TLDR; We propose an optimized ASE 2.0 definition:
- allow POA infection diagnosis codes to anchor infection
- include pts discharged alive on QAD 3
- include hypotension w/out pressors (>/= 2 readings in 6h)
- include NIV or HFNC (>/= 2 days)
- minor changes in Plt, Cr, and Tbili thresholds
07.08.2025 00:11 β π 1 π 2 π¬ 0 π 0
Good perspective from @simrangmd.bsky.social et al re use of PCT in ICU.
Particularly pertinent that as data and practice keep pointing towards shorter antibiotic course therapy, the window for diagnostic stewardship will narrow, limiting PCT benefit.
#IDSky #ClinMicro #AMR
29.06.2025 05:43 β π 6 π 2 π¬ 0 π 0
Check out our viewpoint!
29.06.2025 02:45 β π 0 π 0 π¬ 0 π 0
This is by far the most common vaccine I strongly recommend in ID adult clinical practice. As ID doctors, we see some truly severe cases of zoster, with post-zoster sequelae that may last months or even rarely be permanent. #IDSky doi.org/10.1093/cid/...
26.06.2025 18:53 β π 64 π 15 π¬ 3 π 1
Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial
AbstractRandomized trials of procalcitonin-guided algorithms to discontinue antibiotics in critically ill patients with sepsis report reduced antibiotic duration and possible mortality benefit. However, open-label trial designs, inconsistent algorithm adherence, and unclear stewardship practices have limited confidence in procalcitoninβs benefit. The ADAPT-Sepsis trial addressed several of these gaps through a concealed intervention, robust stewardship, and head-to-head comparison with CRP. Procalcitonin-guided care reduced antibiotic use without significantly impacting mortality, while CRP-guided care showed no benefit. However, algorithm adherence was suboptimal and the absolute reduction in antibiotic duration with procalcitonin was only one day. As shorter fixed-duration therapy becomes standard, procalcitoninβs utility in the ICU may decline. Embedding procalcitonin and other biomarkers into multifaceted stewardship strategies, and addressing barriers to clinician trust and implementation, is essential. Future research should also evaluate whether biomarker use earlier in the sepsis care pathway, particularly in Emergency Departments, can improve early diagnostic accuracy and enhance patient outcomes.
Procalcitonin-guided care cut antibiotic use by 1 day in sepsis patients but had no mortality impact. CRP showed no benefit. Adherence was low; future focus on early biomarker use is needed. ππ
#idsky
21.06.2025 00:30 β π 2 π 1 π¬ 0 π 0
Herpes Zoster Vaccination and Dementia Occurrence
Herpes zoster vaccination eligibility reduced the probability of new dementia diagnoses, suggesting its potential preventive effect.
https://ja.ma/4lagSB6
22.06.2025 13:00 β π 20 π 10 π¬ 0 π 1
πΎLast evening, the MGH & BWH ID faculty celebrated graduates of the MGB ID & MGH Transplant ID Fellowships, along with their families. It was a heartwarming celebration of stories, accolades, laughter, and tears. Special thanks go to our featured speakers Dr. Eric Rubin & Dr. Gabriel Motoa Cardona.π€©
18.06.2025 14:28 β π 7 π 2 π¬ 0 π 1
Last few weeks with this BWH crew! @mgb-id-fellows.bsky.social
09.06.2025 14:26 β π 3 π 1 π¬ 0 π 0
Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients
βΌοΈOur new paper on social media in #TxID is officially out in @thetxidjournal.bsky.social
We summarize findings from our #TxIDChat @txidfellows.bsky.social
We discuss recs for trainees, career advancement, & future directions in this changing landscape. Check it out!
dx.doi.org/10.1111/tid....
14.02.2025 17:41 β π 18 π 7 π¬ 1 π 2
ICE was in my hospital todayβ¦
i am so beyond angryβthis is unacceptable
stay away from our patients and let us do our jobs
24.01.2025 23:11 β π 12509 π 2661 π¬ 347 π 119
CDC's Morbidity and Mortality Weekly Report (MMWR) has provided real-time data and analysis about disease outbreaks and emerging health threats without a break every week since 1960.
Until today.
23.01.2025 18:38 β π 4989 π 2315 π¬ 143 π 226
Trump's Gag Order Halts CDC Publication
MMWR did not publish as usual at 1 p.m. today
Trump's Gag Order Halts CDC Publication www.medpagetoday.com/infectiousdi... For the first time in its more than 60-year history, the CDC's Morbidity and Mortality Weekly Report (MMWR) did not go out as scheduled.
23.01.2025 19:48 β π 16 π 11 π¬ 1 π 2
Scientific advancements aside, this is economically irresponsible
Every $1 spent by NIH generates $2.46
For example, in 2023, $47B in NIH spending generated ~$93B
Halting NIH spending will LOSE the US a lot of money (and talent)
22.01.2025 23:04 β π 1979 π 958 π¬ 60 π 74
For those asking how unusual it is for NIH review panels to be cancelled: I do not recall study sections ever being cancelled during my 30-year career except for during the βsequestrationβ period around 2012-2013 when there was, I think, a government shutdown.
23.01.2025 00:39 β π 167 π 47 π¬ 4 π 4
Oh. My.
21.01.2025 17:48 β π 1 π 0 π¬ 0 π 0
Outcomes of Coccidioides Seropositive Solid Organ... : Transplantation
by enzyme immunoassay (EIA-IgM-only), although this result may be falsely positive.
Methods.
We conducted a retrospective study at a large-volume transplant center in an endemic coccidioidomycosis ...
Excited to share our research on duration of antifungal ppx for Cocci in SOT!
TLDR; For patients repeatedly pos for EIA-IgM-only w no seroconversion, compatible clinical illness, or rads findings, discontinuing antifungal ppx may be reasonable after 1st posttxp yr
journals.lww.com/transplantjo...
17.01.2025 16:21 β π 6 π 2 π¬ 1 π 1
Yersinia enterocolitica Pneumonia in a Heart Transplant Recipient
Click on the article title to read more.
Did you know that Yersinia can cause pneumonia? It sure can. Check out this interesting report by @carlosportales.bsky.social @agstewart.bsky.social onlinelibrary.wiley.com/doi/10.1111/...
18.12.2024 20:24 β π 16 π 5 π¬ 0 π 0
Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients
π₯Out now! Our latest from @txidfellows.bsky.social on the use of social media in #TxID. doi.org/10.1111/tid.... @courtharrismd.bsky.social @rebeccakumar.bsky.social @germhuntermd.bsky.social @paulsaxmd.bsky.social @transplantid.bsky.social
18.12.2024 19:53 β π 7 π 6 π¬ 1 π 0
Published on This Day in 1981.
Pneumocystis carinii Pneumonia and Mucosal Candidiasis in Previously Healthy Homosexual MenβββEvidence of a New Acquired Cellular Immunodeficiency
An illustration showing the reproductive cycle of human immunodeficiency virus type 1 (HIV-1) and sites of action of the major classes of antiretroviral medications.
The NEJM identity sits at the bottom.
On this day in 1981, a landmark paper in NEJM described four patients with evidence of immunodeficiency associated with PJP pneumonia, disseminated CMV, and Kaposi sarcoma. The disease would come to be known as HIV/AIDS. Revisit the paper: nej.md/41iekKD
#MedSky #IDSky
10.12.2024 14:28 β π 482 π 220 π¬ 12 π 26
π€© WE ARE SUPER EXCITED to announce our 2025-2027 class of ID Fellows! π₯
We are thrilled to have matched with such a talented group!
04.12.2024 19:03 β π 54 π 4 π¬ 0 π 7
7-year performance of a clinical mNGS test for diagnosis of CNS infections
Sensitivity 63.1%
Specificity 99.6%
Accuracy 92.9%
4 potential use cases:
β‘οΈunculturable, difficult-to-diagnose organisms
β‘οΈbroadly dx viral infections
β‘οΈrare, unexpected infections
β‘οΈoutbreaks
doi.org/10.1038/s415...
#IDSky
23.11.2024 16:22 β π 7 π 2 π¬ 0 π 0
Official Bluesky account of AST IDCOP. Posts made by this account are not endorsed and may not reflect the views of the AST.
Infectious Disease Doc - WashU
HIVMA Board of Directors
LGBT+ Health, STI, HIV
Queer and Proud
Infectious Diseases Pharmacist | Brigham and Womenβs Hospital
Practicing Doc, Transplant ID Director, ID/Critical Care, Clinical Researcher & Trialist. Professor, University of Nebraska Medical Center, Omaha.
Official account of the University of Pittsburgh, Division of Infectious Diseases.
Medical Director of Transplant ID & #TxID Fellowship PD at MUSC π΄βοΈvia BWH/MGH ID, Mayo IM, UMN med & UW-Madison #GoBadgers | Moderator: @TxIDFellows.bsky.social #TxIDChat | Creator: Women in ID Book Club | #IDSky
RR\ID is an open-access overlay journal that accelerates peer review of important infectious disease-related research preprints. Funded by the Gates Fdn, published by MIT Press, and HQ'd at UC Berkeley π https://rrid.mitpress.mit.edu/
Infectious Diseases physician at Ohio State. Interested in all things #HIV & #HIVOnc. Views are my own.
Fascinated by Transplant Infectious Diseases #TID and Transplant Immunology, T cell senescence, and frailty
Antimicrobial Resistance Research and Epidemiology
Working for Doctors without Borders #MSF
Former: #WHO #LSHTM #MarieCurieFellowship
#AMR #medsky #episky #microsky #aidsky #idsky
infectious diseases fellow at UChicago π΅π½ββοΈ
Mostly just posting cat pictures.
ID at @washuID obsessed with fungal infections. Section Chief, Transplant ID. #fungus #TxID #IDTwitter Head of @WU_Mycoses. Deputy Editor-OFID. He/Him
TxID Fellow @mgh_id/@bwh_id via @ROCregional | MΓ©dico Cirujano @LaUASLP
Interests: coffee, jazz, dogs and infectious diseases.
#GoBills
Antimicrobial Stewardship & Transplant Infectious Diseases at University of Kansas Medical Center. Founder of Transplant ID Early Career Network @txidfellows.bsky.social
Lover of πΆππββ¬π₯πΈπΌοΈποΈπ³πΊπ
Infectious Diseases Fellow BWH & MGH
Transplant ID and Antimicrobial Stewardship at UC Davis in Sacramento, CA. Views are my own.
Antimicrobial Stewardship & Healthcare Epidemiology, open access journal of the Society for Healthcare Epidemiology of America.
https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology