In this updated talk, Dr. Oehler discusses the assessment and management of infections of central catheters. Dr. Oehler begins his talk by covering the epidemiology of central line infections, including the most common organisms involved, and covers the different types of intravascular devices. He then discusses the mechanisms by which central line associated bloodstream infections (CLABSI’s) occur, differentiating hematogenous, hub-related, entry site, and infusate-related etiologies. He also covers infection risk factors, the diagnostic workup, and under what circumstances device removal is necessary. Infection management in the context of specific pathogens is also addressed. Furthermore, Dr. Oehler discusses the concept of antibiotic lock therapy and how it can be an adjunctive management strategy. Lastly, Dr. Oehler differentiates between insertion site and exit site infections where they relate to tunneled catheters and offers a summary of the 5 most effective approaches to reducing CLABSIs in the hospital setting.
Dr. Kraitman reviews the management and treatment of infections occurring in the pregnant female. He initially reviews medication pregnancy risk categories, and then through interactive case review, goes over several examples where antimicrobial agents are used that are contraindicated in pregnancy. He reviews interactions relevant to HIV/AIDS, AIDS associated opportunistic infections, Tuberculosis, Malaria, CMV, Syphilis, and Listeria. He closes by providing information on useful reference resources for managing infections in pregnancy.
The relationship between genetics and infectious diseases is explored. Dr. Akoghlanian also discusses the immune system’s innate and adaptive components, and presents pathogen-host interactions at different levels of the immune system. Lastly, the major types of iatrogenic, acquired, and genetic immune deficiencies are presented, including IgA deficiency, Common variable immhunodeficiency, terminal complement deficiency, MPO deficiency, Chediak-Higashi syndrome, CGD, and others.
Dr. Lakshmi discusses the infectious evaluation of burn patients. She relates the common sources of fever, the principles of burn management, and both common and uncommon infections in the burn victim. Lastly, she mentions other infectious conditions not directly related to the burn exposure that must also be considered.
Dr. Addisu looks at inflammation, and how it can be used as a marker of certain physiologic processes such as infection. He then differentiates the different types of acute phase reactants that are well-described markers of inflammation. He focuses upon the two most widely used markers, the erythrocyte sedimentation rate (ESR) and the C-reactive protein, and compares and contrasts the two. Next, he discusses the procalcitinin and the white blood cell (WBC) count. He closes by contrasting the activity of different inflammatory markers (IM’s) in infectious syndromes such as sepsis and endocarditis, and briefly touches upon several novel assays which show promise as IM’s of the future.
Dr. Sampson looks at the underlying features of a “zooonotic” disease. She then discusses how increasing globalization has interwoven with zoonoses to produce widespread outbreaks of Influenza, SARS, Nipah Virus, and Ebola virus disease. Among the most notable of the Zoonotic diseases of the last several decades is HIV, and she presents a fascinating review of how this retrovirus originated from primates and then spread around the world in only a relatively short period of time.
Drawing inspiration from sessions she attended at IDWeek 2017, Dr. Fredenrich discusses the sociological aspects of antimicrobial stewardship, including the strategies that can be employed to change the prescribing habits of frontline clinicians. She discusses the social determinants of antibiotic prescribing, such as clinician-clinician relationships, patient expectations, fear of adverse consequences, and other pressures. Dr. Fredenrich also discusses everyday barriers, such as trust-building and knowledge sharing that can improve the overall success of an antibiotic stewardship program.
Dr. Kumar relates some of the basic concepts behind medical study design, enabling the listener to utilize simple tools to be able to review the medical literature with a critical eye. He also addresses the question, “What constitutes BEST evidence?” Dr. Kumar also reviews basic statistical concepts, including prevalence/pre-test probability, sensitivity and specificity, negative and positive predictive value, likelihood ratios, and post-test probability. The talk is a very easily understandable and relatable discussion of evidence-based medicine.
Dr. Daniel Haight, Associate Professor at the USF College of Medicine, and Vice President of Community Health with Lakeland Regional Health, presents a primer on ways to foster and enhance antibiotic stewardship efforts in your hospital or health care system. Presented to the northern Iceland clinics and hospital in Akureyri, Iceland in April, 2018. The presentation features English narration with Icelandic/English slide content. Part of IDPodcast’s international podcast series.
Dr. Pasikhova discusses the history of the Pneumocystis pathogen, its epidemiology, and how it is transmitted to patients. She also discusses the pathophysiology of the infection in the context of the immunocompromised cancer patient. The role of steroids in the aquisition of PJP infection is touched upon. Lastly, Dr. Pasikhova describes prophylaxis against Pneumocystis, including specific agents and their usual doses.