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. ...

We can probably all agree that any false positive test result is bad, but I think it’s safe to say that some false positives, like a false positive HIV test for example, is much more anxiety provoking than others. And when it comes to HIV, there have been a number of key advances in the field over the past decade, include the development of improved diagnostics and optimized algorithmic approaches, all of which have allowed for earlier detection of infected patients, and particularly those...

Novel β-lactamase/β-lactamase inhibitors have become critical drugs to combat the most resistant Gram-negative infections. A series of new compounds with even more broad and potent activity are in the horizon to add to the therapeutic armamentarium. Today, we will discuss these drugs with experts in the field. Topics discussed: BL/BLI combinations that are currently available in clinical practice. Future perspectives of BL/BLI armamentarium. Resistance developing for this class of...

The applications of large multiplex panels for detection of pathogens have greatly expanded in the past several years. Initial tests were for detection of respiratory viruses, and the first such test was labor intensive and vulnerable to frequent contamination. Since then, additional sample types have been added, such as cerebrospinal fluid and positive blood culture broths, and tests are easier to perform and reasonably reliable. We discuss a research use only multiplex PCR assay for...

COVID-19 continues to pose major problems in the winter in the USA. Infections and hospitalizations are increasing and there is a fear of emergence of new variants. Therapeutic tools are also evolving. We discuss these new developments! Watch the video version via: https://youtu.be/ElnahBl53e8 Topics discussed: The latest facts on COVID Current therapeutic approaches including antivirals and monoclonal antibodies Future perspectives for the coming year on COVID-19. Guests: Adarsh...

As we enter into the holiday season, many of us look forward to celebrating long-standing traditions with family and friends, which is no different from us here on the podcast! While not necessarily as long-standing as some of the other classic holiday traditions, after 2.5 years on air, we on this podcast have established our own end-of-year tradition, which is to take a look back at some of our favorite papers or more intriguing manuscripts published in the Journal of Clinical Microbiology...

Deciding how extensively to work up and report respiratory cultures is the worst. There are useful guidelines on how to approach this. But, in my experience, very few laboratories strictly follow these guidelines. That can be because of concerns about under-reporting pathogens or about over-reporting microbiota, or it can be the result of pressure from clinical staff to report more organisms than the guidelines suggest. Today, we’ll be talking with two guests about their study on how...

Antimicrobial resistance is the ‘silent pandemic’ and to tackle this challenging public health problem we need to attract the best and brightest. Today we will discuss pathways to work on this field with trainees who will be the next generation of outstanding researchers in the field, currently as part of different T32 training programs in the United States. Welcome to Editors in Conversation Topics discussed: Different pathways to follow careers in antimicrobial research The challenges to...

The idea of applying machine learning and digital pathology platforms to everyday workflows in the clinical microbiology laboratory has become increasing intriguing and appealing, especially as labs continue to optimize efficiency in the midst of workforce shortages. The promise of this new digital frontier is multifold, including decreasing turnaround time and potentially cost, and freeing up technologist time to focus on higher yield activities in the lab. Many labs have now taken the...

There are a number of regulatory proposals under consideration which could have important effects on clinical microbiology labs, and clinical labs more generally. First, the VALID act would change how clinical tests are regulated with particularly important implications for laboratory-developed tests. Second, the Centers for Medicare and Medicaid Services has proposed changes to the educational requirements for lab directors under CLIA and additional changes that would increase the fees that...

Infections caused by Mycobacterium abscessus appear to be increasing in frequency among the immunocompromised population and are challenging to treat. Antibiotic options in these cases are scarce, prolonged therapy is required and new options are needed. We will discuss this important topic with experts in the field. Topics discussed: Define M. abscessus as an opportunistic pathoge The intrinsic phenotypic characteristics of M. abscessus, including resistance to common antimicrobials...

The inoculum effect of antibiotic susceptibility testing is often discussed at playgrounds and infectious diseases conferences, but many of us don’t really have a clear definition of what it is or a good understanding of its importance. We’ll be talking about the inoculum effect and susceptibility testing of Staphylococcus aureus with cefazolin. Some of the questions we’ll discuss are: • What exactly is the inoculum effect and how is it measured? • Does the inoculum effect have clinical...