Editors in Conversation

Today we're talking about testing in schools for COVID-19, and about recalls of SARS-CoV-2 tests due to false positive results, and, about whether we are ready to go to in-person scientific and medical meetings.

Joining me for this roundtable discussion are two frequent guests on the podcast, Dr. Melissa Miller, from UNC School of Medicine, and Dr. Elli Theel, from Mayo Clinic.

Links: School Testing for COVID-19. https://www.cp24.com/news/toronto-school-parents-set-up-diy-covid-19-surveillance-testing-program-1.5590772 and https://www.nytimes.com/2021/09/19/health/coronavirus-school-quarantine-testing.html

False positive COVID-19 tests. https://www.nbcnews.com/news/us-news/view-hosts-say-they-had-false-positive-covid-tests-during-n1280183 and https://www.nytimes.com/2021/10/05/health/at-home-covid-tests-recall.html

Return to In-Person Meetings? https://blogs.jwatch.org/hiv-id-observations/

How can we determine whether someone who has COVID-19 can transmit the virus to other people? Tests in routine clinical use, such as reverse-transcription polymerase chain reaction and antigen tests, are designed to determine whether SARS-CoV-2 is present or not, but many people have proposed that these tests be used to determine whether a patient is infectious. Furthermore, tests for SARS-CoV-2 that are not routinely used in clinical laboratories, such as viral culture and detection of sub-genomic viral RNAs, have also been discussed as indicators of infectivity. But how accurate are any of these tests for determining whether someone is infectious?

Guest:

Dr. Matthew Binnicker, Director of Clinical Virology and Professor of Laboratory Medicine and Pathology at Mayo Clinic. Twitter: @DrMattBinnicker

Links: Can Testing Predict SARS-CoV-2 Infectivity? The Potential for Certain Methods to be a Surrogate for Replication-Competent Virus https://journals.asm.org/doi/10.1128/JCM.00469-21

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Enterococci, particularly vancomycin-resistant isolates tend to affect the most vulnerable and immunocompromised patients and are one of the most difficult bacteria to treat. In absence of robust clinical data, we will discuss therapeutic approaches for these recalcitrant organism.

Tests for antibodies, or serological testing, for SARS-CoV-2 have come a long way since the early days of the COVID-19 pandemic. There are now several commercial tests available and some laboratories have developed tests for specific purposes. Tests can determine whether a person has had COVID-19 in the past, or whether someone has had an antibody response to vaccination or even whether someone has antibodies that can neutralize the virus, preventing it from infecting host cells.

Guests: - Dr. Elitza Theel, Director of the Infectious Diseases Serology laboratory at Mayo Clinic in Rochester, Minnesota.

- Dr. Alex Greninger, Assistant Director of the Clinical Virology Laboratory at the University of Washington Clinical Virology Laboratory, where he is also an Assistant Professor of Laboratory Medicine.

Visit asm.org/eic for links mentioned

During the pandemic, the need to develop therapeutic approaches became critical and so the need to study them in a structured way to critically evaluate their effectiveness. Innovative strategies to conduct clinical trials under difficult circumstances were required. We will discuss these strategies with some people who created them! Objectives: • Understand the main challenges to conduct clinical trials in the middle of a pandemic both in the developed and developing world • Discuss strategies for patient recruitment and evaluation.

• Deliberate on future strategies to study new therapies for emerging pathogens.

Guests: • David Boulware, MD MPH. Professor of Medicine and Infectious Diseases, University of Minnesota. • Eduardo López-Medina, MD. Assistant Professor of Pediatrics at Universidad del Valle, and Director of Pediatric Infectious Diseases, Centro Medico Imbanaco, Cali Colombia.

Accurate antibiotic susceptibility testing, or AST, is a key tool in addressing the rise in antibiotic-resistant bacteria. But AST is one of the most complicated and rapidly changing areas in the clinical microbiology, and the resulting confusion can make it difficult for clinical laboratories to keep up with best practices. Dr. Romney Humphries joins to talk about controversies and myths about AST.

This episode was recorded with a live, remote audience at the World Microbe Forum. It is brought to you by the Journal of Clinical Microbiology, available at jcm.asm.org and on twitter @JClinMicro.

Visit asm.org/eic for links.

Malaria continues to be a major "killer' in the developing world affecting the most vulnerable populations with more than 500,000 deaths per year. Emergence of resistance to antimalarial drugs is major public health issue. In this episode, we will discuss the latest information on this rapidly evolving field with one of the foremost experts in the field.

• Review the main factors leading to malaria resistance • Discuss the main genetic mechanism of resistance to antimalarials. • Elaborate on future approaches for the prevention of resistance in Plasmodium spp.

Guest: Professor Sir Nicholas White. Professor of Tropical Medicine at Oxford University and Mahidol University in Thailand.

Visit https://asm.org/eic for links and https://journals.asm.org/journal/aac to read the AAC Journal

In addition to Staphylococcus aureus, there are a small number of other coagulase-positive staphylococci. We have become increasingly aware of these due to improvements in identification methods used in clinical laboratories. Staphylococcus argenteus is a coagulase-positive Staphylococcus that, until now, had mainly been detected in Australia, the Pacific Islands and Thailand. It was thought that the species might be geographically restricted, however a paper in the June issue of the Journal of Clinical Microbiology describes a large number of isolates collected from patients in North America. We'll be talking to two of the authors of this paper.

Guests: Dr. Julianne Kus, Dr. Audrey Schuetz

The development of β-lactam/β-lactamase inhibitors seems to be expanding rapidly and promise to be the best short-term strategy against the most recalcitrant Gram-negative pathogens. In this podcast, we will discuss the current state of the art in this field. Objectives:

• Discuss how the discovery of β-lactam/β-lactam inhibitors has evolved • Review the current state-of-the-art of developing of novel β-lactam/β-lactamase inhibitors

• Analyze the current and future clinical applications of these drugs against major antimicrobial-resistant pathogens.

Guests:

• Robert Bonomo, MD. Professor and Associate Chief of Staff for Academic Affairs; Director Case-VA Center for Antimicrobial Resistance and Epidemiology, Case Western Research University, School of Medicine. Past Editor of AAC
• Pranita Tamma, MD. MH.S. Associate Professor of Pediatrics and Director, Pediatric Antimicrobial Stewardship Program. Johns Hopkins University. Editor of AAC.

Visit https://aac.asm.org to read more

Our options for susceptibility testing have greatly increased in recent years. In addition to classical phenotypic susceptibility testing by disk diffusion and measurement of the minimum inhibitory concentration, genotypic tests are increasingly available. Genotypic tests range from tests for a single organism and one resistance gene to tests for 20 or more organisms and multiple resistance genes. But what should the clinical microbiologist do when the results of phenotypic and genotypic are in conflict?

Welcome to Editors in Conversation. This episode is brought to you by the Journal of Clinical Microbiology, available at jcm.asm.org and on twitter @JClinMicro. I'm JCM Editor in Chief, Alex McAdam. This podcast is supported by the American Society for Microbiology, which publishes JCM.

Guests: Dr. Patricia Simner, Dr. Jennifer Dien Bard

Visit https://jcm.asm.org to read more