Division of Infectious Diseases

What to Expect in Antimicrobial Stewardship…Shorter is Better, Of Course!

The following was previously posted by Dr. Marcelin to SHEA Journal Club published online in February 2019. Electronic clinical decision support tools and rapid diagnostic testing have significantly impacted the way we practice Infectious Diseases. Despite these scientific gains, Antimicrobial Stewardship still requires an understanding of the behavioral science of prescribing. Prior studies have demonstrated that antibiotic prescribing may be influenced by specific behavioral interventions,… Continue Reading

Prescribing in Pediatric Patients: Who is at Risk?

The following was previously posted by Dr. Marcelin to SHEA Journal Club published online in January 2019. In the inpatient setting, much of the broad-spectrum antibiotic prescribing occurs in the context of the sepsis syndrome, where uncertainty leads to overly broad empiricism. Development of antibiotic-resistant Gram-negative rods (high-risk GNRs) may complicate empiric treatment choices, and in the pediatric population, delay in appropriate treatment can have… Continue Reading

Decisive De-labelling in Cancer Patients: Just what the Doctor Ordered

The following was previously posted by Dr. Marcelin to SHEA Journal Club published online in January 2019. Although 10% of Americans report penicillin allergies, 90% of those allergies are not substantiated. Up to 25% of patients living with cancer report penicillin allergies, but more than half of these are low risk and could tolerate beta-lactams. Cancer patients are likely to receive inappropriate antibiotics for a… Continue Reading

SeptiCyte: Is It Ready for Prime-time?

The following is a summary of a recent ID Journal Club, presented and written by 2nd year ID Fellow Dr. Raj Karnatak: Sepsis defined as “life-threatening organ dysfunction due to the dysregulated host response to an infection” [1]. Sepsis most commonly results from a bacterial infection, or less frequently from a fungal or viral infection. Sepsis is the most expensive condition treated in US hospitals… Continue Reading

Does the Clostridium Smell Diffy? Even the Dogs Disagree…

The C. difficile sniffing dogs are back! There are several prior reports of individual dogs being trained to “sniff out” C. difficile. In a novel approach, the authors of this study trained two dogs simultaneously, and then compared interrater reliability between sniff attempts. They used toxigenic C. difficile frozen stool samples (GDH EIA and PCR positive) and negative controls in an institution where prevalence of… Continue Reading

An Empiric Nudge in the Right Direction

The following review was originally posted by Dr. Marcelin to the September 2018 SHEA Journal Club and featured on Medscape’s SHEA Expert Commentary earlier this month.  Use of empiric antimicrobial treatment in acute care settings is often the result of the “diagnosis momentum” heuristic, wherein the antibiotics started in one location for “sepsis” are continued for several additional days after transfer to a second location. Vancomycin remains… Continue Reading

CRE or not CRE: A Question of Risky Business and Notes from the Field

The following was originally posted by Dr. Marcelin to the August 2018 SHEA Journal Club  Carbapenem-resistant Enterobacteriaceae (CRE) are not as prevalent in the United States as they are in the Eastern Hemisphere; however travel within our global village means creates opportunity for movement of these organisms to our region.  The following is a review of two studies on risk predictors for CRE and three “Notes… Continue Reading

What’s all the buzz about West Nile Virus?

This summer, we have seen several cases of West Nile infection, prompting many questions related to the infection. So, what’s all the buzz about West Nile? Drs. Jasmine Marcelin and Kelly Cawcutt compiled some answers to Frequently Asked Questions about West Nile. What is West Nile Virus?  West Nile Virus is spread via mosquito bites.  Mosquitos get the virus by biting infected birds.  In North America,… Continue Reading

At UNMC, ID fellows learn HIV from the experts

Over the course of their training, fellows in the UNMC’s Division of Infectious Diseases will receive dedicated clinical and didactic training in the area of HIV alongside faculty with expertise in the HIV clinical care and research. Clinical Training: Fellows will have their continuity clinic at UNMC’s HIV clinic one half day each week. The UNMC HIV Program is a regional leader in HIV care… Continue Reading

Travels, Bones and Bugs, Oh My! ID fellows will see it all at UNMC

At UNMC ID we are fortunate to have some very unique experiences for fellows to explore their interests in our various aspects of our specialty. We are also fortunate to have experts and leaders at the helm, leading fellows through these experiences toward their ultimate career choices. One of these leaders is Dr. Angela Hewlett (pictured on the right in the personal protective equipment below),… Continue Reading