Randy McCreery

I recall our Governor spun as good news that we had enough ICU capacity statewide to care for everybody. What was missing was that the capacity was only there because everybody died. It was a mass death experience for about 6w twice, once before, once after vaxs came out.

Changing Course A 74-year-old man with end-stage renal disease (ESRD) on dialysis and cardiac sarcoidosis on chronic prednisone 20 mg daily presents to hospital with 2–3 w

This is a great case for trainees to review, highlighting how to approach a complex patient who may not be responding to treatment as expected. The answer is not always "escalate antimicrobial therapy".
#AMSSky
doi.org/10.1093/cid/...

Another Reason to De-escalate. Check out this week’s KASIC pearl to learn about β-lactam/β-lactamase Inhibitors for MSSA kymdro.org/kasic/?p=8807

#IDsky #AntimicrobialResistance #antimicrobialstewardship #rxsky #pharmacy #FOAMed #NPs #PAs

Abundant

Excited to share our latest publication about SEP-1 metrics during the BCx shortage in the setting of enhanced BCx stewardship efforts

@kcawcutt.bsky.social @ichejournal.bsky.social #IDSky

www.cambridge.org/core/journal...

In contrast to what ATS guidelines insist, antibiotics don't work for viral CAP... #IDSky

#idboardreview 5 wks post kidney transplant (deceased donor) pt had tremors, lower extremity weakness, confusion, urinary incontinence. 6 wks post transplant: fever, hydrophobia, dysphagia, autonomic instability & died 7wks postT #idsky #idmeded #meded

In the latest episode of The SHEA Podcast, Dr. Jonathan Ryder hosts a pro/con debate on procalcitonin with experts Dr. Michael Mansour and Dr. Sheetal Kandiah. They dig into where PCT adds value (or doesn’t) in antimicrobial stewardship and diagnostic decision-making.

bit.ly/4pts2mW

It’s all in formalin?

Could re-title the article “The US could learn a lot from Nebraska”.

a black and white drawing of a man pointing at the camera with the words happy birthday ross ALT: a black and white drawing of a man pointing at the camera with the words happy birthday ross

RIP Ozzie

I had it do that to me about a spreadsheet, so I said sure, let’s see what you can do? It was terrible.

Advances in Understanding Long COVID: Pathophysiological Mechanisms and the Role of Omics Technologies in Biomarker Identification - Molecular Diagnosis & Therapy Long coronavirus disease (COVID) is a multisystem condition that affects a significant proportion of individuals following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with ...

Long C-19 is a plethora of pathways...

No easy fix, because it's many routes to 🤬☠️

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

Defining immunological dysfunction in sepsis: A requisite tool for precision medicine Immunological dysregulation is now recognised as a major pathogenic event in sepsis. Stimulation of immune response and immuno-modulation are emerging approaches for the treatment of this disease. Def...

I bring here an old article from our group classifying the immunological alterations in sepsis into ten major immunophenotypes. Still useful in my view. #IDsky #immunoSky
www.journalofinfection.com/article/S016...
www.journalofinfection.com/article/S016...

#Elephants with jobs: Life guard

☝️A Bank of Sand Dollars !

Ran into a colleague, he asked me how I was doing. I said with enthusiasm I was on my way to “make a sweet diagnosis”. He said “what, diabetes?” I had a quick laugh but I don’t think he heard a word I said after that because he couldn’t stop laughing for the rest of the time we talked. Good 4 him.

Thank you CDC for calling me back after hours on a Friday. You helped me provide world class care to a patient with a rare and difficult to treat infection. You are an absolute global treasure! #IDSky

I loaded an antibiogram into google sheets, data on over 100k isolates. Gemini, the AI assistant, offered, without me asking for it, if I wanted it to analyze the data. I thought sure why not, let’s see what it can do. I asked it a few simple questions and guess what? It’s terrible. #IDSky

Yes last data I have in our region was still about 90% susceptible, GBS I have more recent data it’s ~50%. Need to get updated GAS data.

There was a poster at ID Week out of Henry Ford P-1538 that showed steady ~50% GAS resistance to clindamycin over several years

Real-world HIV RNA and antigen/antibody testing among people who use long-acting injectable PrEP Among a real-world cohort of people who use long-acting injectable cabotegravir preexposure prophylaxis, no breakthrough infection was found. HIV RNA testi

Real-World HIV RNA And Antigen/Antibody Testing Among People Who Use Long-Acting Injectable PrEP -

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

Fascinating topic, would look forward to seeing what you find, I think there really are compellingly pros and cons for different structures.

That’s how dragon dictates it, always thought it was odd, it’s the only thing I can think of that comes out automatically all caps

I canceled Netflix.

I have one on Abacavir. Finally went rogue from my training and no longer getting HLAB5701 screening on intake because there are multiple other kidney sparing options that I’d use first.

Your innie “pan cultures” for hospital onset fever

Only now is it suggested that evidence based medicine be used as evidence in medical malpractice. There’s a lot of weak evidence out there and “custom” often masquerades as weak evidence. Hate to think someone has lost previously because “custom” trumped evidence.

🆕 from Ilges et al:

Real-word utility of procalcitonin (PCT) in patients hospitalized with community-acquired pneumonia: A matched cohort study

▶️ Authors find PCT testing not associated w/ reduced antimicrobial utilization, LOS, or 30-day all-cause mortality

#IDSky

📄: doi.org/10.1017/ice....

If you could get any guitar built new today, would you still get an SG?