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We've come to the end of another week on #GenID at @UNMC_ID lead by our fearless leader @DrJRMarcelin, which means its time for another recap of #IDPearls from team #PasteurellasFellas: https://twitter.com/UNMC_ID/status/1294035482188423168?s=20
We've discussed the interaction between Vanc & Pip-Tazo when it comes to AKI. This is a controversial topic, detailed in this Fact or Fiction article.
https://academic.oup.com/cid/article-abstract/71/2/426/5675135?redirectedFrom=fulltext
https://academic.oup.com/cid/article-abstract/71/2/426/5675135?redirectedFrom=fulltext
The article proposes a mechanism by which pip-tazo & vanc synergistically inhibit tubular reabsorption of creatinine via OAT1/3 transporters, similar to the effects of TMP (as detailed by @CuriousClinPod recently). Wonder what #NephTwitter & @kidney_boy think about this?!
We learned a ton about enterococcus this week, it is a tough bacteria to treat given its limited susceptibilities. Paying attention to the species of enterococcus is really important for empiric treatment!
Additionally, certain Enterococcal species are intrinsically resistant to vanc:
Remember "CGF"
- E. casseliflavus
- E. gallolyticus
- E. flavescens
Thanks @bergmanscott for the excellent pearl! #IDPharmacy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88957/pdf/cm000686.pdf
Remember "CGF"
- E. casseliflavus
- E. gallolyticus
- E. flavescens
Thanks @bergmanscott for the excellent pearl! #IDPharmacy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88957/pdf/cm000686.pdf
We learned the differential for culture-negative endocarditis & key epidemiological clues. My go-to for this issue is this chart from @Ahmed_HBabiker & @Emory_MedMicro
Along these lines, we discussed the Mycobacteria chimaera outbreaks related to contaminated heater-cooler units used in cardiac surgery
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404123/pdf/KITP-14-29720.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404123/pdf/KITP-14-29720.pdf
And on the topic of Mycobacteria, I had to bring up one of the best named bacteria: Mycobacteria jacuzzii. Also, this outbreak investigation sounds like an episode of House, MD!
https://academic.oup.com/cid/article/43/7/823/369381
https://academic.oup.com/cid/article/43/7/823/369381
Have been coming across the issue of fevers in the ICU lately, especially in patients with COVID-19. This chart shared by @TxID_Edu has been a clutch reference I've saved to my favorites! https://twitter.com/TxID_Edu/status/1203337173635756034
We've discussed penicillin prophylaxis for recurrent cellulitis quite a bit, so I had to find the evidence for this. https://www.nejm.org/doi/full/10.1056/NEJMoa1206300
Of course, this week in @NEJM another study was published for recurrent cellulitis prophylaxis: using compression stockings! https://www.nejm.org/doi/full/10.1056/NEJMoa1917197
Another wonderful week with this crew! They keep challenging me every day to learn and grow. Also, they keep me on my toes (socks?!) with their seemingly endless pun game @UNMCIMResidency @claytonmowrer @MrSmartyPants_1 @ADreessen21 @tiff_truong @Molly_M_Miller @HannahLuksa
