monitoring is crucial for effective treatment.'

consensus.app/papers/tuber...

consensus.app/papers/adver...

consensus.app/papers/adjuv...

consensus.app/papers/adjuv...

consensus.app/papers/antim...

consensus.app/papers/body-...

consensus.app/papers/psych...

03.12.2025 12:58 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

Closest point between Russia-USA= 2.5 miles (Diomedes Islands). Closest point between Europe- USA= 2500 miles (Maine-Ireland).

29.11.2025 15:03 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

Why does he keep bringing up Trump's acceptance of vaccine safety as a qualifying argument. Does it matter what someone not qualified to judge vaccine safety says about vaccine safety?

25.11.2025 13:29 β€” πŸ‘ 2    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0
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CRISPR-Cas?associated SCCmec variants in methicillin-resistant Staphylococcus aureus evade rapid diagnostic detection

βœ… Just Accepted
πŸ”— https://bit.ly/3LWRti0

22.11.2025 20:50 β€” πŸ‘ 2    πŸ” 3    πŸ’¬ 1    πŸ“Œ 0
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Triazoles versus Echinocandins for the first-line treatment of invasive pulmonary aspergillosis ? A propensity score weighted multicenter study

βœ… Just Accepted
πŸ”— https://bit.ly/3LV7LYP

23.11.2025 00:14 β€” πŸ‘ 4    πŸ” 2    πŸ’¬ 0    πŸ“Œ 2
A screen shot of the antibiotic personality quiz

A screen shot of the antibiotic personality quiz

It’s World AMR Awareness Week, and this year I had the honor to re-imagine and doodle the antibiotics in the antibiotic personality quiz πŸ˜‡πŸ–οΈ
Thank u @brxad.bsky.social for this amazing and fun opportunity!

C’mon, take the quiz, it’s a #WAAW tradition πŸ˜‰πŸ’Š
#IDSky

quiz.tryinteract.com#/59e68e3a8ec...

18.11.2025 23:11 β€” πŸ‘ 44    πŸ” 18    πŸ’¬ 7    πŸ“Œ 16
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Experimental phage evolution results in expanded host ranges against antibiotic resistant Klebsiella pneumoniae isolates - Nature Communications Ghatbale et al. adapted a co-evolutionary technique to develop Klebsiella pneumoniae phages to be highly active longitudinally against K. pneumoniae clinical isolates, including drug resistant isolate...

Phages!

Authors identified phages w/ lytic capacity against a few clinical isolates, & through experimental evolution were able to vastly expand the host ranges to kill a broader range of clinical K. PNA isolates including MDR (multi-drug resistant) and XDR. #IDSky

www.nature.com/articles/s41...

19.11.2025 14:18 β€” πŸ‘ 1    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0
Prevalence of Neisseria meningitidis in urine from men in Ohio by molecular testing Meningococcal urethritis is recognized as an emerging disease. However, its contemporary prevalence is unknown, and no molecular diagnostic tests are commercially available. With the widespread transition to molecular methods for sexually transmitted infection screening, high-throughput well-validated molecular methods for Neisseria meningitidis detection in urine may be useful for surveillance and diagnosis.MethodsWe tested for N. meningitidis using polymerase chain reaction (PCR) in 1005 residual male urines submitted for standard-of-care gonorrhea/chlamydia testing. Subjects were designated β€œSymptomatic” if an ICD10 code matching urethritis, dysuria, or urethral discharge was noted or β€œRandom” if not. A sodC-targeted PCR was adapted on the Panther Fusion (Hologic) for initial testing; an orthogonal metA-targeted PCR was used for confirmation of initial positive results.ResultsOverall prevalence (95% CI) of N. meningitidis was 1.5% (0.8-2.5%) when considering initial results, and 0.5% (0.2-1.2%) when considering only samples with successful confirmation. An initial detection of meningococcus more frequently confirmed as positive from subjects in the β€œSymptomatic” compared to β€œRandom” cohort (100% vs. 9.1%, p=0.004). Positive and negative percent agreement (95% CI) of sodC PCR with metA PCR as reference was 100% (47.8-100%) and 91.7% (85.2-95.9%) respectively. Only 1 of 15 individuals who were sodC-positive was diagnosed with meningococcal urethritis by culture.ConclusionsOur molecular prevalence study revealed meningococcal urethritis is likely underdiagnosed in Ohio men, with one case for every 4 to 11 men with urogenital gonorrhea. With further optimization and validation, molecular testing may become a viable diagnostic or surveillance method for meningococcal urethritis.

Meningococcal urethritis prevalence in Ohio men is 1.5% (0.8-2.5%) via PCR. Symptomatic cases confirmed 100% vs. 9.1% in random. One case per 4-11 men with gonorrhea. πŸ¦ πŸ”¬

#idsky

17.11.2025 12:30 β€” πŸ‘ 1    πŸ” 1    πŸ’¬ 1    πŸ“Œ 0
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How Rwanda mounted a research response with an investigational vaccine just ten days into a Marburg outbreak - npj Vaccines npj Vaccines - How Rwanda mounted a research response with an investigational vaccine just ten days into a Marburg outbreak

An investigational Marburg vaccine used in Rwanda’s 2024 outbreak is not yet approved but can be deployed in outbreaks if protocols move quickly

A monoclonal antibody was also used in Rwanda, but this isn’t a cure. Past Marburg outbreaks have had 24–88% fatality rates, esp affecting health workers

15.11.2025 07:51 β€” πŸ‘ 7    πŸ” 1    πŸ’¬ 2    πŸ“Œ 1
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Ethiopia confirms first outbreak of Marburg virus disease Ethiopia’s Ministry of Health has confirmed an outbreak of Marburg virus disease in the South Ethiopia Region, the first of its kind in the country, following laboratory testing of samples from a clus...

www.afro.who.int/countries/et...

14.11.2025 21:19 β€” πŸ‘ 2    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0
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Post Treatment Blood Cultures in Patients with Infective Endocarditis: Valuable, Inconsequential or Worse?

βœ… Just Accepted
πŸ”— https://doi.org/10.1093/cid/ciaf618?utmsource=x&utmmedium=organic-social&utmcontent=%40CIDJournal&utmcampaign=CID-Article-Promotion

14.11.2025 15:53 β€” πŸ‘ 5    πŸ” 3    πŸ’¬ 0    πŸ“Œ 4
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Dr. Julie Ann Justo is joined by experts Drs. Krista Gens and Javier A. Villafuerte GΓ‘lvez as they dive deep into the gut microbiome to explore the latest therapeutic frontier for C. difficile infections. This podcast was supported by an unrestricted grant from NestlΓ© Health Science sidp.pinecast.co

14.11.2025 10:01 β€” πŸ‘ 6    πŸ” 3    πŸ’¬ 0    πŸ“Œ 3