ID:IOTS: Recent Episodes
Infectious Disease: Insights of Two Specialists
Join Callum and Jame, two infectious diseases doctors, as they discuss everything you need to know to diagnose and treat infections. Aimed at doctors and clinical staff working in the UK. Queries, comments, suggestions to idiotspodcasting@gmail.com
Paediatric AMS? Surely there aren't any issues with antimicrobial use in paediatrics?!
Jame hears from Dr Charlotte Fuller and Dr Sanjay Patel that yes, yes there is a problem! And YOU can do something about it.
Listen in to hear the answers to these questions:
- What do we know about AMR and antimicrobial use in children?
- What are the barriers to responsible antimicrobial use in children?
- How can DGH AMS teams and paediatrics support each other?
- Are there any other paediatric-specific considerations for infection prevention, diagnosis and management?
- Where can microbiologists learn more about paediatric infection? HINT it is here: https://uk-pas.co.uk/ and here https://bsac.org.uk/paediatricpathways/
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Access
Watch
Reserve (IE the cool stuff)
What are they? Where are they? WHO ARE THEY?
Listen on and find out! (Looking at the prep notes strongly advised for this one).
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There's nothing new under the sun... except for these new antifungals which we will now educate you on!
- One's an inhaled azole (OK not that new)
- One's sort of an echinocandin (shut up)
- Two are unpronounceable (but related to fungicides which we're using already)
And Alyssa and Jame are joined by Dr Neil Stone, ID:IOTS Podcast Novel Antifungal Agent Correspondent, to guide you through it all!
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Callum was recently on the Primary Care Knowledge Boost podcast (https://pckb.org/), talking about what happens to microbiology specimens sent in to the lab. He did so well we thought we'd share it with you here! Enjoy...
Original podcast blurb here:
Doctors Lisa and Sara are joined by Medical microbiology and Infectious Diseases Consultant Dr Callum Mutch to follow the journey of a urine sample and a throat swab as they are processed. We discuss the important points to get right in the pre-analytical, analytical and post analytical stages of their journeys. Some fascinating insights (including how the clinical details can affect what is tested for) that have changed our practice for the better.
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Process your Polyene Prescribing Paralysis by partaking in this proliferous podcast pondering on the particulars of these P-harmacological agents.*
*Alyssa had no part in the making of this podcast description.
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Jame and Callum are joined by Christina Petridou. In this episode we give you an overview of ticks and the key infections they transmit..., but NOT Lyme disease.
Some of the infections we DO cover include: Rickettsiosis (spotted fever group), relapsing fevers, anaplasmosis, ehrlichiosis, babesiosis, TBE & CCHF.
Not Lyme. THIS IS NOT A LYME DISEASE EPISODE.
Show notes (including lots of summary tables and horrible tick pics) for this episode are here.
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Flucytosine. A much maligned antifungal, consigned to adjuvant use in Cryptococcus...
WELL THAT CHANGES... well not today because the resistance barrier is shockingly low, but at least in 20m time you'll know all you need to about 5-FC!
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- Lab containment levels 1-4
- Safety cabinets 1-3
- ACDP approved list of biological agents 2-4
- Counterterrorism act schedule 5 pathogens
- Cat A and Cat B transport
- SAPO?!
Confused? We're not surprised, but things will all become clear.... Once you listen to this masterclass from Dr Claire Gordon on all things biosafety and biosecurity from a UK lab perspective.
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What could be more Rare Imported or Pathogenic than the Viral Haemorrhagic fevers?!
Callum is joined again by Drs Claire Gordon and Amy Bellfield to talk all things VHF and HCID from the clinical lab perspective.
We're sure you'll all be Very Happy Fans by the end of this one...
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Terbinafine! Griseofulvin!
2 weird antifungals that the dermatologists use much more than us!
But we here at the ID:IOTS Podcast love all our antifungal agents equally so here's an episode on literally everything you need to know about both these agents!
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Now this an episode, first of a triple
About all the work of a lab called RIPL
And we'd like to take minute now so sit right here
And learn about all the horrible pathogens you now should fear
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Part 2 of 2 on Echinocandins!
Tihana Bicanic gives a masterclass on Rezafungin, its use now and in the future, and gives an update on the relevant clinical trials and studies you need to know to make you a Master Echinocandologist.
Alyssa and Jame are here too, but very much in receive-only mode. Listen in and find out why!
Notes for this episode are found here: https://idiots.notion.site/132-133-Echinocandins-2d76a1ea09d8811f800ad3a446c6726e
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Alyssa and Jame are joined by Tihana Bicanic, to discuss the second great antifungal drug class, Echinocandins.
Part 1 of 2! (this episode we discuss the old stuff, next episode we discuss Rezafungin in more detail).
Show note for this episode found here: https://idiots.notion.site/132-133-Echinocandins-2d76a1ea09d8811f800ad3a446c6726e
(Note if you have any echo on the audio for this episode, try re-downloading the episode)
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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BIOCIDES ARE COMING FOR YOU.
Find out what they are, what the benefits and harms they have, and what we can do to control their use in consumer products.
This was a fascinating, wide-ranging discussion on the use of agents that can affect the human/animal microbiome and environmental microbes, and the problems with trying to regulate them (in the UK at least). Hope you enjoy it.
Bios:
Natalie Bennett has been a Green Party representative in the UK House of Lords for six years, after being leader of the England & Wales Party from 2012-2016. Her first degree - from the University of Sydney - was in agricultural science, and she can get very geeky about soils; she got tardigrades into Hansard (the parliamentary record) for the first time ever in her maiden speech. Her Consumer Products (Control of Biocides) Bill was introduced to the House in January 2025. Her first book is Change Everything: How We Can Rethink, Repair and Rebuild Society, and her second (Green Thinking Unlearning Outdated Ideas in Science, Economics and Politics) will be out from Routledge next April.
Anastasia “Tash” Theodosiou is an Academic Clinical Lecturer at the University of Glasgow and a Specialty Registrar in Microbiology & Infectious Diseases. Her research explores how the microbiome shapes health and disease, with a particular focus on early life; her PhD produced the world’s first human challenge study performed in pregnancy. She also coined the term microbiotoxicity, a framework for recognising the unintended impacts of antimicrobial products on the microbiome, and is a passionate advocate for embedding microbiome stewardship into clinical practice, prescribing, and policy.
Jame is a podcaster. He works for the NHS on occasion.
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Flustered by fluconazole?
An ignoramus on itraconazole and isavuconazole?
Puzzled by Posa? VEXED BY VORI?
Never fear: You can be amazed at the Azoles, just learn how to use 'em right! That's what this episode's all about! Alyssa and Jame UNITE in the first of our episodes on antifungal drugs!
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AKA Penicillin Allergy 3: Delabel Hard With A Vengeance
A departure from our semi-annual penicillin allergy episode: one on cephalosporin allergy!
Jame and Callum are joined by Fionnuala Cox to discuss Cephalosporin allergy in general, and the CEPH-FAST risk assessment tool in particular.
Ever wanted to know how to deal with cephalosporin allergy? Listen on!
Paper here:
Cox F, Vogrin S, Sullivan RP, Stone C, Koo G, Phillips E, et al. Development and validation of a cephalosporin allergy clinical decision rule. Journal of Infection. 2025 June 1;90(6). Available from: https://www.journalofinfection.com/article/S0163-4453(25)00089-1/fulltext
https://doi.org/10.1016/j.jinf.2025.106495
(It's open access, don't worry)
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Yo ho ho, for our listeners dearest
We present an antibiotics tier list
Ranking drugs from S to D
In a manner oh so Christmassy
So sit back relax and have a drink
As we discourse in cladist think
And if you rank a different way
We'll forgive you this Christmas day.
Proper episodes next year. See you in 2026!
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In which Callum and Jame discuss Brucellosis, named after a Scottish feminist, a disease hard to diagnose but easy to treat, as long as the treatment works which it may not. Listen on!
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It's the best pun Cal's ever done, and I don't say that lightly, son. Here's an episode on Capnocytophagia!
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It’s World Antimicrobial Awareness Week! And did you know AMR might kill us all? The British Society of Antimicrobial Chemotherapy do, and they’ve partnered up with interested politicians to drive AMR up the political agenda. But how?
Jame is joined by Dr Helen Callaby, Dr Nick Brown and Dr Danny Chambers MP to discuss the workings of the UK’s All Party Parliamentary Group on AMR, the BSAC parliamentary internship, how to get involved in pushing AMR up the political agenda, and more!
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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- Sporotrichosis
- Mycetoma
- Chromoblastomycosis
- ...Entomophthorales.
Let's face it: you don't know anything about these diseases.
That's OK: neither do Callum or Alyssa. That's why we've got a guest! Dr David Chandler is a Consultant Dermatologist, BSMM member and is a member of the Global Mycetoma Working Group. Listen on for everything you need to know about chronic subcutaneous infections caused by moulds!
Support the show
Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Alyssa and Callum talk all things dermatophytes and Tinea:
- Tinea capitis – scalp, hair
- Tinea corporis – trunk, limbs (ringworm)
- Tinea manuum/pedis - palms and soles (athlete’s foot)
- Tinea cruris - groin (jock itch)
- Tinea barbae - beard area and neck
- Tinea faciale - face
- Tinea unguium / onychomycosis - nails
What does Anthropophilic mean and how do you pronounce it? Tune in to find out.
Show notes for this episode here: https://idiots.notion.site/12-Moulds-Dermatophytes-3e6b963f48db46808f67985884be5794?source=copy_link
Support the show
Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
If you are enjoying the podcast please leave a review on your preferred podcast app!
Feel like giving back? Donations of caffeine gratefully received!
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Alyssa and Callum are joined by Dr Neil Stone to talk all things Rare, Invasive, and Mouldy. Specifically Fusarium spp., as well as Scedosporium spp. and Lomentospora prolificans.
Heard of these before? No? Well listen in to find out what they are, and why they matter
Show notes for this episode here: https://idiots.notion.site/122-Moulds-Rare-invasive-moulds-af70fc26e81043669c2bf3ef17c14b6c?pvs=74
Support the show
Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Feel like giving back? Donations of caffeine gratefully received!
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Callum and Alyssa are joined by Dr Dora Corzo-Leon to discuss all things Mucorales and Mucormycosis. Listen in to hear about:
- Taxonomy (and why it is confusing)
- Pathogenesis
- Risk factors
- Clinical syndromes
- Diagnostics
- Treatment
Show notes for this episode here: https://idiots.notion.site/121-Moulds-Mucorales-c2343d4588ea4dd19c54de538fd7fe22?pvs=74
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Jame is joined by Chloe from BioMerieux to discuss clinical decision support systems and their application in Microbiology & Infectious Disease! What are they, how do they work, and what are the potential applications in antimicrobial stewardship? Listen on for details!
Note: This episode was produced in collaboration with BioMérieux. An honorarium received from them will be donated directly to charitable causes.
Message from BioMérieux: Every effort has been made to ensure the accuracy of information shared during our podcast appearances. The views expressed by our representatives are in good faith and based on the information available at the time. We accept no liability for any errors, omissions, or discrepancies. For the most accurate and up-to-date product details, please refer to our official website or contact us directly
Register for the BIA Autumn Trainees Meeting here!
Support the show
Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
If you are enjoying the podcast please leave a review on your preferred podcast app!
Feel like giving back? Donations of caffeine gratefully received!
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Callum and Jame are joined by Iain and Darius to talk through the clinical aspects of managing Aspergillosis with a particular focus on the most severe disease. Listen in to hear about current challenges around the management of both invasive and chronic Aspergillosus.
Notes for this episode here: https://idiots.notion.site/118-Moulds-Aspergillus-ce3ba58d045b47b18d9641b56559c6f5?pvs=74
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Alyssa and Callum talk through Aspergillus, the first of our Moulds series. After you hear the puns in this episode you'll be fumi(n)g at us. Tune in to hear about:
- Epidemiology
- Taxonomy
- Pathogenesis
- Lab identification
On the next episode we'll be joined by some special guest to delve into the clinical aspects of the Aspergillosis.
Notes for this episode here: https://idiots.notion.site/118-Moulds-Aspergillus-ce3ba58d045b47b18d9641b56559c6f5?pvs=74
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Take a break from those pesky fungi to learn about another pesky gram-negative! This week it's Pasteurella.
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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In this episode Alyssa is joined by common host Callum to talk about some less common yeast pathogens: Malassezia spp., Rhodotorula ssp., Trichosporon spp. and Saccharomyces spp.
Whilst we're calling these "less common" don't let that fool you - these fungi are everywhere! They are just less commonly causing severe disease in us humans!
Show notes for this episode here: https://idiots.notion.site/116-Yeasts-other-yeasts-30a33d6070c84243b3f42edac4a37ec9?pvs=74
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Listen to this Pretty Comprehensive Pod on PCP.
Alyssa and Callum cover:
- Epidemiology
- Taxonomy (PCP vs PJP?)
- Diagnosis
- Treatment
Note this pod episode also includes some Positively Jolly Puns on PJP
Notes for this episode here: https://idiots.notion.site/115-Yeasts-Pneumocystis-jirovecii-ac05a01902b8457688b40c07020f2c2c
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Alyssa and Callum continue to speak to Jeremy Day about Cryptococcus, focusing on the evidence base for management.
To further encapsulate your learning, be sure to listen to part 1 last week!
Show notes for this episode here: https://idiots.notion.site/113-114-Yeasts-Cryptococcus-14fd0e7ed6a2478cb5734f1e21f49029?source=copy_link
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
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Feel like giving back? Donations of caffeine gratefully received!
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In this episode we are uncovering the most cryptic of cocci, Cryptococcus!
Alyssa and Callum are joined by Jeremy Day to learn all things neo(formans) about this important pathogenic yeast. In this episode we discuss the epidemiology, clinical presentations and diagnosis of Cryptococcus.
To further encapsulate your learning, be sure to listen to part 2 next week!
Show notes for this episode here: https://idiots.notion.site/113-114-Yeasts-Cryptococcus-14fd0e7ed6a2478cb5734f1e21f49029?source=copy_link
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In this episode, Callum and Jame discuss the latest evidence base for endocarditis assessment & management, focusing on the ESC 2023 guidance.
- Echocardiography indications
- Surgery
- Antimicrobial treatments
- AST
AND MORE
…in part 1 because this is was 2-parter.
Show notes for this episode here: https://idiots.notion.site/111-112-Endocarditis-2023-Update-3594d55559314434a3b87d4c30ec41f3
Register for the BIA Autumn Trainees Meeting here!
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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In this episode, Callum and Jame discuss the latest evidence base for endocarditis assessment & management, focusing on the ESC 2023 guidance.
- Epidemiology!
- Prophylaxis!
- How to take a blood culture!
- A long and complicated comparison of the Duke-ISCVID and Duke-ESC criteria that doesn’t really matter because they’re both as good as each other!
AND MORE
…in part 2 because this is a 2-parter sorry
SEE YOU NEXT TIME!
Show notes for this episode here: https://idiots.notion.site/111-112-Endocarditis-2023-Update-3594d55559314434a3b87d4c30ec41f3
Register for the BIA Autumn Trainees Meeting here!
Support the show
Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Feel like giving back? Donations of caffeine gratefully received!
https://www.buymeacoffee.com/idiotspod
The conclusion of the Candida trilogy focuses on the rise of the Lord of the Candida resistance mechanisms: C. auris.
Alyssa and Callum are joined by returning guest Professor Tihana Bicanic to discuss the rise of C. auris. Here we highlight some resources for managing this difficult to treat Candida including the recent UKHSA updated guidelines.
We also discuss anti-fungal resistance mechanisms in Candida in general.
Although this concludes the Candidal section, there are more yeasts yet to come!
Show notes for this episode here: https://idiots.notion.site/108-110-Yeasts-Candida-0eb5f9271f654312b59458d39f8de603?pvs=74
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Feel like giving back? Donations of caffeine gratefully received!
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Yes we've done a Candida episode, but what about SECOND Candida episode?
This week in the second part of the Candida Trilogy Alyssa and Callum are joined by Professor Tihana Bicanic to discuss all things invasive Candidiasis.
Listen in to hear about treatment and diagnosis of this important condition, as well as some areas of current research and the most recent guidelines from ECMM-ISHAM. (Note this episode was recorded before they were released).
Show notes for this episode here: https://idiots.notion.site/108-110-Yeasts-Candida-0eb5f9271f654312b59458d39f8de603?pvs=74
Support the show
Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Feel like giving back? Donations of caffeine gratefully received!
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In this episode there will be puns where you yeast expect them...
But more seriously, what does Candida albicans actually mean? What are yeasts anyway? How does this all relate to the Romans?
These questions, and more, will be answered as Alyssa and Callum continue the Fungal series with this, the first in a 3-parter on all things Candida!
In this episode we cover the Taxonomy (newly confusing), Epidemiology and Pathogenesis of Candida spp. before talking about superficial candidiasis.
Look out for upcoming episodes on invasive Candidiasis and C. auris!
Show notes for this episode here: https://idiots.notion.site/108-110-Yeasts-Candida-0eb5f9271f654312b59458d39f8de603?pvs=74
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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What exciting times! Clinical trials into the management of SAB! SNAP publication on the horizon!
But how do we interpret and apply the results of these trials to our patients? This week Jame and Callum are joined by Dr Clark Russell, Clinical Lecturer in Infectious Diseases to discuss:
- The difficulty in interpreting current clinical trials in SAB.
- The emerging concept of "low risk" SAB and how to define this.
- The heterogeneity of SAB and how this might be exploited.
Notes for this episode here: https://idiots.notion.site/107-SAB-update-1316a1ea09d8800ba701ca7ebc8d4093
Previous episodes for the basics of Staphylococcus aureus and SABATO & SNAP trials:
-
It starts with Staph
-
SNAP trial protocol
-
SABATO trial & 73. SABATaddendum
Register for the BIA Autumn Trainees Meeting here!
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Callum and Alyssa are joined by Professor Malcolm Richardson to talk about all things fungal diagnostics.
In this, part 1 of 2 on diagnostics we discuss the use of biomarkers such as beta-D-Glucan and galactomannan, as well as serology and molecular techniques.
Notes for this episode can be found: here.
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Callum and Alyssa are joined by Professor Malcolm Richardson to talk about all things fungal diagnostics.
In this, part 1 of 2 on diagnostics we discuss the use of microscopy, histopathology and culture in diagnosing fungal infections.
Notes for this episode can be found: here.
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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IT'S A BREAKPOINTS BREAKOUT!
Jame and Callum are joined by the drugnamic duo of Julie-Ann Justo & Erin McCreary from the Breakpoints podcast to delve into the IDSA DTR Gram negative Guidance.
Show notes for this episode are here.
Breakpoints podcast can be found here: https://breakpoints-sidp.org/
Lyrics:
Tryin’ to use some drugs to kill these bugs
Erin and Julie are PK PD thugs
Gonna make these two ID:IOTS look like mugs
It’s gonna be a Breakpoints Breakout
Sorry the song sounds so tinny, Podcast host is doing something strange to it. Link to original MP3 here.
Register for the BIA Autumn Trainees Meeting here!
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My my! Mycology?
Join Callum and special co-host Alyssa for this, the first in the all new ID:IOTS Mycology Mega-series.
Here we cover:
- What the British Society of Medical Mycology is and what they do
- Why we're doing this series on fungi
- The Global and UK Burden of fungal disease.
- The spectrum of fungal disease clinically,
- The taxonomy of these pathogens,
- and the WHO Fungal Pathogen List.
Notes for this episode can be found here.
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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So now, Loyal Listener, you know all about Susceptible, Sensitive at higher doses, Resistant, MICs, ECOFFs/ECVs and how to use the EUCAST breakpoints table....
But what about the wild-west of bug-drug combos where there are no breakpoints?
Well in this episode, Jame and Callum talk through the EUCAST approach to this situation.
Show notes for this episode here
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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BREAKPOINTS. We all love them. S breakpoints... R breakpoints... dash, IE, NA...
Wait, dash, IA, NA, Brackets?!
LISTEN ON (and read the accompanying prep notes), and soon you'll know! In this episode Jame and Callum talk through the EUCAST breakpoints table and how to interpret it
Show notes for this episode here
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Jame is joined by Kate from BioMérieux as they take a deep dive into the BCID2 and the Vitek Reveal, 2 new devices used for rapid identification and antimicrobial susceptibility testing of blood culture isolates.
Note: This episode was produced in collaboration with BioMérieux. An honorarium received from them will be donated directly to charitable causes.
Message from BioMérieux: Every effort has been made to ensure the accuracy of information shared during our podcast appearances. The views expressed by our representatives are in good faith and based on the information available at the time. We accept no liability for any errors, omissions, or discrepancies. For the most accurate and up-to-date product details, please refer to our official website or contact us directly
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This week Jame is joined by Nick and Dal from BioMérieux as they take a deep dive into the Vitek2, one of the machines available for performing Automated Antimicrobial Susceptibility Testing.
Note: This episode was produced in collaboration with BioMérieux. An honorarium received from them will be donated directly to charitable causes.
Message from BioMérieux: Every effort has been made to ensure the accuracy of information shared during our podcast appearances. The views expressed by our representatives are in good faith and based on the information available at the time. We accept no liability for any errors, omissions, or discrepancies. For the most accurate and up-to-date product details, please refer to our official website or contact us directly
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Jame and Callum are joined by Dr Fiona McGill, lead author of the 2016 Joint Specialist Societies Meningitis Guidelines.
Listen to hear an overview of the epidemiology, presentation, diagnosis and management of both bacterial and viral meningitis in the UK.
Show notes for this episode here
Register for the BIA Autumn Trainees Meeting here!
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HO HO HO, MERRY FISMAS!!!
On the Third & Final Pod of FISmas these ID:IOTS have for you… 6 golden topics! Listen to hear about:
1. Personalised approach to invasive fungal infection
2. Agricultural anti-fungals and One Health
3. Candida auris
4. NTM standards of care
5. Narrative reporting
6. Fluoroquinolones and the MHRA warnings
Jame and Callum attended the Federation of Infection Societies 2024 annual meeting in Liverpool; here they share their reflections on the sessions they attended on: a wide mix of topics
We hope these episodes have been ADVENTatious to your learning.
Notes for this episode here
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HO HO HO, MERRY FISMAS!!!
On the Second Pod of FISmas these ID:IOTS have for you… an all-enveloping, capsidating update on the High Consequence Infectious Diseases, measles, RSV and other viruses that you ‘R naught’ going to want to skip!
Jame and Callum attended the Federation of Infection Societies 2024 annual meeting in Liverpool; here they share their reflections on the sessions they attended on: Viral pathogens
Final episode on fungi etc. coming soon!
Notes for this episode here
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HO HO HO, MERRY FISMAS!!!
On the First Pod of FISmas these ID:IOTS have to you… a terrifying update on the Antibiotic Apocalypse!
Jame and Callum attended the Federation of Infection Societies 2024 annual meeting in Liverpool; here they share their reflections on the sessions they attended on: Bacteria and Antimicrobial resistance.
Episodes on viruses, fungi etc. coming soon!
Notes for this episode here
Register for the BIA Autumn Trainees Meeting here!
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Jame regales Callum with tales of his online adventure to the BSAC OPAT conference. Listen in to hear some updates on: implementation of OVIVA; subcutaneous antibiotics; and the BSAC OPAT good practice guidelines
Notes for this episode here.
Register for the BIA Autumn Trainees Meeting here!
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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WAAW! This week, to celebrate World AMR Awareness Week, Callum is Joined by Andrew, Fran, Jo and Simon from the Scottish Antimicrobial Prescribing Group.
Listen in to hear all about SAPG and their important work, plus we discuss WAAW and what you can do to help tackle AMR.
Show notes for this episode here, including links to the resources mentioned.
Sign up to be an #antibioticguardian here.
Register for the BIA Autumn Trainees Meeting here!
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Questions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.social
Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Have you ever looked at your microbiology lab report and wondered "What does resistant mean anyway?"
We're sure you have (and if you haven't you should have)! And conveniently we've recorded this podcast episode to explain how it all works! We talk through the definition of S, I & R, plus some explanation on the science behind these letters.
This is the first in the new Antimicrobial Susceptibility Testing (AST) mini series. Make sure to listen to this one first!
Show notes for this episode here.
Register for the BIA Autumn Trainees Meeting here!
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They're new, they're weird, and we don't use them very much (or at all), but that won't stop your favourite ID:IOTS sounding off on these novel tetracyclines!
In this episode we discuss: An overview of the 3 drugs, including spectrum & penetrance; pharmacokinetics; EUCAST breakpoints; resistance mechanisms; and the recommendations for use in the IDSA DTR Gram Negative guidelines 2024.
Prep notes for the episode here.
Got a question? Use the new 'send us a text' link in the episode description!
Register for the BIA Autumn Trainees Meeting here!
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In which Jame talks about the rationale for IVOS, evidence base for the pros and cons, and then finishes by giving the UK oral switch criteria an absolute rinsing.
Prep notes available here.
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Moraxella means more moronic puns from Jame&Callum. A short episode for some sort rods. Listen to hear about this coccobacillus, how to identify it in the lab and what sort of clinical syndromes it causes.
Show note for this episode here
Send us a text
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Join Jame and Callum as they discuss this paper which examines where these new antibiotics are going, and why they aren't widely available.
Notes for this episode here
Send us a text
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Prep notes for completed episodes can be found here (Not all episodes have prep notes).
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Join Jame and Callum on this episode about the ultimate 4 rings of power: Tetracyclines. The swiss army knife of antibiotics. We talk through the history, uses, mechanism, PK/PD and resistance.
Become a pharmacophil as you learn something about pharmacophores.
Shows notes for this episode here
Send us a text
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Jame and Callum are joined by Lee John and Ella for this episode around the arch-villain of atypical pneumonia and the bogeyman of every spa. Yes Legionella pneumophila (and friends) are addressed in depth whilst this podcast is aerosolised around the world.
Show notes for this episode here
Send us a text
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You'll be whooping with knowledge after listening to this one. Come hear all about Bordetella species. From pertussis to kennel cough you'll hear it all.
Show notes for this episode here
Send us a Text Message.
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Send us a Text Message.
The Spring Meeting of the British Infection Assocation is a must for UK infection trainees; In this week's episode Callum summarises for Jame (who was there, but didn't take any notes) the main learning points from the meeting.
Show notes for this episode here
BIA membership is FREE to UK infection trainees, reasonably priced for everyone else, and paid memberships come with online access to the Journal of Infection! Sign up today at https://www.britishinfection.org/join.
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Send us a Text Message.
Jame was there but Callum wasn't! The British Society for Antimicrobial Chemotherapy have several conferences throughout the year, including a Spring meeting with their AGM. But what topics were discussed, I hear you wonder? WELL WONDER NO MORE: Jame'll take you through it!
Notes for this episode here
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In this episode, the ID:IOTS Podcast Microbiome Correspondent Dr Anastasia "Tash" Theodosiou, finishes educating Callum and Jame (mostly Callum) on the concept of Microbiotoxicity!
This episode is part 2 of 2. Here we discuss:
- What is microbiotoxicity?
- Risk factors for microbiotoxicity
- Which antibiotics are associated with microbiotoxicity?
- Mitigating microbiotoxicity
https://www.researchgate.net/profile/Anastasia-Theodosiou
https://x.com/doctoranastasia
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In this episode, the ID:IOTS Podcast Microbiome Correspondent Dr Anastasia "Tash" Theodosiou, returns to talk about her favourite subject!
This episode is part 1 of 2. Here we discuss:
- What is the microbiome
- Viewing the microbiome as an organ system
- The microbiome's association with disease
- How we study the microbiome
Stay tuned for part 2 (in 1-2 weeks depending on editing), when we talk about the effect of medicine on the microbiome, microbiotoxicity, and what you can do to keep your patients' microbiomes in tip top shape!
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Join us for this special 80th episode celebrating Jame's favourite trial.
https://www.nejm.org/doi/full/10.1056/NEJMoa1808312
Prep notes (including the images referred to in the poem) here.
Special thanks to the Wikiguidelines Endocarditis crew for their work summarising the evidence this poem was based on.
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Presenting: More on Penicillin-Binding-Proteins than you realistically ever need to know!
- What is the difference between Gram positive and negative bacteria's cell walls?
- What is a Penicillin Binding Protein (PBP)?
- Why are they called PBPs?
- What do PBPs do?
- What makes MRSA resistant to (most) beta-lactams?
These any many more questions answered!
Notion page here - you'll need it for this one, check it out!
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One PK table to rule them all
One table to find them
One table to bring them all
And in the darkness blind them…
…with awesome antibiotic PK facts you can use to bedazzle your friends and enemies alike!
Prep notes here.
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The last Pharmacokinetics episode had finally been …Excreted!
This episode covers the ‘drug out’ bit of pharmacokinetics, including things such as:
-What is clearance?
-how to calculate half life
and
-doesn’t everything leave through the kidneys anyway? (That is sort of true, also shut up).
Check out our prep notes (including for this episode) here.
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It's the second Pharmacokinetics episode you never knew you wanted! Let’s talk about how antibiotics are distributed around the body once absorbed, using the examples of Amoxicillin and CallumShutUpicillin (listen to episode for clarification).
What exactly is the volume of distribution? Want a handy reference for the plasma protein binding of various antimicrobials? Then this is the episode for you! Check out our prep notes (including for this episode) here.
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It's the Pharmacokinetics episode you never knew you wanted! Callum didn't know either, but never mind that let's talk about how antibiotics are absorbed, and how we can use that to improve our use of them in clinical practice.
Want ammunition for that oral switch? Got someone who's doubting oral antibiotics' effectiveness? Then this is the episode for you! Check out our prep notes (including for this episode) here.
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In this final episode of the Nobbling the Nonfermentors mini-series, Jame and Callum discuss the (mostly historical) pathogen Burkholderia mallei, causative agent of Glanders.
We did it. We got to the end.
Nonfermentors... Nobbled.
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Post-publication, Callum and Jame give a little extra information on the SABATO trial in its final form compared to it's pre-publication state.
Final article here:
Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial, Kaasch, Achim J Valiente, Adoración et al. Lancet Infect Dis. 2024 Jan 17:S1473-3099(23)00756-9.
PMID: 38244557.
https://doi.org/10.1016/S1473-3099(23)00756-9
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JOURNAL CLUB, YO, IT’S A SABATO!!!
Join Jame and Callum as we travel back in time to when we recorded this deep dive into the SABATO trial pre-print, now peer-reviewed and published in the Lancet ID!
In the next episode we'll give a little update as to how the final article differs from the preprint (not much).
We also talked about in our FIS Highlights Episode 3.
We loved this trial and we hope you’ll all give it a read, it’s well worth it!
Article here:
Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial, Kaasch, Achim J Valiente, Adoración et al. Lancet Infect Dis. 2024 Jan 17:S1473-3099(23)00756-9.
PMID: 38244557.
https://doi.org/10.1016/S1473-3099(23)00756-9
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In this penultimate episode in the Nobbling the Nonfermentors mini-series, Jame and Callum discuss the regionally important neglected tropical disease Melioidosis, caused by Burkholderia pseudomallei.
This episode was based disproportionately on the following article, and we extend our thanks to the authors for thoughfully publishing it so close to us wanting to do a podcast episode on Melioid!
Meumann, E.M., Limmathurotsakul, D., Dunachie, S.J. et al. Burkholderia pseudomallei and melioidosis. Nat Rev Microbiol (2023).
https://www.melioidosis.info/
Link to prep notes here.
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In this Episode, Callum reflect on his recent runaway success passing the FRCPath Part 2, passes on some tips and tricks for the exam, and then we talk about what 3 antibiotics we would take with us to a Desert Island (that has all pathogens and environments where you would find said pathogens, so not just a desert apparently).
'Prepping to Pass' episodes mentioned: 40, 42, 43 & 50.
The Table and Links mentioned in this episode can be found here: https://idiots.notion.site/70-Reflections-on-Part-2-2023-a193fd830c9b4d6c9381107471fcdbca
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How do you think about antibiotics?
This Christmas we give the best gift of all: no puns in an episode.
Join Jame and Callum as they talk about a method for thinking about and explaining antibiotics.
Here are the show notes for this episode: https://idiots.notion.site/69-Choosing-an-antimicrobial-4e7446a91ff6413aa14924a2ba905ffa
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Did you think the evidence base for Stenotrophomonas was bad? Well allow us to introduce you to Burkholderia cepacia complex!
BCC is pretty niche but a key pathogen in people living with cystic fibrosis. We talk through the (very) limited treatment options and evidence base for this difficult bug.
Prep notes for this episode here: https://idiots.notion.site/68-Burkholderia-cepacia-complex-7bba8a7c74df490cb2e91d087a3cdb2a
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Callum and Jame wrap up their thoughts on the recent FIS conference.
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Join Jame, Callum and Pals for a discussion on some highlights from FIS 2023: https://microbiologysociety.org/event/full-events-listing/federation-of-infection-societies-fis-conference.html
Mentioned in episode:
ESCMID brain abscess guidelines: https://www.sciencedirect.com/science/article/pii/S1198743X23003993#
ORAL study protocol: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05783-8
ACBLM/ALM: https://www.acb.org.uk/
Pathology networks: https://www.england.nhs.uk/pathology-networks/
UCLH/HTD: https://www.uclh.nhs.uk/our-services/find-service/tropical-and-infectious-diseases
uclh.parasitologyspr@nhs.net
Review article on anti-fungal resistance and global health: https://www.nature.com/articles/s41579-022-00720-1
NITCAR website: https://nitcollaborative.org.uk/wp/
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Join Jame, Callum and Pals for a discussion on some highlights from FIS 2023: https://microbiologysociety.org/event/full-events-listing/federation-of-infection-societies-fis-conference.html
Mentioned in episode:
UCHL HLH protocol and referral details: https://www.uclh.nhs.uk/our-services/find-service/medical-specialties-1/hlh-service
SNAP trial: https://www.snaptrial.com.au/
SNAP trial email: snap-trial@unimelb.edu.au
SABATO (pre-print) https://www.medrxiv.org/content/10.1101/2023.07.03.23291932v1
RESISTANCE/The Mould that Changed the World: https://www.mouldthatchangedtheworld.com/
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In this episode Jame and Callum are joined by Louis, host of the let's talk micro podcast.
Listen in for a discussion on what a Biomedical Scientist is and how to become one. We explore the key details that clinicians need to add to their specimen request details; and ponder how laboratory managers can make this easier for clinicians.
How to request a test:
https://global.oup.com/academic/product/how-to-request-a-test-a-clinicians-guide-to-the-interpretation-and-evaluation-of-medical-tests-9780192866615?cc=gb⟨=en&
Let's talk micro podcast:
https://rss.com/podcasts/letstalkmicro/
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Ready for some startling Steno statistics? In this big 1-parter, Callum & Jame go through Stenotrophomonas maltophilia, from start to finish.
Unlike Pseudomonas & Acinetobacter, Steno is much less commonly seen outside of ITU & the immunocompromised; but when it shows up you have to know what you’re doing. Luckily for you, there’s basically only 2 treatments! (In Europe: you’ll see what I mean).
2 crap puns in this one, so… get ready for that.
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In Part 2 of our episodes on Acinetobacter we talk abouit resistance, and then do a deep dive into the evidence base for the management of CRAB: Carbapenem-Resistant Acinetobacter Baumanii-calcoaceticus complex.
Do have a look at the prep notes for this episode if you want more information on Acinetobacter.
Links to podcasts mentioned in this episode
ID:IOTS Episode 41: Bugs Without Borders
Febrile episodes 76 & 77: Piece de (Gram-negative) Resistance
Episode 76
Episode 77
For links to the papers we used, see the prep notes!
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In this episode, Callum and Jame go over the second big family of nonfermentors, Acinetobacter. In part 1 we talk about the organisms themselves, risk factors, clinical syndromes and diagnostics before talking a little about treatment.
In Part 2 (released next week) we’ll talk about Carbapenem-Resistant Acinetobacter Baumanii-calcoaceticus (CRAB), and resistance mechanisms in general.
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In part 2, we discuss the limited treatment options for pseudomonas infection, some wildcard options and the resistance mechanisms that make Pseudomonas such a tricky bugger to treat!
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Prep notes for completed episodes can be found here: https://idiots.notion.site/ID-IOTS-Prep-Notes-cf9b043fbb5a41309e15270f6079abf5?pvs=4
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It was a long time coming, but it’s here. Jame and Callum set off on our mini-series, Nobbling the Nonfermentors, starting with an introduction to glucose-nonfermenting organisms before moving on to the biggie: Pseudomonas aeruginosa!
Part 2 next week covers treatment of Pseudomonas, including a deep dive into Pseudomonas resistance mechanisms. Stay tuned!
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://idiots.notion.site/ID-IOTS-Prep-Notes-cf9b043fbb5a41309e15270f6079abf5?pvs=4
(Not all episodes have prep notes)
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Jame and Callum were delighted to be invited as guests to the podcast Microbe Mail by host Vindana (Vin) Chibabhai. Check out the Microbe Mail podcast:
https://microbemail.captivate.fm/ @microbemail
We discuss how bactericidal and bacteriostatic are defined, what the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) are and why this isn't as simple as it first seems. We then discuss specific clinical situations and where bactercidal vs static have been compared.
Links/papers mentioned in this episode:
The basics of beta lactamases
Wald-Dickler N, Holtom P, Spellberg B. Busting the Myth of ‘Static vs Cidal’: A Systemic Literature Review. Clin Infect Dis. 2018 17;66(9):1470–4.
Use of bacteriostatic agents in Neutropenic fever:
The RCT referred to in the abstract is here:
Jaksic B, Martinelli G, Oteyza JP, Hartman CS, Leonard LB, Tack KJ. Efficacy and Safety of Linezolid Compared with Vancomycin in a Randomized, Double-Blind Study of Febrile Neutropenic Patients with Cancer. Clinical Infectious Diseases. 2006 Mar 1;42(5):597–607
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Prep notes for completed episodes can be found here: https://idiots.notion.site/ID-IOTS-Prep-Notes-cf9b043fbb5a41309e15270f6079abf5?pvs=4
(Not all episodes have prep notes)
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Jame and Callum are together in person to talk about the importance of keeping your house in order. Being an infection specialist does not automatically make you an antimicrobial steward. We reflect on some challenges to being an antimicrobial steward when practising infection medicine
The choosing wisely campaign mentioned by Jame:
https://www.choosingwisely.org/
A course on Antimicrobial Stewardship which is a good starting point:
https://www.futurelearn.com/courses/antimicrobial-stewardship
The IDSA guidance on AmpC production risk organisms mentioned by Jame:
https://www.idsociety.org/practice-guideline/amr-guidance/#AmpC%CE%B2-Lactamase-ProducingEnterobacterales
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Prep notes for completed episodes can be found here: https://idiots.notion.site/ID-IOTS-Prep-Notes-cf9b043fbb5a41309e15270f6079abf5?pvs=4
(Not all episodes have prep notes)
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We were delighted to be joined by Dr Anastasia "Tash" Theodosiou to talk about breastfeeding, antibiotics and the risks of antibiotic harm to mum and baby. Tash is an infectious diseases/medical microbiology trainee, host of the HelloMicro blog and a certified breastfeeding support specialist.
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://idiots.notion.site/ID-IOTS-Prep-Notes-cf9b043fbb5a41309e15270f6079abf5?pvs=4
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2 years. It’s been a hell of a ride. Here’s to 2 more.
Links from this episode:
KASIC 1-page evidence-summary on aminopenicillins for resistant enterococcal UTIs: https://bit.ly/44CtNnq
AUDIENCE SURVEY!!!
Please do fill this out, it would mean a lot to us: https://forms.gle/aCq2djmfKPjA6tkMA.
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Prep notes for completed episodes can be found here: https://idiots.notion.site/ID-IOTS-Prep-Notes-cf9b043fbb5a41309e15270f6079abf5?pvs=4
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This is the urine antibiotic drug penetrance you never knew you wanted. Jame might be prouder of this than his own children. Callum, as you will be able to tell, remains indifferent*.
Figure out which antibiotics you can trust, and which you can't. Use the table in the prep notes and links to win arguments, justify treating 'resistant' organisms in the urine, BREAK HEARTS - you name it!
Enjoy!
Prep notes for this episode: https://idiots.notion.site/UTI-Drug-Choice-5deb611895254444a040bf78d2003cdb
*To the episode, he thinks Jame's children are delightful.
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Catheter-associated UTI: Callum’s nemesis. His white whale. His Sauron. His favourite rant.
Want to know how favourite? Listen on!
Useful links (see show notes for more)
RICAT study
Chlorhexidine meatal cleaning
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Loyal Listeners! Free yourselves from this outdated language! Emancipate your hospitals from 'Escalation antibiotics'!
In today's episode, Callum and Jame rant for 35 minutes about how we talk about changing therapy, and how talk of escalating antibiotics leads to desire for 'big gun' antibiotics.
Apologies for Callum's audio quality on this episode. We'd apologise for Callum in general, but you chose to listen, really you've only yourself to blame.
Links:
Tunnocks Tea Cakes
Ledaig whisky
ID:IOTS guide to Aminoglycosides
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The title says it all. We're going back to the lab for this discussion. Join Jame and Callum as they have an in depth discussion about the nature of urine culture.
Prep notes for this episode available here.
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Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Ever wondered what a clinical scientist is or how to become one? Are you a clinical scientist and looking to sit the FRCPath exams? Join Jame and Callum as they talk to Phillipa Burns and Vicki Fleming about their experiences in preparing for their FRCPath exams in microbiology.
Here are some of the resources mentioned during this episode:
Colour atlas of bacteriology
UK Reference laboratory manuals
Tropical Medicine Notebook
Bailey & Scott's Diagnostic Microbiology, 15th Edition
Review agars from the manufacturer:
EO labs
Oxoid
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Welcome to the party pal! The penicillin allergy assessment and delabelling party, that is. Callum takes Jame through the latest evidence base in antibiotic allergy in general, and beta lactam allergy assessment and management in particular.
Links:
PENFAST Score paper:
Trubiano JA et al. Development and Validation of a Penicillin Allergy Clinical Decision Rule. doi: 10.1001/jamainternmed.2020.0403.
Sulfonamide allergy paper here (couldn't find anything published more recently):
Urbancic KF et al. Taking the challenge: A protocolized approach to optimize Pneumocystis pneumonia prophylaxis in renal transplant recipients. doi:10.1111/ajt.14498
Dutch beta lactam allergy guidelines:
https://swab.nl/en/exec/file/download/192
And finally...
Norvell MR et al. Cefazolin vs. second-line antibiotics for surgical site infection prevention after total joint arthroplasty among patients with a beta-lactam allergy. https://doi.org/10.1093/ofid/ofad224
Yippee Ki-Yay, my delabellers, we'll see you in a fortnight.
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Join Callum with guests Morgan Evans, Olivia Hawkes and Katy Hill for the final(?) part of the ECCMID 2023 highlights
ECCMID sessions discussed:
- Antimicrobial stewardship poster session
- Ethical dilemmas with antimicrobial therapy
- The value of diagnostic information for antimicrobial stewardship
- Tick borne diseases and prevention
Music: https://pixabay.com/music/acoustic-group-outrigger-144123/
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Join Callum with guests Andrew Seaton, Marianna Avellar, Hannah Pymont, Eva Garmendia, Sanjay Patel and Dave Hettle live from ECCMID 2023.
ECCMID sessions discussed:
- Fairytales or reality, checking some eminence paradigms for treatment of severe infections
- Neglected tropical skin diseases
- Non-canonical approaches to treatment of infections
- Paediatric interactive cases: dilemmas for the microbiologist and infection specialist
- Clinical grand round
For the AMR studio podcast: https://www.uac.uu.se/the-amr-studio/
BSAC paediatric pathways: https://bsac.org.uk/paediatricpathways/
Music: https://pixabay.com/music/acoustic-group-outrigger-144123/
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Join Callum with Guests Robert Ball, Kelly Bicknell & Rob Read live from ECCMID 2023.
ECCMID sessions discussed:
- Antibiotic stewardship for urinary tract infections: challenges and opportunities
- Viral Infection in immunosuppressed patients: what is new?
- Responsible publishing in CM/ID
- Secondary haemophagocytic lymphohistiocytosis and infectious diseases
Review article on HLH:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094004/
Music:
https://pixabay.com/music/acoustic-group-outrigger-144123/
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Callum is reunited with Jame following their separation at ECCMID 2023. Callum shares some highlights including Archaea and their role in human health, Digitalisation within the microbiology lab and the ESCMID/IDSA interview
Links to publications on Archaea:
https://www.moissleichingerlab.com/projects/
https://twitter.com/chmoei?lang=en
Digitalisation and machine learning in microbiology presentation link: https://appliedmicrobiologyresearch.net/en/blog/keynote-by
https://twitter.com/AppliedMicrobi2?s=20
Carlos del Rio, president of the IDSA
https://twitter.com/CarlosdelRio7?s=20
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Jame rides solo today, going over the beta-lactamase inhibitors, old and new, how to think about them and when to use them in anger.
New Show notes format! Available at https://idiots.notion.site/Beta-Lactamase-Inhibitors-f9999b6a4867470996a31c53e661b5ac
NB: For now all old show notes are available in the usual Onedrive folder.
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Jame and Callum are joined by the one and only Sara Dong of Febrile fame to look at the American Board of Internal Medicine's Infectious Disease Certification Exam.
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Jame and Callum are joined by semi-recent FRCPath Microbiology part 1 exam passers Callum and Jame to discuss how best to prepare for this exam. This exam is sat by all infection trainees in the UK, as well as other health care professionals working in infection such as clinical scientists.
Full revision resources notes available in the linked OneDrive folder below (if you can't access it let us know).
Let us know once you pass! (Disclaimer: previous sentence for engagement purposes only, please do not let us know once you pass).
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Jame and Callum are joined by Vin from Microbe Mail to discuss the management of Difficult to Treat Resistance (DTR) Gram negative infections in South Africa.
If you haven't already check out Microbe mail for a high quality infection podcast linking the lab and clinical management.... wait that sounds familiar!
Vin is a associate Professor in Clinical Microbiology at the University of the Witwatersrand, Johannesburg, South Africa and a practising clinical microbiologist with the National Health Laboratory Service. She is passionate about microbes (of course), antimicrobial resistance, antimicrobial stewardship, diagnostics, healthcare associated infections, fungal infections, One Health...let's just say it's a very long list!
References:
- Metallo-β-lactamase resistance in Enterobacteriaceae is an artefact of currently utilized antimicrobial susceptibility testing methods
- Best practices: Appropriate use of the new β-lactam/β-lactamase inhibitor combinations, ceftazidime-avibactam and ceftolozane-tazobactam in South Africa
- Colistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-Analysis
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Jame and Callum are joined by recent FRCPath Microbiology part 2 exam passers Olly and Rob to discuss how best to prepare for the exam. This is the final exam required to qualify as a medical/clinical microbiologist in the UK.
Full revision resources notes available in the linked OneDrive folder below (if you can't access it let us know!). Let us know once you pass!
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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It's time for journal club! Jame and Callum discuss community acquired pneumonia treatment and a paper from 2021 which examines shorter duration therapy for patients responding to therapy.
Paper discussed:
Dinh, Aurélien et al. “Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial.”
Lancet 2021;397: 1195-1203.
doi:10.1016/S0140-6736(21)00313-5
Shorter is Better site:
https://www.bradspellberg.com/shorter-is-better
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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In this episode as requested on twitter (sort of), Callum & Jame compare and contrast Gram positive & negative bacteraemia. Happy new year!
Please also see our older episode on bloodstream infection: www.buzzsprout.com/1782416/9162105-5-back-to-bacteraemia
SABATO trial details here: https://twitter.com/sebpoule/status/1518496524552056833?s=46&t=Dre0YLRm_gwnKQ8OakDarw
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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This Christmas, Jame shares a tale of woe: the rise and fall of Plazomicin, a hapless victim of antibiotic market forces. The conversation then proceeds/degenerates into a discussion of the economics of Antimicrobials in general, with a focus on the ‘Netflix’ model being piloted in the UK.
WE’LL BE BACK NEXT YEAR SEE YOU THEN
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Join Jame and Callum as they take a deep dive into urinalysis, a commonly (mis)used test for UTI (and other conditions). This test put you into murky waters when used clinically and we hope to give some information to avoid being a pisse prophet.
Some sources referred to in this episode:
NICE Clinical knowledge summary
SMI 41: Investigation of urine
Summary article of PPV and NPV for urinalysis:
- Diagnosis and treatment of urinary tract infections across age groups, AJOG, 2018
Performance of LE and Nitrite at differing levels of bacteruria:
- Evaluation of Leukocyte Esterase and Nitrite urine dipstick, J Clin microbiol, 1999
Review of urinalysis diagnostic utility by presenting symptoms:
- Does this woman have an acute uncomplicated urinary tract infection? JAMA 2002
Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Callum and Jame discuss the HACEK organisms (apart from Haemophilus which we discussed in episode 32).
Questions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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An atypical episode about pneumonia. Callum and Jame discuss their pet peeves.
Questions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
Prep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5
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Callum and Jame talk about everyone's favourite antibiotic class that covers Staph, Pseudomonas and Gram negatives, is predominantly renally excreted and isn't a quinolone, the aminoglycosides. We go over classification, mechanism of action, spectrum, resistance mechanisms, PK/PD, penetrance to various tissues, toxicity, and dosing.
This is a companion piece to our star appearance on Febrile in August: https://player.captivate.fm/episode/0777091c-0991-42d4-89a9-4032d77b4fa5
Questions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_pod
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Join Jame and Callum as they talk you through Haemophilus spp. Turns out that Haemophilus influenzae isn't the cause of Influenza. We answer some questions such as: What are X and V?
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Useful resources:
-SMI on HACEK organisms https://www.gov.uk/government/publications/smi-id-12-identification-of-haemophilus-species-and-the-hacek-group-of-organisms
-Dermnet page on Chancroid https://dermnetnz.org/topics/chancroid
- EUCAST breakpoints page https://www.eucast.org/clinical_breakpoints
Join Jame and Callum as they discuss the two titans of diarrhoea, Salmonella and Shigella. Who knew Salmonella species were so complex? Jame explains something that will SHOCK you about Shigella (maybe).
Review of Salmonella: Shu-Kee Eng, Priyia Pusparajah, Nurul-Syakima Ab Mutalib, Hooi-Leng Ser, Kok-Gan Chan & Learn-Han Lee (2015) Salmonella: A review on pathogenesis, epidemiology and antibiotic resistance, Frontiers in Life Science, 8:3, 284-293, DOI: 10.1080/21553769.2015.1051243
Original article on Edinburgh S. Typhi outbreak investigation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130034/pdf/jhyg00084-0045.pdf
Yersinia. Not very important today, very very important in the past! Callum and Jame talk through the medically important Yersinia species, and how to treat them.
Links:
CDC page for treatment of plague:
https://www.cdc.gov/plague/healthcare/clinicians.html
UK HSA SMI 21: ID of Yersinia Species
https://www.gov.uk/government/publications/smi-id-21-identification-of-yersinia-species-from-faeces
The 'Jump' test for mesenteric adenitis Jame mentioned has a name (the J-up test), and it works! Sensitivity 87%, Specificity 70%.
DOI: 10.1177/2333794X19884824
Join Jame and Callum and they discuss some of the other Enterobacterales Gram negatives. Particularly breaking down them into their families and into Lactose fermenters and non-fermenters. Jame has a small breakdown around our Twitter handle near the end.
Comments suggestions and criticisms to idiotspodcasting@gmail.com or @IDiots_pod
Some lists:
Chromosomal AmpC Carriers (high-risk): HECK YES
· Hafnia alvei, Enterobacter cloacae, Citrobacter freundii, Klebsiella aerogenes, Yersinia enterocolitica
Lower Risk Chromosomal AMPC: Vulgar Providencia Store AMPC
· Proteus Vulgaris, Providencia, Serratia, Acinetobacter, Morganella, Providencia
Intrinsic Colistin Resistance:
· Burkholderia cepacia (Nonfermenter), Proteus, Providencia, Serratia
Biochemical mimics of Salmonella (also can group)
· Hafnia, Morganella,Proteus
Cat 3 organisms:
· Salmonella typhi/paratyphi, Shigella dysenteriae type 1, E.coli O157, Yersinia Pestis
Some useful resources:
SMI ID 16: identification of Enterobacteriaceae
https://www.gov.uk/government/publications/smi-id-16-identification-of-enterobacteriaceae
Janda JM, Abbott SL. 2021. The changing face of the family Enterobacteriaceae (order: “Enterobacterales”): new members, taxonomic issues, geographic expansion, and new diseases and disease syndromes. Clin Microbiol Rev 34:e00174-20.
https://doi.org/10.1128/CMR.00174-20
Join Jame as he continues to talks through the ESCMID and IDSA treatment of Multi Drug Resistant Gram negative guidelines/guidance. Callum listens and occasionally asks a question! Jame is so passionate on this subject that we have split the episode into two parts.
ECDC guidelines
· https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-0691.2011.03570.x
· https://www.ecdc.europa.eu/en/news-events/multidrug-resistant-extensively-drug-resistant-and-pandrug-resistant-bacteria-0
Canadian guidelines
· https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2018-44/ccdr-volume-44-1-january-4-2018/ccdr-rmtc-44-1-ar07-eng.pdf
IDSA
- https://www.idsociety.org/practice-guideline/amr-guidance-2.0/#
Comparison of IDSA and ESCMID
-
https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(22)00054-4/fulltext
-
https://amr.solutions/2019/01/13/categories-of-resistance-mdr-xdr-pdr-udr-and-new-dtr/
Join Jame as he talks through the ESCMID and IDSA treatment of Multi Drug Resistant Gram negative guidelines/guidance. Callum listens and occasionally asks a question! Jame is so passionate on this subject that we have split the episode into two parts.
ECDC guidelines
· https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-0691.2011.03570.x
· https://www.ecdc.europa.eu/en/news-events/multidrug-resistant-extensively-drug-resistant-and-pandrug-resistant-bacteria-0
Canadian guidelines
· https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2018-44/ccdr-volume-44-1-january-4-2018/ccdr-rmtc-44-1-ar07-eng.pdf
IDSA
- https://www.idsociety.org/practice-guideline/amr-guidance-2.0/#
Comparison of IDSA and ESCMID
-
https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(22)00054-4/fulltext
-
https://amr.solutions/2019/01/13/categories-of-resistance-mdr-xdr-pdr-udr-and-new-dtr/
ID:IOTS is 1 year old today! Jame and Callum have a short chat about the the podcast, why we started and where we’re going. Of course, the talk ID:IOTS are the friends we made along the way…
If you want to send us cake email idiotspodcasting@gmail.com
Back after a summer break, Jame and Callum discuss the fascinating machine that is the MALDI-TOF. Matrix Assisted Laser Desorption Ionisation Time Of Flight mass spectrometry. We discuss the basics of how it functions, its application in the lab and some pros and cons of its use along with what the future may hold. Here are some relevant videos and papers:
- Exciting video of MALDI-TOF
https://www.youtube.com/watch?v=0jeFpXHZ8W0&ab_channel=BrukerDaltonics - MALDI-TOF to detect MRSA https://www.frontiersin.org/articles/10.3389/fmicb.2020.00232/full
- Direct MALDI-TOF on blood cultures
https://www.spandidos-publications.com/10.3892/etm.2020.9365 - MALDI-TOF to detect CPE
https://www.frontiersin.org/articles/10.3389/fmicb.2021.789731/full
Join Jame and Callum as they discussion all things beta lactamase including ESBL, AmpC and Carbapenemases. We talk through classification systems, patterns of resistance and some methods of detection.
Some resources we found helpful:
Summary of beta lactamase classification:
https://microbeonline.com/betalactamase-classification/
Summary of AmpC:
https://www.idstewardship.com/heck-yes-get-amped-updates-ampc-harboring-bacteria/
EUCAST detection of resistance:
https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Resistance_mechanisms/EUCAST_detection_of_resistance_mechanisms_170711.pdf
UK SMI on Carbapenemases:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1080594/B_60i3.1.pdf
More in depth AmpC:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763639/
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Callum and Jame provide an overview of the Carbapenem class of antibiotics discussing: what they are; their spectrum of action (looking in particular at what they don't cover); resistance; how to use them; and side effects.
This site has a useful summary of the new formulation of carbapenems and their spectra:
http://www.microbiologynutsandbolts.co.uk/the-bug-blog/new-sweets-on-the-market-but-will-these-new-flavours-live-up-to-their-vibrant-colours
Here is the NEJM paper on Tebipenem Jame mentions:
https://www.nejm.org/doi/full/10.1056/NEJMoa2105462
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Jame and Callum continue their discuss of the Enterobacterales, looking at Klebsiella spp. with focused discussion on some microbiological history, K1 syndrome, and the pharmacokinetics of antimicrobials for endophthalmitis.
For the graphic Jame suggested look at Figure 4 in this paper: https://academic.oup.com/femsre/article/41/3/252/3830265
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Jame and Callum have put this off for far too long... we start exploring the Gram negative bacilli by considering Enterobacterales in general and then discussing E. coli. We focus particularly on the gastrointestinal syndromes causes by different pathogenic strains of E. coli. Did you ever wonder what "coliforms" on a culture result meant - hopefully now you will find out!
In this episode Jame and Callum discuss other Beta-lactam antibiotics: aztreonam, temocillin and pivmecillinam... with some substantial tangents into C. difficle and carbapenems.
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In this episode Jame and Callum talk through the two most medically important Gram negative cocci: Neisseria meningitidis and Neisseria gonorrhoeae.
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Callum and Jame provide an overview of the Cephalosporin class of antibiotics, discussing mechanism of action, spectrum, classification, PK/PD, side effects and some clinical uses.
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In this episode Jame and Callum discuss Nocardia and Actinomyces, continuing the journey through Gram positive bacilli.
We'll move away from GPBs in the next few episodes before returning to discuss anaerobic GPBs.
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In this episode we continue exploring the realm of Gram positive bacilli. Jame and Callum discuss Listeria, Lactobacillus and Erysipelothrix. These complete the "non-branching GPBs" we are discussing, along with Bacillus and Corynebacterium.
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In this episode we continue exploring the realm of Gram positive bacilli. Jame and Callum discuss Corynebacterium looking at Diptheroids and Diptheria and explaining the difference.
We're going to spend the next few episodes talking about Gram positive Bacilli and the infections they cause.
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In this episode we are moving away from the Gram positive cocci into the realm of Gram positive bacillus. Jame and Callum start discussions with the Bacillus spp. focusing on the main culprits for human infections, in particular Anthrax.
We're going to spend the next few episodes talking about Gram positive Bacilli and the infections they cause.
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Is this episode Jame and Callum (mainly Jame) talk about "penicillin allergy" and B-Lactam allergies in general. This complements the earlier episode on penicillins. We discuss the classification, epidemiology, assessment and management of this situation. Links to resources discussed:
SAPG https://www.sapg.scot/guidance-qi-tools/quality-improvement-tools/penicillin-allergy-de-labelling/
emcrit https://emcrit.org/ibcc/penicillin/
In this episode Jame and Callum discuss Infective Endocarditis. In this 2nd of two episodes on this topic we discuss the: severity assessment, indications for surgery, treatment options by organism and innovations in practice.
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In this episode Jame and Callum discuss Infective Endocarditis. In this 1st of two episodes on this topic we discuss the: definition, causative organisms, risk factors, symptoms/signs; diagnostics; and the Duke's criteria
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Callum and Jame provide an overview of the penicillin class of antibiotics, discussing mechanism of action, spectrum, classification, PK/PD, side effects and resistance mechanisms.
Also you can laugh at Jame as he tries to pronounce "isoxazolyl"
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In this episode of the ID:IOTS podcast Callum and Jame talk about Enterococci, completing cocci for the 2nd time...
In this episode of the ID:IOTS podcast Callum and Jame continue looking at clinical syndromes mostly associated with Gram positive cocci by looking at lower respiratory tract infections/pneumonia.
Callum and Jame finish off their discussion of Skin & Soft Tissue infection by going over the assessment and management of Necrotising Fasciitis.
Callum and Jame record a 'quick' episode on SSTI, which turned out to be so long we split into 2 parts!
In this episode of the ID:IOTS podcast Callum and Jame go back to the patient bedside to discuss bacteraemia looking at definitions, how bacteraemia occurs, how to diagnosis a bacteraemia and some management considerations.
In this episode of the ID:IOTS podcast Callum and Jame talk about some other Gram positive cocci of clinical relevance (and sometimes irrelevance).
What are the coagulase negative Staphylococci (CNS)? In this episode of the ID:IOTS podcast Callum and his Jame coalesce their clinical knowledge of coagulase negative Staphylococci
In the second episode of the ID:IOTS podcast Callum and Jame try to demystify the classification of Streptococci
In the first episode of the ID:IOTS podcast Callum and Jame talk for longer than intended about everyone's favourite Gram positive coccus, Staphylococcus aureus.