Division of Infectious Diseases

According to the CDC, each year in the US, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result of these infections. Inappropriate antibiotic use is an important driver for development of drug resistant bacteria. Antibiotic misuse is prevalent in all health care settings including acute care hospitals, outpatient centers and long-term care facilities. Studies have found that 40% to 75% of antibiotic use may be inappropriate or unnecessary in the nursing homes. The Centers for Medicare and Medicaid Services (CMS) is now requiring all long-term care facilities to develop an antimicrobial stewardship program to promote appropriate antibiotic use in these facilities.

This year at the annual meeting of AMDA-The Society for Post-Acute and Long-Term Care Medicine, a 90-minute session was dedicated to help the medical directors, other clinical practitioners, and nursing home administrators in developing an antimicrobial stewardship program in their facilities.

Dr. Muhammad Salman Ashraf, who is an associate professor in the division of infectious diseases at the University of Nebraska Medical Center along with other colleagues from AMDA infection advisory committee reviewed the effectiveness of various previous and current nursing home antimicrobial stewardship programs. They introduced the attendees to the available resources and tools (link to CDC website here) that can be utilized to develop such a program and provided important tips to implement those tools. Approximately 300 or more attendees joined this session, which was very well received. Dr. Ashraf feels very optimistic about reduction of antibiotic misuse in the post-acute and long-term care facilities after looking at the positive attitude of the attendees towards tackling this problem.

Content Courtesy of Dr.  Ashraf. 

Today is Dr. Randy Fowler’s last day as a fellow in the clinical microbiology laboratory.  His new position will be with the CDC as a laboratory leadership fellow.  Although the fellowship is managed by the CDC, Dr. Fowler will work at the Minnesota Public Health Laboratory where he will be focusing on national Carbapenem Resistant Enterobacteriacae (CRE) surveillance.

We would all like to extend our sincere gratitude for all of his work and support during his time here! If you see Dr. Fowler, please extend your thanks and well wishes today!

See more about Dr. Fowler and the Clinical Microbiology Fellowship here.

Fellowship application season is nearing and as the Program Director for our ID fellowship, I wanted to highlight a few of the great things about our program.  Our fellows have a robust clinical experience that includes not only the typically complex patients seen at a tertiary referral center, but also includes extensive experience caring for immunosuppressed patients.  In addition to our General ID service, we have two separate immunocompromised services that care for oncology and solid organ transplant patients.  The faculty fellows work with are nationally recognized experts in their field, but are also very approachable and devoted to the education of trainees.  In addition to our inpatient experiences, fellows gain knowledge in HIV/AIDS management working in our multidisciplinary HIV clinic which cares for >1100 persons with HIV.

An important part of fellowship is developing skills in interpreting and performing research and we provide our fellows with a 6 month mentored research experience centered on their career goals.  A research committee assists fellows in mentor identification and project development.  Fellows also participate in a two-week research training program provided by UNMC.  Fellows have the opportunity to be mentored by well-known experts in a variety of areas including HIV/AIDS, immunocompromised hosts, orthopedic infections, hospital epidemiology, antimicrobial stewardship, and biopreparedness.

As new career opportunities develop for ID physicians we have worked to provide our fellows with the skills to engage in these fields.  UNMC ID fellows receive extensive experience in the area of infection control and antimicrobial stewardship.  UNMC also offers the opportunity to stay for an option third year to further develop a research portfolio or to add a critical care medicine fellowship.  My goal as a program director is to provide fellows with an education experience that provides them with skills and knowledge to make them successful in whatever career path they choose.  The opportunities available to ID physicians continue to expand and hope you will consider UNMC ID.  If you are interested in more information, please feel free to visit our website and/or contact me.

 – Dr. VanSchooneveld

Read more about the UNMC ID fellowship here.

Dr. Andrea Green on “Why I Love ID”

Let me count the ways!  I like that we are not limited to just one organ system.  I like investigating difficult cases and solidifying a diagnosis.  I like that we can treat and for the most part, cure patients of their infections.  I like guiding other clinicians with appropriate anti-infective use. To me, it is the most interesting, challenging, dynamic and rewarding field in medicine and I feel privileged to be a part of it.

See more about Dr. Green and the UNMC ID Division here.