Dr. Olga Klinkova, Infectious Diseases Clinician at the Moffitt Cancer Center and Research Institute, discusses the recent updates to the diagnosis and management of community acquired pneumonia. Dr. Klinkova begins her talk by referring to the recently introduced IDSA-ATS guidelines, released in August, 2019. She then discusses updates in the microbiology of CAP, including the most likely organisms, the role of MRSA, atypicals and the significance of viral pathogens. She then mentions diagnostic modalities and the relevance of clinical prediction algorithms such as CURB-65 and the Pneumonia Severity Index (PSI). Treament considerations including outpatient versus inpatient, and inpatient non-severe versus inpatient severe management are also differentiated. Specific treatment agents and therapy durations are also mentioned. Lastly, she discusses options for the management of MRSA pneumonia and aspiration syndromes.
Dr. Ju Hee Katzman begins her lecture by discussing some basic epidemiology of Tuberculosis, a major killer worldwide and still a significant infectious cause of mobility in the U.S. Dr. Katzman reviews the traditional diagnostic modalities for diagnosing TB (including expectorated sputum samples for smear and culture). She then goes on to discuss specific molecular techniques for diagnosing TB that will play an increasingly larger role in the future. Lastly, she touches upon the ways in which AI (Artificial Intelligence) can be utilized to detect and treat active tuberculosis in settings where health provider availability is greatly challenged.
Dr. Bachmeier presents an up-to-date review of newer-generation antimicrobials designed to be effective against infections with multiple drug-resistant pathogens. He first reviews the different types of extended-spectrum beta-lactamase (ESBL) resistance. He then discusses the significance of Carbapenemase-producing enterobacteriaceae and ESBL producing E coli, Klebsiella pneumonia, and Pseudomonas aeruginosa strains. Such organisms have become increased threats to our patients over the last two decades while new drug approvals have dwindled. Dr. Bachmeier reviews Ceftolozane-tazobactam, Ceftazidime-avibactam and their current indications. He then reviews Meropenem-vaborbactam and its utility in the treatment of Klebsiella pneumonia carbabenemase (KPC) infections. He then discusses imipenem-relebactam and its advantages in the treatment of MDR gram-negative infections. Lastly, he reviews plazomycin, eravacycline, and Cefiderocol.
Dr. Sinnott’s grand rounds presentation reflects upon the history of infectious diseases, from the late 1960’s, when the battle with infectious agents was felt to have been won, to the present age of widespread antimicrobial resistance, emerging pathogens, and the newer therapies of the “post-antibiotic era.” He focuses on genetic susceptibility, and how this has played a major role in infectious diseases outbreaks of the past. He also touches upon commercial “boutique” genetics services which offer to sequence an individual’s genome for ancestry and hereditary purposes. Lastly, he comments on the importance of the human microbiome to disease susceptibility and wellness.
Dr. Nguyen examines the complex problem of the addiction crisis, a major cause of morbidity and death in much of the US, and especially in the state of Florida. He first discusses the epidemiology of addictive disorders and the US states where these patients are more likely to be found. He then discusses specific addiction-related medical syndromes, including acute eosinophilic pneumonia, crack cocaine lung, complications of body packing, fungal sinusitis, endocarditis, skin and soft tissue infections, fungal pneumonia, and other septic complications of injection drug use
Dr. Oehler discusses three fascinating patients from his archives involving cases that were good enough to publish in medical journals. He first discusses a 59 year old patient with a fever, headache, and a lytic bone infection. He next reviews a 49 year old homeless man with an aquatic cellulitis and an unusual bacteremia. Lastly, he shares the history on a 50 year old patient with acute graft thrombosis after eating at a mexican restaurant. In the process of discussing these cases, Dr. Oehler discusses the differential diagnosis of these presentations and the unusual syndromes that form the ultimate diagnoses.
Dr. Lopez-Perez examines the infectious diseases syndromes that via bioterrorism and natural outbreaks could be responsible for “end of the world” scenarios. He initially focuses on agents of bioterrorism, including Anthrax, Smallpox, Plague, Tularemia and Botulism. He then goes on to discuss the threat posed by pandemic influenza. He also touches upon the possibility of genetically engineered pandemics, in which techniques such as “CRISPR” could be used to create “designer organisms” or to replicate or modify already fearsome pathogens (such as influenza or smallpox) with devastating results.
Dr. Kraitman reviews the chronology of cancer treatment history, beginning with the dawn of cancer surgery and progressing through radiation, chemotherapy, immunotherapy, and ultimately, gene therapy. He then explains the basics of Chimeric Antigen Recepter T Cell therapy, a new state of the art therapy utilizing targeted T cells to destroy specific cancer cells. Dr. Kraitman then discusses potential toxicities of CART therapy, including neurotoxicty, Cytokine release syndrome, and HLH, and approaches to manage these adverse effects. Lastly, the speaker discusses infections associated with CAR-T therapy, including bacterial, fungal, and viral pathogens from a clinical series.
Dr. Sabapathy reviews the epidemiology of tick-borne diseases. She discusses the common identification techniques for the various tick species. She compares and contrasts Lyme disease versus Southern Tick-associated Rash Illness (STARI). She also draws a distinction between Lyme and Borrellia myamotoi. Lastly, she discusses how climate change is increasing the prevalence and distribution of tick-associated infectious diseases.
In this comprehensive review of breast feeding and breast milk by a physician and new mom, Dr. Asquith opens by discussing why breast feeding benefits both babies and their mothers. She relates the common reasons why some moms elect not to breast feed or stop breast feeding early. Dr. Asquith then shares data on the epidemiology of breast feeding by across the country. Next, she mentions the typical schedule for a breast feeding mom and essential care steps to ensure proper hygiene for breast feeding equipment. Dr. Asquith then dives deeper into some of the immunological and anti-infective benefits of nursing. She then shares information on the safety of nursing when a mom is sick with infectious syndromes like the Flu, travelers diarrhea, HSV and Zika virus. She closes by touching on milk banking and human milk pasteurization.