Microbe Magazine Podcast

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 Pathology and Medicine at Stanford Health Care and the Stanford University School of Medicine Dr. Ryan Relich, Director of Clinical Microbiology and the Special Pathogens Unit laboratory at IU Health and Eskenazi Health and an Associate Professor of Clinical Pathology and Laboratory Medicine at the Indiana University School of Medicine This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at htt

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 disseminating cutting-edge research that will have notable implications in the global fight against antimicrobial-resistant pathogens. Topics discussed: The role of antimicrobial stewardship in preventing emerging of resistance. The types of high-quality manuscripts that AAC is seeking in this area. Encourage excellence in antimicrobial stewardship research. Guests: Pranita Tamma, MD MPH, Associate Professor of Pediatrics Director, Pediatric Antimicrobial Stewardship Program, Johns Hopkins University, Baltimore MA, Edi

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 beta-lactamase inhibitor. We will also discuss the rational for combining these agents, as well as what lab directors should consider before validating and offering this susceptibility testing.   Guests: Dr. Trish Simner - Director of the Medical Bacteriology and Infectious Disease Sequencing Laboratories, Johns Hopkins Hospital Dr. Romney Humphries - Director of the Division of Laboratory Medicine and the Medical Director of the Microbiology Laboratory at Vanderbilt University Medical Center. Links: Multicenter Evaluation of

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 you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up. Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

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. We 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 beta-lactamase inhibitor. We also discuss the rational for combining these agents, as well as what lab directors should consider before validating and offering this susceptibility testing. Guests: Dr. Trish Simner - Director of the Medical Bacteriology and Infectious Disease Sequencing Laboratories, Johns Hopkins Hospital Dr. Romney Humphries - Director of the Division of Laboratory Medicine and the Medical Director of the Microbiology Laboratory at Vanderbilt University Medical Center. Links: Multicenter Evaluation of an MIC-Based Aztr

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 - Associate Professor Department of Medicine, Division of Allergy and Infectious Diseases. Adjunct Associate Professor, Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA. Roy Chemaly, MD, MPH - Professor of Medicine, Chief Infection Control Officer, Director, Clinical Virology Research, University of Texas MD Anderson Cancer Center, Houston, TX. This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to

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 breakpoints were changed, and how well commercial platforms perform piperacillin-tazobactam testing using FDA or CLSI breakpoints. Spoiler alert: the news isn’t great. If you are interested in beta-lactam/beta lactamase combinations, you should check out the previous episode of this podcast, hosted by our friend Dr. Cesar Arias, the Editor-in-Chief of Antimicrobial Agents and Chemotherapy. Cesar and the guests did a great review of recent developments in this fast-moving area. Guests: Dr. Trish Simner - Director of the Medica

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. Guests: William M. Shafer, Professor, Department of Microbiology and Immunology, Emory University School of Medicine, Co-Director, Emory Antibiotic Resistance Center Yonatan Grad, Melvin J. and Geraldine L. Glimcher Associate Professor of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membershi

e 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 with acute HIV. Among these advancements has been the development of 4th and 5th generation serologic assays, which offer multiple benefits over prior assay versions, but unfortunately, are not immune to the possibility of false positive results. So, confirmatory test remain a necessary – the challenge though is that depending on the institution and environment, the turnaround time for such confirmatory testing can be prolonged, leaving patients and clinicians in a kind of diagnostic limbo. So, is there a way to minimize the

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 antibiotics. Guests: Robert Bonomo. Professor, Department of Medicine, Pharmacology and Molecular Biology and Microbiology, Case Western Reserve University, Director of VA CARES Center, Cleveland, OH Patricia A. Bradford Antimicrobial Development Specialists LLC, Nyack, New York, USA This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up. Visit journals.asm.org/j

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 detection of pathogens in joint infections, and learning how it compares to targeted metagenomic sequencing and culture for detection of pathogens in periprosthetic joint infections. Guests: Dr. Marisa Azad - Assistant Professor of Medicine in the Division of Infectious Diseases at The Ottawa Hospital and an Associate Clinical Scientist at the Ottawa Hospital Research Institute. Dr. Robin Patel - Co-Director of the Bacteriology Laboratory at the Mayo Clinic, where she is Professor of Medicine and Professor of Microbiology. Thi

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 Bhimraj, MD. Director of Education and Fellowships, Division of Infectious Diseases, Houston Methodsit Hospital. Chair IDSA Guidelines for COVID-19. This episode of Editors in Conversation is brought to you by the Antimicrobial Agents and Chemotherapy Journal and hosted by AAC Editor in Chief, Cesar Arias. AAC is available at https://asm.org/aac. Follow Cesar on twitter at https://twitter.com/SuperBugDoc for AAC updates. Subscribe to the podcast at https://asm.org/eic

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 over the past year. And so as you’ll see, thanks to the different areas of expertise and general interest among our panel today, we’ve selected quite a variety of papers to discuss, ranging from evaluation of new blood culture systems to use of metagenomics for infective endocarditis and to the potential application of interferon gamma release assays for detection of Histoplasma infections. And so, suffice it to say, there will be something of interest for everyone listening. But, for those watching today, you are clearly

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 over-reporting of organisms from respiratory tract cultures can lead to over treatment with antimicrobials. Guests: Dr. Sarah Parker, pediatric infectious disease specialist at Children’s Hospital Colorado and the Medical Director of the Antimicrobial Stewardship Program. Dr. Andrea Prinzi, infectious disease medical science liason with bioMerieux. This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available

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 follow an academic and research pathways Future perspectives and guidance for early stage investigators who want to pursue research on antimicrobial resistance. Guests: Cheyenne Lee.  4th Year Ph.D. Candidate | McBride Lab, Microbiology and Molecular Genetics (MMG) Program Initiative for Maximizing Student Development (IMSD) Graduate Student Representative, Emory University, Atlanta, GA. T32 predoctoral fellow Edwin Chen, MD, PhD. Infectious Diseases Fellow, Postdoctoral T32 Fellow, University of Pittsburgh. Pittsburgh,

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 initial leap into automated culture and imaging systems, but what’s next? Are the digital pathology AI algorithms ready for prime-time in clinical microbiology labs? Is the future now? Guests: Dr. Niaz Banaei, Medical Director of the Stanford Health Care Clinical Microbiology Laboratory and Professor of Pathology and Medicine at Stanford University Dr. Dan Rhoads, Section Head of Microbiology at Cleveland Clinic This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JC

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 clinical labs pay to CMS. If you have been waiting for someone to explain these changes and how they could affect your lab, you’ve come to the right podcast. Guests: Dr. Melissa Miller, Director of the Clinical Microbiology Laboratory and a Professor at the University Of North Carolina School Of Medicine Mary Lee Watts, Director of Federal Affairs at ASM This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM

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, prologued 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 Treatment approaches and rationale for these strategies Guests: Kelly Dooley, MD. PhD, MPH.  Professor of Medicine, Johns Hopkins University and Editor of AAC Charles L. Daley, MD, Professor and Chief of the Division of Mycobacterial and Respiratory Infections. National Jewish Health Thomas Dick, PhD. Professor, Center for Discovery and Innovation, Hackensack Meridian Health This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members

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 significance? • How common is the inoculum effect with Staph aureus and cefazolin?

As July 26, the world has documented 19,188 cases of monkeypox, with 3,591 cases in the US alone, making the US the country with the most known infections amid the global outbreak. The WHO has declared monkeypox a public health emergency. Although this disease has been known for years, certain features suggest that we are facing a unique outbreak of monkeypox with the potential for worldwide spreading. In this special podcast edition of Editors in Conversation we will discuss the diagnosis and treatment of monkeypox with experts in the field who have dealt with significant number of cases in the US. Topics: • The significance of the monkeypox outbreak • The approach for the diagnosis of monkeypox • The treatment approaches and prevention tools for monkeypox This special episode is brought to you by Journal of Clinical Microbiology and Antimicrobial Agents and Chemotherapy journals. Hosts: - Cesar A. Arias, Editor in Chief of AAC, - Dr. Elli Theel, Editor of JCM This podcast is supported by the American Societ