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Posts by Alfred Luk

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Join us next Tues. Feb. 10 at 11am ET for a webinar on practical, evidence-based approaches to fungal diagnostic testing.

Presented by Julie M. Steinbrink, MD, MHS, of Duke University and Martin Hönigl, MD, of Medical University of Graz, Austria.

Register: https://bit.ly/3OiX1Ez

2 months ago 4 3 1 0
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Single-Dose Amphotericin B for HIV-Related Cryptococcal Meningitis Cryptococcal meningitis remains a life-threatening opportunistic infection among people with advanced HIV, even in high-resource settings. For decades, the standard induction regimen in the United Sta...

Is It Time to Use Single-Dose Amphotericin B for HIV-Related Cryptococcal Meningitis in the USA?

The answer is yes!
doi.org/10.1001/jama...

3 months ago 23 11 5 0
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ASTMH - Non-CDC Options for Molecular and Serologic Testing for Parasitic Diseases Posted 19 March 2025

Great resource for parasitic testing options from @astmh.bsky.social while CDC services are offline.

5 months ago 6 3 0 0
Random Education: Aspergillus
Random Education: Aspergillus YouTube video by Dr. Glaucomflecken

Aspergillus by @glaucomflecken.bsky.social

8 months ago 2 0 0 0
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For the awake and dedicated. 7am session - top papers in transplant ID. #TxID #WTC2025

8 months ago 6 0 0 0
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AJT Transplant ID Exchange

Don't miss the new @amjtransplant.bsky.social #TxID blog led by Emily Blumberg ajt-transplant-id-exchange.squarespace.com #wtc2025 @ast-idcop.bsky.social @ast-tyfcop.bsky.social @astinfo.bsky.social

8 months ago 13 6 0 0
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Dr. Robert (Bob) Rubin Transplant ID Award Recipient for 2025 is the amazing @kottonnelson.bsky.social !!! #TxID #MedEd @astinfo.bsky.social

8 months ago 29 8 0 1
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Packed house at talk on #MDR challenging cases at #WTC2025 - clearly a growing concern in #TxID #IDSky discussion of ceftaz avi plus aztreonam v cefidericol for CRE @ast-idcop.bsky.social @txidfellows.bsky.social @astinfo.bsky.social @ttsorg.bsky.social

8 months ago 15 4 0 0
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Accuracy of plasma cell-free DNA PCR for non-invasive diagnosis of mucormycosis | Journal of Clinical Microbiology Mucormycosis is an invasive mold infection associated with high morbidity and mortality. Early diagnosis and effective antifungal treatment are critical for improving clinical outcomes. However, diagn...

Accuracy of plasma cell-free DNA PCR for non-invasive diagnosis of mucormycosis

@jordan1990.bsky.social and colleagues at Stanford

journals.asm.org/doi/10.1128/...

9 months ago 18 10 0 1
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Lack of Association Between Histoplasma Urine Antigen Values and Clinical Response in Persons without HIV AbstractBackground. Histoplasma urine antigen detection, a valuable diagnostic tool, is often used to monitor response to antifungal therapy, but persisten

Lack of Association Between Histoplasma Urine Antigen Values and Clinical Response in Persons without HIV

Marisa Miceli and colleagues

academic.oup.com/ofid/advance...

8 months ago 11 6 2 1
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Outcomes of Invasive Aspergillosis in Liver Transplant Recipients From an Institution Using Targeted Antifungal Prophylaxis and an Antifungal Stewardship Program Background Recent evidence suggests liver transplant recipients (LiTRs) with invasive aspergillosis (IA) have lower rates of dissemination and mortality compared to historical data. However, contemp...

Outcomes of Invasive Aspergillosis in Liver Transplant Recipients From an Institution Using Targeted Antifungal Prophylaxis and an Antifungal Stewardship Program

Duke TxID fellow Brennan Collis and co from Melbourne

IA was uncommon, mortality low in LiTx

onlinelibrary.wiley.com/doi/10.1111/...

11 months ago 9 1 0 0

Register @ cmvstream.com

11 months ago 1 0 0 0
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CMV Stream 2025 - CMV STREAM Live Online! CMV Management in Solid Organ Transplantation Insights and Challenges from the New 4th Consensus Guidelines Friday, April 25th, 2025 3:00 PM EST REGISTER NOW Register Now Days Hours Minut...

Registration link: cmvstream.com

11 months ago 1 0 0 0
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🍄🍄Happy to share the link to free full text version of our new article in press: Current Antifungals and the Developing Pipeline with the fantastic @moorewjustin.bsky.social. #IDSky #PharmSky Thank you to the editors @drluiso.bsky.social @alukmd.bsky.social & Dr. Helen Boucher for the opportunity.

1 year ago 11 7 1 0
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Histoplasmosis (2025)

Update on the Clinical Practice Guidelines for treatment of Histoplasmosis. Thank you to all the authors @fungaldoc.bsky.social @germhuntermd.bsky.social @jobadd.bsky.social @iddoc4kids.bsky.social Nathan Bahr

www.idsociety.org/practice-gui...

1 year ago 19 3 1 0
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Facts and myths about measles It seems ironic that Robert F Kennedy Jr, one of the most prominent antivaccine activists, has been made Secretary of Health and Human Services in the USA while one of the largest recent measles outbr...

Facts and myths about measles

@thelancetinfdis.bsky.social @hoferu.bsky.social

www.thelancet.com/journals/lan...

1 year ago 24 10 0 1
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New upcoming seminar from TTS to address a growing concern in the immunocompromised community: Measles

tts.org/116-tts/educ...

1 year ago 6 1 0 0

😱

1 year ago 0 0 0 0

Was an honor to work with @drluiso.bsky.social and all the amazing authors who contributed to this issue!

1 year ago 0 0 0 0
SCIENCE IN PERIL

Research funding at risk

UNDERSTANDING RESEARCH COSTS

Research requires funding for both direct costs (like lab supplies) and Facilities & Administrative (F&A) costs.

F&A covers essential expenses that support research but aren't tied to a single project, such as...

IT and cybersecurity for data protection

Laboratory space and utilities

Administrative support for grants and operations

WHAT WILL HAPPEN IF F&A COST REIMBURSEMENT RATES ARE CUT?

Research institutions will lose millions of dollars to do critical research

THE IMPACTS WOULD BE DEVASTATING.

Fewer clinical trials, delaying new treatments

Slowed scientific discovery and innovation

Weakened local economies and research-driven industries

Job cuts and fewer opportunities to train future leaders

SCIENCE IN PERIL Research funding at risk UNDERSTANDING RESEARCH COSTS Research requires funding for both direct costs (like lab supplies) and Facilities & Administrative (F&A) costs. F&A covers essential expenses that support research but aren't tied to a single project, such as... IT and cybersecurity for data protection Laboratory space and utilities Administrative support for grants and operations WHAT WILL HAPPEN IF F&A COST REIMBURSEMENT RATES ARE CUT? Research institutions will lose millions of dollars to do critical research THE IMPACTS WOULD BE DEVASTATING. Fewer clinical trials, delaying new treatments Slowed scientific discovery and innovation Weakened local economies and research-driven industries Job cuts and fewer opportunities to train future leaders

Previous F&A cost reimbursement rates varied by institution. Rates averaged around 28%, but some organizations had negotiated rates over 60%.

Costs vary widely, with rates set based on factors like institution size, location, and rent or utility costs.

HOW IS RESEARCH AT RISK?

The National Institutes of Health (NIH) announced a policy change that limits F&A cost funding to 15% for both new and existing grants.

The policy drastically cuts essential federal support for biomedical research.

A group of universities and states filed a lawsuit claiming the funding cuts are illegal.

A federal judge temporarily paused the funding cuts, but F&A costs remain at risk.

Scientists and the public are speaking out to share how important it is to maintain funding for research and innovation.

RESEARCH SAVES LIVES.

NOW, WE MUST SAVE RESEARCH

Previous F&A cost reimbursement rates varied by institution. Rates averaged around 28%, but some organizations had negotiated rates over 60%. Costs vary widely, with rates set based on factors like institution size, location, and rent or utility costs. HOW IS RESEARCH AT RISK? The National Institutes of Health (NIH) announced a policy change that limits F&A cost funding to 15% for both new and existing grants. The policy drastically cuts essential federal support for biomedical research. A group of universities and states filed a lawsuit claiming the funding cuts are illegal. A federal judge temporarily paused the funding cuts, but F&A costs remain at risk. Scientists and the public are speaking out to share how important it is to maintain funding for research and innovation. RESEARCH SAVES LIVES. NOW, WE MUST SAVE RESEARCH

What’s at stake with proposed health research funding cuts?

Good explainer by Lizzy Knippler, Community Engagement Coordinator at the Duke CFAR. Please share these graphics widely!

1 year ago 19 14 1 0

The link doesn’t seem to be working?

1 year ago 1 0 0 0
Unfortunately and unsurprisingly, the administration continues to charge ahead, running roughshod over norms, laws, and the dignity of and most basic protections for the people most vulnerable to infections. Many of the changes are summarized here, up to date as of Feb 4. Who will speak up, or better still, ACT UP for these individuals?

The National Science Foundation has reportedly shared with program officers a list of forbidden "DEI"-related words that will result in grants being flagged. These include routinely used terms like "female", "biased", "systemic", "inclusion" and "exclusion" along with other words that specifically target vulnerable populations. While few clinical researchers rely on NSF grants, it can be reasonably expected that similar censorship with grants from NIH, CDC, etc is inevitable.
USAID funding remains frozen, and in fact there are reports of efforts underway to eliminate the entire agency. The effects have already been devastating for programs dedicated to controlling TB, malaria, and HIV, among others. Despite claims that these would be exempt, distribution of antiretrovirals remains frozen.
The Senate Finance committee advanced RFK Jr for confirmation as HHS Secretary. Kennedy's disdain for evidence-based medicine is no secret. He is a conspiracy theorist who engages in dangerous race-based pseudoscience. The IDSA has fallen short of other professional societies (e.g. the American Public Health Association, which represents 25,000 public health professionals) in calling for the outright rejection of RFK Jr's nomination.
The CDC and NIH remain muzzled, unable to communicate with interstate or international agencies or the public. They have been instructed to recall submitted or accepted manuscripts to scrub objectionable language. They remain barred from traveling until at least the end of April. How will these actions affect our ability to detect and respond to infectious disease outbreaks?

Unfortunately and unsurprisingly, the administration continues to charge ahead, running roughshod over norms, laws, and the dignity of and most basic protections for the people most vulnerable to infections. Many of the changes are summarized here, up to date as of Feb 4. Who will speak up, or better still, ACT UP for these individuals? The National Science Foundation has reportedly shared with program officers a list of forbidden "DEI"-related words that will result in grants being flagged. These include routinely used terms like "female", "biased", "systemic", "inclusion" and "exclusion" along with other words that specifically target vulnerable populations. While few clinical researchers rely on NSF grants, it can be reasonably expected that similar censorship with grants from NIH, CDC, etc is inevitable. USAID funding remains frozen, and in fact there are reports of efforts underway to eliminate the entire agency. The effects have already been devastating for programs dedicated to controlling TB, malaria, and HIV, among others. Despite claims that these would be exempt, distribution of antiretrovirals remains frozen. The Senate Finance committee advanced RFK Jr for confirmation as HHS Secretary. Kennedy's disdain for evidence-based medicine is no secret. He is a conspiracy theorist who engages in dangerous race-based pseudoscience. The IDSA has fallen short of other professional societies (e.g. the American Public Health Association, which represents 25,000 public health professionals) in calling for the outright rejection of RFK Jr's nomination. The CDC and NIH remain muzzled, unable to communicate with interstate or international agencies or the public. They have been instructed to recall submitted or accepted manuscripts to scrub objectionable language. They remain barred from traveling until at least the end of April. How will these actions affect our ability to detect and respond to infectious disease outbreaks?

Meanwhile, our members are experiencing significant moral injury, and some have expressed levels of morale that rival the nadirs felt during the worst of COVID19. Every day it is a new insult, the cumulative effect being the disassembly of public health protections and further marginalization of the most vulnerable in society. 

Reticence to call attention to ourselves, potentially putting our work in the administration's cross hairs, is entirely understandable. After all, we don't want to imperil existing and ongoing advocacy efforts, including those related to bolstering the ID workforce. A sober analysis would concede that the likelihood of any potential actions moving the needle on any of these issues is low. I would argue, however, that standing up for what is right is the most important thing we can do to reinforce our commitment to social justice and to our members and the patients in our care. 

What we can do and how we can do it is up for debate; some bold ideas have already been presented in the IDea exchange forum and I welcome further input from colleagues. What is certain is that as rank-and-file individuals, our voices can easily be dismissed, but as a trusted, bipartisan professional organization that represents >13,000 infectious diseases experts, we cannot be ignored, and we must not allow ourselves to cower in silence. The reality is that things are going to get worse, and standing up to the assault on public health will only get more difficult as the administration becomes further emboldened and the actions set in motion gather steam. 

In the words of John Lewis, "If not us, then who? If not now, then when?"

Meanwhile, our members are experiencing significant moral injury, and some have expressed levels of morale that rival the nadirs felt during the worst of COVID19. Every day it is a new insult, the cumulative effect being the disassembly of public health protections and further marginalization of the most vulnerable in society. Reticence to call attention to ourselves, potentially putting our work in the administration's cross hairs, is entirely understandable. After all, we don't want to imperil existing and ongoing advocacy efforts, including those related to bolstering the ID workforce. A sober analysis would concede that the likelihood of any potential actions moving the needle on any of these issues is low. I would argue, however, that standing up for what is right is the most important thing we can do to reinforce our commitment to social justice and to our members and the patients in our care. What we can do and how we can do it is up for debate; some bold ideas have already been presented in the IDea exchange forum and I welcome further input from colleagues. What is certain is that as rank-and-file individuals, our voices can easily be dismissed, but as a trusted, bipartisan professional organization that represents >13,000 infectious diseases experts, we cannot be ignored, and we must not allow ourselves to cower in silence. The reality is that things are going to get worse, and standing up to the assault on public health will only get more difficult as the administration becomes further emboldened and the actions set in motion gather steam. In the words of John Lewis, "If not us, then who? If not now, then when?"

I am deeply disappointed by the subdued response of the Infectious Diseases Society of America (@idsainfo.bsky.social) to the dismantling of public health structures, both in the US & globally

Here's what I wrote in the closed listserv (response: 🦗) in hopes of stimulating discussion here #IDSky

1 year ago 308 90 14 2
Visual Abstract

Visual Abstract

Would global warming bring an increase of invertebrate-associated cutaneous invasive fungal infections?

Kontoyiannis & Casadevall

journals.asm.org/doi/10.1128/...

1 year ago 19 7 1 0

Congratulations 🎉

1 year ago 0 0 0 0
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Impact of fluconazole on outcomes of patients with primary pulmonary coccidioidomycosis: a commercial health insurance claims-based, propensity score matched analysis AbstractBackground. Patients with pulmonary coccidioidomycosis often experience prolonged symptoms lasting weeks to months. Limited data exist regarding wh

Great work by CDC (Mycotic Diseases Branch) and @grthompsonmd.bsky.social. Healthcare data analysis evaluating fluc efficacy on pulmonary #coccidioidomycosis in immunocompetent patients. Again, fluc is not effective.
#IDSky #MedMyco

1 year ago 9 2 2 0
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The ACIP 2025 vaccine schedule for adults by medical condition (as well as age) is now available - with some great updates www.cdc.gov/vaccines/hcp...

1 year ago 15 9 0 0
Figure 1. Study flow diagram.

Figure 1. Study flow diagram.

Figure 2. Patients with proven or probable invasive pulmonary Aspergillus by diagnosis methods.

Figure 2. Patients with proven or probable invasive pulmonary Aspergillus by diagnosis methods.

Evaluation of Viracor Fungal Plus PCR Profile I @MSKCC

"In our cohort, PCR targeting Mucorales and Nocardia can improve the early detection of invasive pulmonary infection, whereas Aspergillus PCR has a low added value"

@fungalspore.bsky.social @ebabady.bsky.social
journals.asm.org/doi/10.1128/...

1 year ago 16 5 2 0
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Summary of new antibiotic agents for the treatment of MDR Gram negative bacterial infections

doi.org/10.1016/S014...

#IDSky

1 year ago 29 13 4 2
Mortality risk according to antiretroviral therapy (ART) status at the time of presentation with cryptococcal meningitis. The dynamic relationship between time on ART at cryptococcal meningitis presentation and mortality risk in the combined Ambisome Therapy Induction Optimisation (AMBITION) and Antifungal Combinations for Treatment of Cryptococcal Meningitis in Africa (ACTA) cohort was determined using univariable logistic regression models with days on ART as the single predictor (using restricted cubic splines with 3 knots) and mortality as the outcome for (A) 2-week and (B) 10-week mortality, restricted to participants on ART for up to 6 months. The gray shading represents 95% confidence intervals. Mortality risk in those on ART for more than 6 months and those not on ART at the time of cryptococcal meningitis diagnosis are shown for comparison, with error bars representing 95% confidence intervals, and the dotted line indicating the mortality risk estimate in those not on ART.

Mortality risk according to antiretroviral therapy (ART) status at the time of presentation with cryptococcal meningitis. The dynamic relationship between time on ART at cryptococcal meningitis presentation and mortality risk in the combined Ambisome Therapy Induction Optimisation (AMBITION) and Antifungal Combinations for Treatment of Cryptococcal Meningitis in Africa (ACTA) cohort was determined using univariable logistic regression models with days on ART as the single predictor (using restricted cubic splines with 3 knots) and mortality as the outcome for (A) 2-week and (B) 10-week mortality, restricted to participants on ART for up to 6 months. The gray shading represents 95% confidence intervals. Mortality risk in those on ART for more than 6 months and those not on ART at the time of cryptococcal meningitis diagnosis are shown for comparison, with error bars representing 95% confidence intervals, and the dotted line indicating the mortality risk estimate in those not on ART.

We know that in ART-naive patients with Cryptococcal meningitis, ART initiation should be delayed, but what about those already on ART?

In this retrospective analysis, higher mortality observed w recent ART (<2 wks), and with ART continuation vs interruption

academic.oup.com/cid/advance-...

1 year ago 28 8 1 0
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#idboardreview Pt pricked his thumb w/ wood splinter. 1 wk later, painless papule at injury site & over next weeks, tender lymphangitis developed. No improvement w/oral cephalexin or amox-clavulanate. No fever nor systemic sx, no travel/water exposure #IDSky #idmeded #meded #dermsky

1 year ago 15 2 1 0