Notification at this web site.

The University of Washington's National HIV Curriculum, headed by Dr. David Spach, is one of the best on-line resources for HIV information anywhere.

I refer people to it *all the time*.

Really hoping valuable resources like this are up and running again soon. #IDSky
www.hiv.uw.edu

Association between Delayed Broad-Spectrum Gram-negative Antibiotics and Clinical Outcomes: How Much Does Getting It Right with Empiric Antibiotics Matter? Empiric antibiotics are frequently unnecessarily broad-spectrum. This study compared clinical outcomes between matched patients who received early vs. dela

Ceftriaxone FTW as empiric GNR coverage! No increased risk of harm to patients who had escalation of ABX therapy. #IDSky
academic.oup.com/cid/advance-...

I worry about the same with cabotegravir prep.

Virologic failure and emergent integrase strand transfer inhibitor drug resistance with long acting cabotegravir for HIV treatment: A meta-analysis Although 48-week virological failure rates were low, emergent integrase resistance among those failing injectable cabotegravir was common (41-71%), and cro

Potential impact of increasing CAB/RPV use on the future efficacy of INSTIs as first-line therapy for HIV.

#IDsky #HIVsky

@cidjournal.bsky.social

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

【Mayo Clinic CME Orthopedic Infectious Diseases 2025】

👉Comprehensive #OrthoID learning course is coming soon!

👉Great learning opportunity for #IDFellow #IMResident #OrthoResident!

ce.mayo.edu/orthopedic-s...

#IDMedEd #IDFellow #OrthoID #MayoClinicINFD #MSIS #EBJIS

🆕🔥Just published 🔥🆕
Updates on the Treatment of Drug-Susceptible and Drug-Resistant Tuberculosis(TB)
An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline #idsky #TBsky
www.atsjournals.org/doi/full/10....

“Weight and See”: Initial Weight Gain After Starting Antiretroviral Therapy Is Not Associated With Antiretroviral Regimen Type And Does Not Predict Subsequent Weight Trajectory Abstract. In a Canadian HIV cohort, 61% gained/26% lost/12% stable weight in the first year of antiretroviral therapy (ART). Weight gain was not associated

🆕💫“Weight and See”: Initial Weight Gain After Starting Antiretroviral Therapy Is Not Associated With Antiretroviral Regimen Type And Does Not Predict Subsequent Weight Trajectory #idsky #hivsky
academic.oup.com/ofid/advance...

Outcomes of Debridement, Antibiotics, and Implant Retention in the Management of Infected Total Knee Arthroplasty: Analysis of 5,178 Cases from the National Australian Registry - PubMed These findings underscore the critical influence of patient-related factors and the timing of DAIR treatment on the need for additional surgery. DAIR after four weeks had an increased risk of subseque...

The cutoff for what constitutes “Acute PJI” is inconsistently (and somewhat arbitrarily) defined, but this recent cohort study of >5000 DAIR procedure out of Australia suggests that treatment outcomes deteriorate when DAIR is performed more than 4wk postoperatively

pubmed.ncbi.nlm.nih.gov/39710215/

Not because thrush is a critical OI but more as evidence that anti-cd4 and low cd4 in these patients does (or doesn’t) impact immune response

For sure, outcomes data is so hard to get critical mass to make conclusions, especially for more rare OIs. I do wonder if querying thrush diagnosis or treatment would be frequent enough to still see a signal here.

This is excellent and interesting! Any plans to look at OI outcomes?

Cant wait, the waxing poetical phase of innoculum effect has worn thin

Also helpful in these sub-analyses that aren’t p value approved to show all the data: do the comorbidities skew hard in these smaller groups with innoculum effect based on treatment received?

This one is a bit fuzzy to me. Why isn’t the comparison in efig3 more direct: cefazolin vs oxacillin for each innoculum effect instead of presence of abscence.

Looks like in figure 2 almost all cefazolin InE strains also had oxacillin InE (but not vice versa)?

Cheap, smart and efficient: how giant rats are transforming the fight against TB After success in Tanzania, other African countries may introduce the rodents to help sniff out the disease

“… rats have detected #Tuberculosis but follow up clinical tests have been negative; in some of these cases, patients later developed TB... Apopo is monitoring these patients to better understand rats’ sensitivity to low levels of bacteria”.
www.theguardian.com/global-devel...

Ayer el #CDC reportó el 1er caso confirmado en 🇺🇸 de enfermedad severa por influenza A aviar H5N1 #birdflu en humanos. Desde Abril 2024: 61 casos en humanos en USA. Hasta ahora transmisión entre humanos NO se ha demostrado. #idsky #pedsidsky Link:
www.cdc.gov/media/releas...

Educational graphic

Spinal implant infections are a serious complication of fusion surgeries. Our faculty member, Dr. Tai, is advancing understanding of their diagnosis and management, focusing on the key differences between early and chronic infections. #IDSky
academic.oup.com/cid/article/...

Science’s 2024 Breakthrough of the Year is lenacapavir, an injectable drug that demonstrated remarkable success at preventing HIV infection with one shot every 6 months. The drug attaches to the lattice-like capsid proteins that shield the virus’s genetic material—a mechanism that could inspire other antivirals. Lenacapavir could help end the HIV/AIDS epidemic, but that will hinge on access for those who need it most.

Science’s 2024 Breakthrough of the Year is lenacapavir, an injectable drug that demonstrated remarkable success at preventing HIV infection with one shot every 6 months.

Learn more about this year's #BOTY and other big advances in science: scim.ag/3BrCtUn

#3 can be great, but key is to give the fellow the appropriate tools and system for finding quality research on a topic. Easy to get in the weeds as a trainee.

Alright #IDSky, #HIVSky, let’s get talking. I have some questions about the RePRIEVE trial. I’ve been mulling over the results, and have a few potential critiques* that come from a place of genuine curiosity. Hoping for some discussion; particularly if you think I missed something.

Flat dosing of pyrazinamide at 1000mg achieved a higher proportion of participants within the therapeutic window compared with weight-banded dosing and flat dosing at 1500mg

Has anyone already switched to flat dosing of pyrazinamide at 1000mg/day for TB?

doi.org/10.1164/rccm...

#IDSky
#TBSky

Seems like culture negative sepsis might be a wide net that includes a number of non-infectious etiologies that wouldn’t be antibiotic responsive and have poor prognosis. Were they “Pulmonary origin sepsis” or organ failure resulting in pulmonary syndrome. (Hepatopulmonary, cardiopulmonary).

Across 14 studies with ~21k patients, PICC lines had a two-fold higher risk of bloodstream infection than midlines, but midlines had higher rates of superficial vein thrombosis, infiltrations, and leaks. PICCs are higher cost and have higher patient dissatisfaction. www.cambridge.org/core/journal...

“Oh, I always am cold”
-patients that think their struggle is finally being seen when I ask about chills…

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. In a multicenter, non...

🔥BALANCE RCT🔥
74 hospitals in 7 countries
3,608 patients
A 7-day course of antibiotics for hospitalized patients with bloodstream infections was non inferior to 14d within a 4% prespecified margin for mortality at 90 days #idsky
www.nejm.org/doi/full/10....

That's what I came up with for now, sorry it got a little long. Curious to hear others' input!

Statins felt like a safer thing to poke around at on IDSky than something more sacred like whether innoculum effect exists (*ducks*).

Supplemental Figure 8b, Reprieve Trial

5. There's a lot of chatter in my circles about the number needed to treat (NNT) from this figure. Here, the calculation for NNT used the overall 35% risk reduction and applied it to each subgroup, even though each subgroup has different risk reduction. Is this presentation of NNT legit stats-wise?

Excerpt of Table 2 from Reprieve trial.

4. Only the subgroup of 5-10% risk showed stat sig benefit. Combined, for 0-5% risk, statin had no effect (1.8% vs 1.7%). Reduced MACE was largely driven by patients with > 5% risk, and statins already should be considered here HIV or not. Should this change how we view statins in low risk PLHIV?

3. Cardiologists (ACC) say consider statin when risk is 5%-7.5%. Statins reduce MACE in this group (e.g. HOPE-3 trial), but still ACC says "consider." Based on REPRIEVE, HIV societies recommend statin universally in this group. Why are ACC recs different than our societies at this risk level?