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Simran Gupta

@simrangmd.bsky.social

Transplant/Oncology ID fellow at BWH/DFCI. @harvardmed. former @MayoAZ_IMRES. @UConnHealth alum. Dog mom & dancer.

429 Followers  |  201 Following  |  5 Posts  |  Joined: 20.11.2024  |  1.768

Latest posts by simrangmd.bsky.social on Bluesky

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€” πŸ‘ 1    πŸ” 2    πŸ’¬ 0    πŸ“Œ 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€” πŸ‘ 6    πŸ” 2    πŸ’¬ 0    πŸ“Œ 0

Check out our viewpoint!

29.06.2025 02:45 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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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€” πŸ‘ 64    πŸ” 15    πŸ’¬ 3    πŸ“Œ 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 procalcitonin’s 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, procalcitonin’s 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. πŸ“‰πŸ’Š

#idsky

21.06.2025 00:30 β€” πŸ‘ 2    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0
Herpes Zoster Vaccination and Dementia Occurrence

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€” πŸ‘ 20    πŸ” 10    πŸ’¬ 0    πŸ“Œ 1
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🍾Last 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.🀩

18.06.2025 14:28 β€” πŸ‘ 7    πŸ” 2    πŸ’¬ 0    πŸ“Œ 1
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Last few weeks with this BWH crew! @mgb-id-fellows.bsky.social

09.06.2025 14:26 β€” πŸ‘ 3    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0
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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

‼️Our 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€” πŸ‘ 18    πŸ” 7    πŸ’¬ 1    πŸ“Œ 2
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Trump Pauses Disbursements to Program Supplying H.I.V. Treatment Worldwide Pepfar, which is estimated to have delivered lifesaving treatment as many as 25 million people in 54 countries, faces a funding delay of as long as 180 days.

This will kill so many people living with HIV who depend on PEPFAR programs to stay on their HIV treatment driving further HIV drug resistance.

www.nytimes.com/2025/01/24/u...

24.01.2025 21:27 β€” πŸ‘ 877    πŸ” 477    πŸ’¬ 45    πŸ“Œ 133

ICE was in my hospital today…

i am so beyond angryβ€”this is unacceptable

stay away from our patients and let us do our jobs

24.01.2025 23:11 β€” πŸ‘ 12509    πŸ” 2661    πŸ’¬ 347    πŸ“Œ 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€” πŸ‘ 4989    πŸ” 2315    πŸ’¬ 143    πŸ“Œ 226
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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€” πŸ‘ 16    πŸ” 11    πŸ’¬ 1    πŸ“Œ 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€” πŸ‘ 1979    πŸ” 958    πŸ’¬ 60    πŸ“Œ 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 β€œsequestration” period around 2012-2013 when there was, I think, a government shutdown.

23.01.2025 00:39 β€” πŸ‘ 167    πŸ” 47    πŸ’¬ 4    πŸ“Œ 4

Oh. My.

21.01.2025 17:48 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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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€” πŸ‘ 6    πŸ” 2    πŸ’¬ 1    πŸ“Œ 1
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Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of Infective Endocarditis: A Retrospective Cohort Study Short time to blood culture positivity (TTP) was an independent risk factor of infective endocarditis in this large (N=1703) Staphylococcus aureus bacterem

πŸ†•πŸ’«Retrospective Cohort Study
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of IE
Short TTP was associated wit IE
NPV >95% suggests that TTP>13h can be used to risk stratify pts with SAB #idsky #EMIMCC
academic.oup.com/cid/article/...
academic.oup.com/cid/advance-...

21.12.2024 14:14 β€” πŸ‘ 22    πŸ” 8    πŸ’¬ 4    πŸ“Œ 3
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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€” πŸ‘ 16    πŸ” 5    πŸ’¬ 0    πŸ“Œ 0
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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

πŸ”₯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€” πŸ‘ 7    πŸ” 6    πŸ’¬ 1    πŸ“Œ 0
Published on This Day in 1981.  
Pneumocystis carinii Pneumonia and Mucosal Candidiasis in Previously Healthy Homosexual Men — Evidence 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.

Published on This Day in 1981. Pneumocystis carinii Pneumonia and Mucosal Candidiasis in Previously Healthy Homosexual Men — Evidence 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€” πŸ‘ 482    πŸ” 220    πŸ’¬ 12    πŸ“Œ 26
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🀩 WE ARE SUPER EXCITED to announce our 2025-2027 class of ID Fellows! πŸ₯‚

We are thrilled to have matched with such a talented group!

04.12.2024 19:03 β€” πŸ‘ 54    πŸ” 4    πŸ’¬ 0    πŸ“Œ 7
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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:
➑️unculturable, difficult-to-diagnose organisms
➑️broadly dx viral infections
➑️rare, unexpected infections
➑️outbreaks

doi.org/10.1038/s415...

#IDSky

23.11.2024 16:22 β€” πŸ‘ 7    πŸ” 2    πŸ’¬ 0    πŸ“Œ 0

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