Editors in Conversation

Susceptibility testing for piperacillin-tazobactam has undergone rapid evolution, largely driven by some surprising results from the MERINO trial, which compared the efficacy of piperacillin-tazobactam and meropenem for treatment of patients with ceftriaxone-resistant E. coli or Klebsiella pneumoniae bacteremia. We discuss how the results of the MERINO trial led to reconsideration of breakpoints for pipercillin-tazobactam at the Clinical Laboratory Standards Institute, or CLSI, how the breakpoints were changed, and how well commercial platforms perform piperacillin-tazobactam testing using FDA or CLSI breakpoints. Spoiler alert: the news isn't great. If you are interested in beta-lactam/beta lactamase combinations, you should check out the previous episode of this podcast, hosted by our friend Dr. Cesar Arias, the Editor-in-Chief of Antimicrobial Agents and Chemotherapy. Cesar and the guests did a great review of recent developments in this fast-moving area.

• Dr. Trish Simner - Director of the Medical Bacteriology and Infectious Disease Sequencing Laboratories, Johns Hopkins Hospital
• Dr. Romney Humphries - Director of the Division of Laboratory Medicine and the Medical Director of the Microbiology Laboratory at Vanderbilt University Medical Center.

The Center of Diseases Control and Prevention (CDC) has categorized emergent resistance in Neisseria gonorrhoeae as an "urgent" public health problem. We discuss the emerging problem of gonorrhea and implications for public health with experts in the field

• The clinical implications of resistance to B-lactams and quinolones in Neisseria gonorrhoeae
• Mechanisms of resistance in these organisms
• Insights into therapeutic approaches to treat resistant gonococcal infections.

• William M. Shafer, Professor, Department of Microbiology and Immunology, Emory University School of Medicine, Co-Director, Emory Antibiotic Resistance Center
• Yonatan Grad, Melvin J. and Geraldine L. Glimcher Associate Professor of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health

This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up.

Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

We can probably all agree that any false positive test result is bad, but I think it's safe to say that some false positives, like a false positive HIV test for example, is much more anxiety provoking than others. And when it comes to HIV, there have been a number of key advances in the field over the past decade, include the development of improved diagnostics and optimized algorithmic approaches, all of which have allowed for earlier detection of infected patients, and particularly those with acute HIV. Among these advancements has been the development of 4th and 5th generation serologic assays, which offer multiple benefits over prior assay versions, but unfortunately, are not immune to the possibility of false positive results. So, confirmatory test remain a necessary – the challenge though is that depending on the institution and environment, the turnaround time for such confirmatory testing can be prolonged, leaving patients and clinicians in a kind of diagnostic limbo. So, is there a way to minimize the risk of false positive first-tier HIV serologic results? And that is the question will be the focus of our discussion today.

Watch this episode: https://youtu.be/kq61A3Jz67U

Guests:

• Dr. Shivanjali Shankaran - Assistant Professor and ID Clinician in the Division of Infectious Diseases at Rush Medical Center in Chicago
• Dr. Beverly Sha - Professor of Medicine, also in the Division of Infectious Diseases at Rush Medical Center

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel.

Visit https://journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

Follow EIC, Alex McAdam on twitter for JCM updates via https://twitter.com/JClinMicro and co-host, Elli Theel at https://twitter.com/ellitheelphd.

Subscribe to the podcast at https://asm.org/eic

Novel β-lactamase/β-lactamase inhibitors have become critical drugs to combat the most resistant Gram-negative infections. A series of new compounds with even more broad and potent activity are in the horizon to add to the therapeutic armamentarium. Today, we will discuss these drugs with experts in the field.

• BL/BLI combinations that are currently available in clinical practice.
• Future perspectives of BL/BLI armamentarium.
• Resistance developing for this class of antibiotics.

• Robert Bonomo. Professor, Department of Medicine, Pharmacology and Molecular Biology and Microbiology, Case Western Reserve University, Director of VA CARES Center, Cleveland, OH
• Patricia A. Bradford Antimicrobial Development Specialists LLC, Nyack, New York, USA

This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up.

Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

The applications of large multiplex panels for detection of pathogens have greatly expanded in the past several years. Initial tests were for detection of respiratory viruses, and the first such test was labor intensive and vulnerable to frequent contamination. Since then, additional sample types have been added, such as cerebrospinal fluid and positive blood culture broths, and tests are easier to perform and reasonably reliable. We discuss a research use only multiplex PCR assay for detection of pathogens in joint infections, and learning how it compares to targeted metagenomic sequencing and culture for detection of pathogens in periprosthetic joint infections.

• Dr. Marisa Azad - Assistant Professor of Medicine in the Division of Infectious Diseases at The Ottawa Hospital and an Associate Clinical Scientist at the Ottawa Hospital Research Institute.
• Dr. Robin Patel - Co-Director of the Bacteriology Laboratory at the Mayo Clinic, where she is Professor of Medicine and Professor of Microbiology.

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro.

Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

COVID-19 continues to pose major problems in the winter in the USA. Infections and hospitalizations are increasing and there is a fear of emergence of new variants. Therapeutic tools are also evolving. We discuss these new developments!

Watch the video version via: https://youtu.be/ElnahBl53e8

• The latest facts on COVID
• Current therapeutic approaches including antivirals and monoclonal antibodies
• Future perspectives for the coming year on COVID-19.

• Adarsh Bhimraj, MD. Director of Education and Fellowships, Division of Infectious Diseases, Houston Methodsit Hospital. Chair IDSA Guidelines for COVID-19.

This episode of Editors in Conversation is brought to you by the Antimicrobial Agents and Chemotherapy Journal and hosted by AAC Editor in Chief, Cesar Arias.

AAC is available at https://asm.org/aac.

Follow Cesar on twitter at https://twitter.com/SuperBugDoc for AAC updates.

Subscribe to the podcast at https://asm.org/eic

As we enter into the holiday season, many of us look forward to celebrating long-standing traditions with family and friends, which is no different from us here on the podcast! While not necessarily as long-standing as some of the other classic holiday traditions, after 2.5 years on air, we on this podcast have established our own end-of-year tradition, which is to take a look back at some of our favorite papers or more intriguing manuscripts published in the Journal of Clinical Microbiology over the past year. And so as you'll see, thanks to the different areas of expertise and general interest among our panel today, we've selected quite a variety of papers to discuss, ranging from evaluation of new blood culture systems to use of metagenomics for infective endocarditis and to the potential application of interferon gamma release assays for detection of Histoplasma infections. And so, suffice it to say, there will be something of interest for everyone listening. But, for those watching today, you are clearly getting an extra special treat as you get to see us do this episode wearing our best holiday gear and accessories.

Guest:

• Dr. Trish Simner.

Links:

Nasal Swab Performance by Collection Timing, Procedure, and Method of Transport for Patients with SARS-CoV-2. DOI: https://doi.org/10.1128/JCM.00569-21

Multicenter Postimplementation Assessment of the Positive Predictive Value of SARS-CoV-2 Antigen-Based Point-of-Care Tests Used for Screening of Asymptomatic Continuing Care Staff. DOI: https://doi.org/10.1128/JCM.01411-21

Laboratory Safety: Handling Burkholderia pseudomallei Isolates without a Biosafety Cabinet. DOI: https://doi.org/10.1128/JCM.00424-21

The clinical utility of 2 high-throughput 16S rRNA gene sequencing workflows for taxonomic assignment of unidentifiable bacterial pathogens in MALDI-TOF MS. DOI: https://doi.org/10.1128/JCM.01769-21

Performance of Fully Automated Antimicrobial Disk Diffusion Susceptibility Testing Using Copan WASP Colibri Coupled to the Radian In-Line Carousel and Expert System. DOI: 10.1128/JCM.00777-21

Benefits Derived from Full Laboratory Automation in Microbiology: A Tale of Four Laboratories. DOI https://doi.org/10.1128/JCM.01969-20

Reflex Detection of Ciprofloxacin Resistance in Neisseria gonorrhoeae by Use of the SpeeDx ResistancePlus GC Assay. DOI: https://doi.org/10.1128/JCM.00089-21

Comparative Performance of Latest-Generation and FDA-Cleared Serology Tests for the Diagnosis of Chagas Disease. DOI: https://doi.org/10.1128/JCM.00158-21

Diagnosing Pulmonary Tuberculosis by Using Sequence-Specific Purification of Urine Cell-Free DNA. DOI: https://doi.org/10.1128/JCM.00074-21

Indeterminate QuantiFERON Gold Plus Results Reveal Deficient Interferon Gamma Responses in Severely Ill COVID-19 Patients. DOI: https://doi.org/10.1128/JCM.00811-21

Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

Follow JCM on Twitter via @JClinMicro

Deciding how extensively to work up and report respiratory cultures is the worst. There are useful guidelines on how to approach this. But, in my experience, very few laboratories strictly follow these guidelines. That can be because of concerns about under-reporting pathogens or about over-reporting microbiota, or it can be the result of pressure from clinical staff to report more organisms than the guidelines suggest. Today, we'll be talking with two guests about their study on how over-reporting of organisms from respiratory tract cultures can lead to over treatment with antimicrobials.

• Dr. Sarah Parker, pediatric infectious disease specialist at Children's Hospital Colorado and the Medical Director of the Antimicrobial Stewardship Program.
• Dr. Andrea Prinzi, infectious disease medical science liason with bioMerieux.

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro.

Antimicrobial resistance is the 'silent pandemic' and to tackle this challenging public health problem we need to attract the best and brightest. Today we will discuss pathways to work on this field with trainees who will be the next generation of outstanding researchers in the field, currently as part of different T32 training programs in the United States. Welcome to Editors in Conversation

• Different pathways to follow careers in antimicrobial research
• The challenges to follow an academic and research pathways
• Future perspectives and guidance for early stage investigators who want to pursue research on antimicrobial resistance.

• Cheyenne Lee. 4th Year Ph.D. Candidate | McBride Lab, Microbiology and Molecular Genetics (MMG) Program Initiative for Maximizing Student Development (IMSD) Graduate Student Representative, Emory University, Atlanta, GA. T32 predoctoral fellow
• Edwin Chen, MD, PhD. Infectious Diseases Fellow, Postdoctoral T32 Fellow, University of Pittsburgh. Pittsburgh, PA.
• Kara Hood, PhD. Pos-doctoral T32 Fellow, Texas Medical Center Program in Antimicrobial Resistance, Houston Methodist Research Institute, Houston, TX.

This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up.

Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

The idea of applying machine learning and digital pathology platforms to everyday workflows in the clinical microbiology laboratory has become increasing intriguing and appealing, especially as labs continue to optimize efficiency in the midst of workforce shortages. The promise of this new digital frontier is multifold, including decreasing turnaround time and potentially cost, and freeing up technologist time to focus on higher yield activities in the lab. Many labs have now taken the initial leap into automated culture and imaging systems, but what's next? Are the digital pathology AI algorithms ready for prime-time in clinical microbiology labs? Is the future now?

• Dr. Niaz Banaei, Medical Director of the Stanford Health Care Clinical Microbiology Laboratory and Professor of Pathology and Medicine at Stanford University
• Dr. Dan Rhoads, Section Head of Microbiology at Cleveland Clinic

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro.

• Evaluation of MetaSystems automated fluorescent microscopy system for the machine-assisted detection of acid-fast bacilli in clinical samples. https://journals.asm.org/doi/10.1128/jcm.01131-22
• Computer vision and artifical intelligence are emerging diagnostic tools for the clinical microbiologist. https://journals.asm.org/doi/10.1128/JCM.00511-20?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

Follow JCM on Twitter via @JClinMicro