Antimicrobial in critically Ill adult patients receiving #ECMO: challenges, evidence, and future directions 💉 PK/PD concepts & considerations 🧫 antibacterials 🍄 antifungals 🦠 antivirals 🩺 management recommendations: dose optimization, challenges/recommendations, ABT stewardship 🔓 bit.ly/45vjrbt

Working with 🩸 donors, it is good to have guidance on asymptomatic pts with ➕babesia screens. Blood banks use PCR which can be positive for months to years after infection. Guidance is to 🚫not treat unless positive smear doi.org/10.1093/cid/...

2025 was an exciting year in the world of ECMO infections research Some highlights below: A 🧵 #IDSky

🧵 Essential ID Papers for 2025: A Clinician’s Guide Each year brings a flood of amazing ID literature. Here are candidates for some of the most important ID papers of 2025, spanning guidelines, trials, antimicrobials, and vaccines. 👇

A phase 2 open label RCT of weekly Islatravir + Lenacapravir in patients living with HIV combared B/F/TAF: -Similar rate of viral suppression (VL<50) -Similar effect on CD4 count Likely one step closer to a weekly oral HIV med. #IDSky www.acpjournals.org/doi/10.7326/...

WHO-certified Tropical Diseases Eliminated in 2025 African Trypanosomiasis: 🇬🇳 🇰🇪 Malaria: 🇬🇪 🇸🇷 🇹🇱 MTCT HBV: 🇲🇻 Onchocerciasis: 🇳🇪 Trachoma: 🇧🇮🇪🇬🇲🇷 🇵🇬 #IDSky

Brazil 🇧🇷 meets elimination targets for mother-to-child transmission of HIV #IDSky www.who.int/news/item/18...

🇳🇱 RCT of DFI w/ suspected osteo and w/o debridement/amputation and got bone+ulcer biopsy Comparison: abx targeting unblinded 🦴 cx or ulcer cx Outcome: Remission at 12 months Outcome: No difference RR 1.13; (95% CI 0.80-1.60). Why? Both cxs concordant 85% of time #IDSky doi.org/10.1093/cid/...

New Let’s Talk ID episode out now! 🎙️ @paulsaxmd.bsky.social sits down with infectious disease and critical care physician @mbrigmon.bsky.social of @uthealthsa.bsky.social to discuss forging a career in ID Critical Care. Available on all podcast apps. Transcript: www.idsociety.org/multimedia/p...

Happy Hanukkah to #IDSky!

Possible nosocomial transmission of malaria 🦟 in 🇺🇸?!? A 65M in NY developed severe P. falciparum malaria (16% parasitemia) after hospitalization for SDH. Extensive tracing determined transmission at hospital with likely 🩸 borne transmission from returning traveler #IDSky doi.org/10.1093/ofid...

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...

This single-center quality improvement study found that 45% of C. difficile infections were preventable due to inappropriate antibiotic use or treatment of non-guideline conditions. These findings support continued antimicrobial stewardship efforts to reduce CDI rates. doi.org/10.1017/ash....

Travel medicine clinic does not have many travelers to Switzerland 🇨🇭 -70yo 🇺🇸 traveler to 🇨🇭 died from Tick-Borne Encephalitis after 🥾 in Alps -12th case in 🇺🇸 traveler since 2000 -TBE vaccine 💉 recommended for travelers to Europe/Asia with⬆️ tick exposures #IDSky wwwnc.cdc.gov/eid/article/...

New paper out today where we tried to apply the framework of preventability to our C diff cases. Unpreventable (53%) -1/3 received no abx -1/5 receive CPG abx only Preventable (47%) -1/4 conditions not on CPG -1/4 non-CPG treatment given Goal: ⬇️ preventable CDI doi.org/10.1017/ash.... #IDSky

Historical #IDSky quotes that still are true today: “It is a regrettable fact that discussion of syphilis of the nervous system and its treatment is still necessary” H. Houston Merritt @nejm.org 1939 #IDSky www.nejm.org/doi/full/10....

A paper in Nature reports the details of a 60-year-old male individual from Germany who achieved sustained HIV remission after a stem cell transplant, the seventh-known case reported to date. go.nature.com/4rNjedx #medsky 🧪

A @idsainfo.bsky.social position statement in @cidjournal.bsky.social describing why the society backed out of ATS CAP guidelines. [In viral pneumonia] “briefly withholding antibiotics for patients with nonsevere illness to clarify the diagnosis is safe” #IDSky academic.oup.com/cid/advance-...

The fourth case of transplant-transmitted rabies reported in this week’s MMWR. -🦇 Strain -Symptoms 5 week transplant in kidney recipient -Donor with neurological symptoms, but died at home from presumed cardiac arrest #IDSky www.cdc.gov/mmwr/volumes...

Are there any stewards on #IDSky that have experience working to improving local antimicrobial prescribing in non-CF bronchiectasis exacerbations? Are there hospitals were ID is very involved in antibiotic selection and duration?

Two Transplant ECMO #IDSky papers this week: 1) 🇺🇸 Pre-🫁 transplant ECMO associated with ⬆️ BSI post-transplant link.springer.com/article/10.1... 2) 🇨🇭Post ❤️ transplant ECMO associated with ⬆️ 1 yr infections including bacterial and fungal journals.lww.com/transplantat...

A great @cidjournal.bsky.social case series that led to lots of discussion with the fellows today- 4 🇬🇧 pts with HBV reactivation after change off of a TAF-based HIV regimen Pt1/4: +HBcAB, -HBVsAg, -HBVsAB Pt2/3: +HBcAB, -HBVsAg,+HBVsAB #IDSky academic.oup.com/cid/advance-...

New #IDSky paper describing antimicrobial dosing in ECMO by @haifalyster.bsky.social: 🔑 Critical illness contributes to more PK variability than ECMO 🔑 Lipopophilic, protein-bound drugs sequestered by circuit 🔑 Use extended infusions for beta-lactams www.sciencedirect.com/science/arti...

I just had my first day as the Associate Director of my hospital’s Infectious Disease Fellowship! I’m excited to spend more time with the fellows! #IDSky

Fascinating article on the history of syphilis: “English people called it the “Spanish disease”… the Spanish called it mal inglés. The Dutch called it “Spanish smallpox” The Russians blamed the Poles, and the Turks referred to it as the “Christian disease”” #IDSky academic.oup.com/jid/advance-...

European Guidelines: ✅ Repeat BCx in asymptomatic pts at end of therapy for IE 🇺🇸 Guidelines: ❌ Single center 🇨🇭 study of ~600 pts with IE shows limited utility I have not heard of this practice. Do any US hospitals get routine BCx at end of IE therapy? doi.org/10.1093/cid/... #IDSky

Egypt 🇪🇬 became the 27th country to eliminate Trachoma representing decades of public health investment. Trachoma still found in 30 countries #IDSky www.who.int/news/item/12...

More evidence to be aggressive with Linezolid dosing in ECMO. #IDSky link.springer.com/article/10.1...

Hey ID Fellows, what are your favorite ID consults? Asked that question during a recent visit to the ID division at Johns Hopkins, and here's what their fellows said. #IDSky blogs.jwatch.org/hiv-id-obser...

New CID State of the Art Review released today on antibiotic allergy delabeling: academic.oup.com/cid/article/... #IDSky

The updated SOFA-2 scores was released today! It updates original SOFA score with more contemporary practices. #IDSky jamanetwork.com/journals/jam...

One year of outpatient clindamycin prescriptions at a military healthcare system demonstrated that less than half of patients had a beta-lactam allergy and that the top 2% of prescribers accounted for 18% of prescriptions. doi.org/10.1017/ash....

There are many factors that influence this decision: Trainee’s: ✅career goals ✅previous research experience ✅upcoming clinical responsibilities Mentor’s: ✅ability to take another project or connect to a different mentor Both: ✅Previous conversations and expectations

In an outpatient setting with ⬆️ rates of clindamycin resistance, who is prescribing clindamycin? ⬆️ 2% of prescribers = 20% of scripts (check out Pareto graph in figure 1) ❌ scripts from ER +Primary Care ❌Indications w/ beta-lactam allergy- 🦷 infection ❌ w/o: SSTI doi.org/10.1017/ash.... #IDSky

@kenkoonwong.bsky.social with another deep look at the SoMe ## of #IDWeek2025: 1) ID is divided between #IDSky and #IDTwitter 2) More posts+ engagement on 🦋than X 3) Certain accounts such as @boghuma.bsky.social @sairabt.bsky.social @jonathanrydermd.bsky.social are essential follows for IDWeek

#IDResearchChallenges 🥼🧫🧬👨‍🔬👩‍🔬 Your trainee who crushed their poster session at #IDWeek2025, really wants another project so that they can go to #IDWeek2026 Do you: A) Find a new project ASAP B) Wait for 📝 draft C) Wait for 📝 submission D) Other #IDSky

Reports of Serph filter as treatment for ECMO released in single center 🇭🇷 case series showed ~53% clearance in 24 hours and reduction in several inflammatory markers #IDSky www.frontiersin.org/journals/med...

#IDWeek2025 was such a wonderful experience! What were the favorite sessions of #IDSky (for me to catch up on after the meeting)?

Due to the USG Shutdown, I wasn’t able to attend or present @idweek.bsky.social. I was supposed to give the talk on top viral studies that will impact your practice. Here are the papers I was going to highlight: See next posts

Check out my mentee’s poster (1841). IM PGY2 Dr. Hill presents on factors associated with false positive HBVsAg in military service members #IDWeek2025

MIC Speaker #2 Dr. Bryson (VCU): Can I Trust this Susceptibility Testing Result? Acceptable variation in testing regardless of method used. Certain drug/bug combos have higher variability (ex. Cefidercol w/ significant variation by media brand and method) #IDWeek2025

The Many Facets of Clinical Breakpoints begins with “What Makes a Good Breakpoint?” by Dr. Lewis (OHSU): Breakpoints-a mix of science and art based on: 1) MIC distribution, mechanisms of resistance (the original way breakpoints were determined) 2) PK-PD 3) Clinical data #IDWeek2025

Dr. Kontoyiannis on his career at #IDWeek2025- 1) Early career- identifying clinical characteristics of mucor (rediscovered “reverse halo” sign) 2) Epi-increasing prevalence w/ rise of Vori in early 2000s 3) Late 2000s- better outcomes with early Ampho 4) Development of a treatment algorithm

Has anyone on #IDSky been able to fill out CME forms for lectures at #IDWeek2025?

Check out my mentee’s poster (1403). IM PGY-3 Dr. Powers presents on outcomes of inpatient IGRAs #IDWeek2025

Check out my mentee’s poster (1389). IM PGY3 Dr. Kim presents on factors associated with false positive IGRAs in military service members #IDWeek2025

Fiji 🇫🇯 eliminated trachoma! Making it the fourth country in 2025 to reach elimination status: 🇧🇮 🇫🇯 🇲🇷 🇵🇬 www.who.int/news/item/20... #IDSky

Mentorship matters. So proud of my mentees presenting at IDWeek this year. #IDWeek2025

Staph aureus bacteremia debates! Ceftobiprole as adjunctive therapy in persistent Staph aureus bacteremia (Dr. Turner, Duke): Theory: 1) In vitro synergistic with dapto 2) 99% susceptible in vitro, but only 94% of ceftaroline 3) Ceftobiprole -very good against MDR MRSA #IDWeek2025

Check out my mentee’s virtual poster (718). USUHS M4 Cecelia Peden presents on sexual networks of military service members with chlamydia #IDWeek2025