Join Dr. Ben Pinsky and Dr. Greg Berry as they dissect recent news stories, including the USDA's testing for H5N1 in ground beef and a surprising bubonic plague case in Oregon. They also tackle the resurgence of measles in the U.S., the local reappearance of malaria, and a curious study on Neosporin's potential to prevent viral infections. Overview: H5N1 Influenza Virus: Dr. Ben Pinsky provides an update on recent cases of H5N1 in humans and animals, including concerns about dairy cattle...

The pipeline of antibiotic discovery is a major necessity due to the continuous evolution of resistance to currently used antimicrobials. This pipeline faces important challenges due to the lack of investment on antimicrobial research in the private sector and an economic model that discourages investment. In the last few years, however, encouraging signs are occurring but major gaps still remain. The World Health Organization has regularly assessed the preclinical and clinical antibacterial...

The European alchemists of the 12th century sought to find the philosopher’s stone, a substance that would transmute base metals, such as lead, into precious metals, such as silver and gold. Today, we discuss whether data analysis, including machine learning, can transmute base laboratory data into precious clinical tools. We will use antimicrobial susceptibility testing as a case-study for new applications of data analysis. Some of the questions we will address include: How can relatively...

Antimicrobial resistance is a priority public health problem with complex roots and connotations. However, due to a lack of focus on this topic, research training programs, specifically those focused on AMR are limited. Additionally, scientific meetings that particularly highlight the science of antimicrobial resistance are scarce. We recently published a commentary that evaluates the state-of-the-art of the training programs in AMR in the US. We discuss this topic with the leading author and...

Rhodococcus infections are uncommon, however they can cause serious disease in certain patients. There are a number of challenges though when dealing with Rhodococcus infections, including the fact that much of what we know around their susceptibility profiles and the clinical management of infected individuals actually comes from a number case series and in some situations, from the veterinary literature.  So today, our two guests are going to tell us about their experiences with Rhodococcus...

Phage therapy has gained a lot of traction but the challenges created by this approach have not been properly assessed at a big scale. We often read about therapy successes on isolated cases but, rarely, we read or hear about failures. AAC recently published a case series of patients who failed phage therapy. Today, we will discuss this topic with the principal investigator on the research. Topics discussed: Phage therapy as an approach for MDR bacteria. The challenges of phage therapies....

The protozoan Lophomonas has been reported to be a pathogen of humans in a large number of case reports and case series. Most of these case reports describe infections of the respiratory tract. Editors in Conversation is joined by two experts to discuss this possible parasite. Some of the questions addressed include: What are the characteristics of the species in the genus Lophomonas? What are the laboratory and morphological data that suggest that Lophomonas species cause human...

Tuberculosis is one of the most deadly infectious diseases that still causes significant burden of disease, particularly in the developing world.  The emergence of resistance to first line agents severely limits the therapeutic options and threaten the ability to control dissemination of this disease. Fortunately, new drugs and regimens are now emerging as important alternatives against these organisms.  Today, we will discuss this topic with outstanding experts in the field. Welcome to the...

A new generation of B-lactamase inhibitors is likely to reach the market in the upcoming year. These broad-spectrum inhibitors exhibit activity against the most feared class B metallo-B-lactamases maintaining the inhibition of other enzymes. Recently AAC has published three papers that describe the mechanistic bases of taniborbactam resistance among metallo-enzymes. This knowledge is crucial to understand the limitation of these compounds in clinical practice. Today, we will discuss this...

We managed to make it through 2023 without a major epidemic or pandemic, and as we get into the holiday spirit and look forward to the new year, some of us took a look back and picked out one of our favorite JCM paper published in 2023, which I will tell you, was no easy task as there were many of good ones to choose from! And personally, after looking through all the issues over the last year, it never ceases to amaze me the variety of topics that we publish on in JCM – including unique...

Gonorrhea remains one of the more common sexually transmitted infections. In North America, the number of reported cases has generally risen for over ten years, with interruptions in the early days of the COVID-19 pandemic, followed by returns to rising rates of infection. Under the selective pressure of antimicrobial treatment, antimicrobial resistance has risen, which has led to limited options for treatment Today, we will be discussing antimicrobial resistance in N. gonorrhoeae,...

In the last few years we have witnessed the rise of very resistant fungal species some of them likely influenced by environmental conditions and climate change. Fortunately, there has been a bit of an explosion in the development of new antifungals and the pipeline has been strengthened in the last decade. We will have the ability to have new molecules with distinct and novel mechanisms of action in the near future that may contribute to combat recalcitrant fungal infections. Topics...

Despite the many advances in diagnostic testing for infectious diseases, detection of Coccidoides infections continues to rely on serologic assessment for anti-fungal antibodies, and what is perhaps more astonishing is that the serologic methods we use today, such as complement fixation and immunodiffusion, were first developed about a century ago. These assays are technically challenging to maintain and perform, and as a result few labs offer this testing, and even if performed on-site,...

Climate change is possibly the major threat that planet earth is experiencing in this century with potential catastrophic consequences. As the planet warms, the change in weather patterns is affecting the microbial ecology in such a manner that humans are facing new health threats including emerging diseases and facing species of organisms that are more likely to survive these new climatic conditions and resist clinically useful antimicrobials. Topics discussed: The global threat of global...

Fungi that are resistant to antifungal drugs have been very much in the news and even the subject of the hugely popular television program, The Last of Us. We talk with two experts in mycology and fungal susceptibility testing about the recent descriptions of terbinafine-resistant dermatophytes in the United States. Some of the questions we will address include:  • What are the manifestations of infections caused by terbinafine-resistant dermatophytes?  • What species, including novel...

Artificial intelligence (AI) has the potential to change the way we practice medicine and public health. The tools and AI approaches can substantially impact a broad range of fields from the manner we approach patient care to strategies to discover new antimicrobials, track pandemics and deploy public health measures. AAC recently published a commentary on the impact of AI in infectious diseases and we have a conversation with the lead author of the manuscript and a expert guest who is...

Dr. Elli Theel and Dr. Alex McAdam discuss recent viral outbreaks with expert virologists. Recorded before a live audience at ASM Microbe 2023. Topics: What are the recent epidemiologic and diagnostic findings with Mpox?  What are the reservoirs for influenza A H5N1 and how is it transmitted to humans? Why was there such a large number of cases of human metapneumovirus this past respiratory virus season? Guests: Dr. Ben Pinsky, Director of the Clinical Virology laboratory and Professor of...

In response to the global burden of antimicrobial resistance (AMR) and the critical role antimicrobial stewardship plays in optimizing antibiotic use and reducing the subsequent emergence of AMR, Antimicrobial Agents and Chemotherapy is excited to add a new section to the journal focused on antimicrobial stewardship studies. Combatting the devastating burden of AMR requires novel, multipronged approaches from clinicians and scientists alike. Launching this new section is an important step in...

The combination of aztreonam with ceftazidime-avibactam is increasingly used for treatment of antimicrobial-resistant Gram-negative bacilli. Clinical laboratories are asked to perform susceptibility testing using this combination, but many laboratory directors have been unsure how to approach this. Today, we’ll discuss a recent paper in the Journal of Clinical Microbiology in which the investigators evaluated a promising method for testing this combination of two antimicrobials and a...

Recorded at ASM Microbe 2023, Cesar has a conversation with Dr. Maria Elena Bottazzi about the role of minority women in science and discovery, the journey of Hispanic women in science and the current challenges posed by society to deliver science and global health equity. Guest: Dr. Maria Elena Bottazzi - Sr. Associate Dean of the National School of Tropical Medicine at Baylor College of Medicine, Distinguished Professor of Biology at Baylor University, Waco This episode is brought to...

As many of you are likely aware, May is recognized as Women’s Health Care Month by the National Cervical Cancer Coalition, and this year, the CDC has identified the week of May 14th as National Women’s Health Week. So, what better way to recognize these national events on the podcast than to talk about diagnostics for a number of extremely common and uniquely female issues – of course, I’m talking about infectious causes of vaginitis and vaginosis. Classically, diagnosis of these infections...

As the number of immunocompromised patients rise in our hospitals, the presentation of severe infections caused by HSV and CMV are rising. Most importantly, lack of response and documented resistance are becoming more frequently observed. Topics discussed: The clinical problems caused by resistant HSV and CMV infections. Mechanisms of resistance in these organisms. Insights into novel therapeutic approaches to treat resistant gonococcal infections. Guests: Christine M. Johnston, MD, MPH -...

Susceptibility testing for piperacillin-tazobactam has undergone rapid evolution, largely driven by some surprising results from the MERINO trial, which compared the efficacy of piperacillin-tazobactam and meropenem for treatment of patients with ceftriaxone-resistant E. coli or Klebsiella pneumoniae bacteremia. We discuss how the results of the MERINO trial led to reconsideration of breakpoints for pipercillin-tazobactam at the Clinical Laboratory Standards Institute, or CLSI, how the...

The Center of Diseases Control and Prevention (CDC) has categorized emergent resistance in Neisseria gonorrhoeae as an “urgent” public health problem. We discuss the emerging problem of gonorrhea and implications for public health with experts in the field Topics discussed: The clinical implications of resistance to B-lactams and quinolones in Neisseria gonorrhoeae Mechanisms of resistance in these organisms Insights into therapeutic approaches to treat resistant gonococcal infections. ...