Life-threatening infections caused by antimicrobial resistant organisms, commonly referred to as ‘superbugs’ have taken the media by storm. MRSA, VRE, MDRO, KPC, CRE, CDI – all acronyms that put fear in our hearts that one day, we will have run out of treatment options. That one day, our patients will die from infections that we once could cure.
Sadly, what was once a threat, is predicted to be a reality by 2050. Certain experts predict that these ‘superbugs’ will be the most common cause of death globally in 2050. That is truly terrifying.
What can we do?
We can fight back with science. The Society for Healthcare Epidemiology of America (SHEA) is sponsoring the Race Against Resistance for the 4th year. Money raised is used to fund educational scholarships involved in treating, and researching, ways to prevent the 2050 predictions from coming true. This is a chance to take a stand against ‘superbugs’, to support those fighting against them today, to help change the future.
So, who is racing?
Dr. Kelly Cawcutt and Dr. Jasmine Marcelin, are faculty physicians within UNMC’s Division of Infectious Diseases and have leadership roles in Infection Prevention and Antimicrobial Stewardship, respectively. They also serve as Co-Directors for Digital Innovation & Social Media Strategy for the ID Division. Together, they are the UNMC IDSHEAroes – two social media Co-Directors, trying to do some good.
Here are their TOP TEN reasons for racing:
10 – To beat Dr. Hilary Babcock, who won last year.
9 – Because honestly, it’s a pretty catchy title & team name.
8 – To remind everyone that antibiotics cannot treat a ‘cold’ or the flu. Or measles.
7 – To inspire our younger colleagues in medicine that anyone can help make a difference.
6 – To focus on healthy & wellness in a profession that has been struggling with burnout.
5 – To help SHEA and our racing teammates raise more money this year than EVER before
4 – To raise awareness of ‘superbugs’ & antimicrobial resistance by publicly sharing the Race Against Resistance.
3 – To provide the funds that train the next generation in Infection Prevention & Antimicrobial Stewardship.
2– To honor those who fought the fight against resistance before us, and the ones we have lost along the way.
1 – To never lose another patient to an infection we cannot treat.
How are we racing?
With physical wellbeing through exercise! Dr. Cawcutt is recovering from a partial knee reconstruction and will be #RacingInRehab to gain independent ambulation. Dr. Marcelin is#RacingForWellness by focusing on active exercise every day as a reminder that we cannot provide excellent care for others, if we do not care for ourselves first.
If you are interested in supporting the UNMC SHEAROES in the Race Against Resistance, you can donate here.
Pastor Joyce Miller is a Lutheran minister and chaplain at Nebraska Medicine and has been a pillar of comfort for grieving faculty, staff and patient families during illness and death. She began by acknowledging that Islam, Judaism, and Christianity share similar roots, therefore it is no surprise that there are similar customs among these faiths. Miller shared the major fasting period of Christianity – Lent – is an important 40-day period of prayer, charity and alms-giving in preparation for Easter.
Kate Tyner, an Infection Preventionist working with the Nebraska Antimicrobial Stewardship Assessment and Promotion Program (ASAP), shared about fasting specifically within the Catholic faith. She related that before the Vatican II council decision, Catholics observed strict abstinence from meat on Fridays, but that after the decision, this strict abstinence was relaxed outside of the Lenten period. Tyner also shared a beautiful quote about what fasting means: “The willingness to deny ourselves awakens in us a capacity to give ourselves in greater love to our faith.” (Adapted from Magnificat daily devotion provided by Father Donald Haggerty).
Bryan Alexander, an ID Pharmacist working with the Antimicrobial Stewardship program, shared about fasting in the Orthodox Christian faith, which we learned is a stricter fasting regimen, including fasting from meat, wine, dairy and fish with backbones on Wednesdays and Fridays, and approximately 180-200 days of limited fasting per year. Alexander related that the purpose of the limited fasting was to “simplify your diet to focus on your day”, and that the act of fasting makes feasting more joyful, especially with the communal nature of the feasts at the end of a fast.
Dr. Raj Karnatak, a senior ID fellow, shared what fasting means in the Hindu faith. The Sanskrit word for fast is Upvaas, which means “staying near God”. He shared that in his culture, different foods carry various implications. Food is divided into three categories 1) Sattvic food: fruits, vegetables and dairy. 2) Rajsic food: Spicy food, garlic, onion (Believed to create unrest in mind). 3) Tamsic food: Meat, fish, and eggs (can serve to decrease spiritual enhancement); therefore, fasting often involves abstinence from Rajsic and Tamsic foods. People can fast in different ways in Hinduism – complete abstinence from all food/water, abstinence from only food, limiting intake to just one meal per day, or even abstinence from speaking (Maunvrat). He reminded us that fasting has been used as a political/social justice tool, as Mahatma Gandhi did fasting for human rights.
Nowairah Syed, a teacher at Noor Academy and wife of Dr. Ashraf, shared about fasting in Islam. The fasting month of Ramadan (which means dryness or scorching heat) occurs in the 9th lunar month, with daily fasts (abstaining from food and water) from sunrise to sunset. The daily breaking of fast is called Iftar. Dr. Fadul shared that in Sudan, men would sit outside in the community with food around sunset so that if someone was too weak from fasting to make it inside their homes, they could celebrate Iftar wherever they were at sunset, a testament to the strong sense of community responsibility. Because it is based on the lunar calendar, Ramadan can last for 29-30 days and is at a different time every year. Syed shared that Ramadan is a reminder for Muslims to be better people, both spiritually and physically, refraining from anger and frustration. It is a reminder to exercise patience, understand others and giving to charity. The fast is broken daily with dates and water, and at the end of Ramadan, called Eid, Muslims gather to celebrate with a big Feast.
After hearing about fasting in different faiths, there was spirted discussion and sharing as the group waited for sundown at 8:43pm on that evening, then it was time to feast. There was so much food there that everyone was filled and still had enough to take home leftovers. It was an event where after sharing this occasion with friends and colleagues, and learning about different cultures, one left feeling full both physically and spiritually, regardless of individual faith backgrounds.
Drs. Fadul and Ashraf were previously colleagues together at another institution where they created this tradition, and Dr. El-Ramahi joined them here; we are thrilled that they have shared it with us here at UNMC. We hope that in subsequent years the event is even bigger, expanding to the Department of Medicine and beyond, so that more people can share this special occasion, learn about different cultures, and recognize the impact of diversity in our lives.
The authors validated that the IDSA guideline-based criteria had a sensitivity of 97% (95% CI 84.2-99.9), specificity of 33.9% (95% CI: 30.1-37.8), negative predictive value of 99.5% (95% CI: 97.3-100.0), and a positive predictive value of 7.5% (95% CI: 5.2-10.4). They found that application of these testing criteria would have avoided testing in 32% of patients, and avoided unnecessary antibiotics) in 23% of patients.
Lt Col Schnaubelt began her military career as a Cadet at the United States Air Force Academy with hopes of flying fighter jets. Her focus quickly changed after a visit to Haiti where she realized that her true passion was a career in medicine. After the academy she attend medical school at Loyola University Chicago. Dr. Schnaubelt completed her internal medicine residency at Wright State University, and infectious diseases fellowship at San Antonio Military Medical Center. Following her medical training, she was deployed to Afghanistan, and was then assigned to Landstuhl Regional Medical Center in Germany.
Following her assignment in Germany, Dr. Schnaubelt was selected as an 
Congratulations, Dr. Schnaubelt, on a well-earned promotion, recognizing your talents and long list of accomplishments. We appreciate you and thank you for your service, as both a military officer, and an UNMC ID faculty member.
This is yet another study demonstrating the ease of implementation of checklists/bundles for improving quality of patient care. 
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