In this episode of The ICHE Podcast, we take a deep dive into the evolving role of plasma cell-free DNA (cfDNA) metagenomic next-generation sequencing (mNGS) in the diagnosis of infectious diseases. Hosted by experts from UCLA Health, this discussion breaks down what cfDNA mNGS is, how it differs from more traditional pathogen detection tools like PCR, and where it fits in the diagnostic landscape.

Dr. Ishminder Kaur, Dr. Daniel Uslan, and Dr. Shangxin Yang join the episode to explore the clinical utility, benefits, and pitfalls of this rapidly emerging diagnostic modality. The group reviews several individual studies, highlighting how they approached their research questions, key findings, and the implications for patient care and antimicrobial stewardship. The conversation also addresses challenges such as interpreting complex results, cost considerations, and potential overuse.

Whether you’re a clinician, laboratorian, or infection preventionist, this episode provides critical insights into when and how cfDNA mNGS may enhance your diagnostic toolkit—and when it might not.

Each guest closes with a practical takeaway: concrete advice for healthcare professionals who are considering incorporating cfDNA testing into their own clinical or infection control practice.

In this episode of The ICHE Podcast, David Calfee joined by three experts who contributed to the development of the updated SHEA guidance on high-level disinfection (HLD) and sterilization: Dr. Emily Sickbert-Bennett, Dr. Audrey Calderwood, and Dr. Erica Shenoy. Together, they bring expertise in infection prevention and hospital epidemiology to a discussion of what’s new, what’s changed, and how this guidance can be applied in real-world settings.

The episode begins by exploring why an update to the 2008 CDC guideline was necessary and how this new document builds upon and clarifies existing practices. The speakers walk through the multi-year process that began in 2018, outlining the rigorous evidence review and unanimous consensus required for each recommendation. They also clarify what was considered out of scope, including topics such as low-level disinfection, environmental cleaning, and access or cost concerns.

Listeners will learn how to interpret the guidance within their own institutions, including when no formal recommendation is provided due to insufficient evidence. The episode highlights emerging technologies like disposable scopes, 3D printed devices, and borescopes—discussing which are ready for clinical use and which require further evaluation.

To close, each guest offers a practical action item to help listeners improve safety and quality related to HLD and sterilization in their own facilities. This is a must-listen for anyone involved in infection prevention, reprocessing, or clinical safety.

In this episode of the ICHE Podcast, we bring together Dr. Loreen Herwaldt (University of Iowa) and Dr. Jessica Seidelman (Duke University) to explore the latest research and strategies aimed at reducing the burden of surgical site infections (SSIs). SSIs remain a significant cause of postoperative morbidity and mortality, contributing to prolonged hospital stays, increased healthcare costs, and serious complications for patients.

The conversation begins with a broad discussion of the current landscape of SSI prevention and the continuing challenges that hospitals and infection prevention teams face. Both guests then share findings from their recent studies, explaining the key questions they set out to answer, the methods they used, and the implications of their results. They also reflect on important limitations and lessons learned along the way.

Listeners will gain valuable insights into the real-world complexity of SSI prevention, from institutional barriers to the nuances of implementing evidence-based practices. The episode concludes with each guest offering a practical, actionable takeaway for infection preventionists—something you can do now to improve surgical safety in your facility.

In this episode of The ICHE Podcast, Editor-in-Chief David Calfee is joined by Drs. Catherine Passaretti and Michael Klompas for a timely discussion on healthcare-acquired respiratory viral infections (HA-RVIs). Together, they explore how frequently these infections occur, the primary sources of transmission—including infected healthcare personnel (HCP)—and the infection prevention strategies aimed at minimizing risk.

Dr. Passaretti walks listeners through her recently published letter proposing updates to current HCP return-to-work guidelines following COVID-19 infection. She explains the rationale behind the proposal, citing key concerns with existing guidance. Dr. Klompas then discusses two papers: one by Stone et al., which investigates the impact of current return-to-work policies, and another by Klompas himself, which reflects on the broader implications and outlines additional strategies to reduce HCP-to-patient transmission risk.

The episode concludes with actionable insights from each participant, offering practical steps that healthcare facilities can implement today to enhance respiratory virus prevention and reevaluate HCP return-to-work protocols based on evolving evidence and epidemiology.

This conversation offers valuable guidance for healthcare leaders, infection preventionists, and policy makers navigating a post-COVID landscape.

In this episode of the ICHE Podcast, we explore the critical issue of blood culture contamination and the role of initial specimen diversion devices (ISDDs) in reducing false-positive results. Host Dr. David Calfee is joined by a distinguished panel of experts including: Dr. Maria Navas, Dr. Mark Rupp, Dr. Lucy Tompkins, and Dr. Francine Touzard Romo.

The discussion begins with an overview of blood culture contamination—what it is, how it happens, and why it matters for patient care. Our experts examine the prevalence of contamination and its consequences, including unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs.

The conversation then shifts studies recently published in ICHE on ISDDs—what they are, how they function, and whether they are an effective solution. Drs. Tompkins, Touzard Romo, and Navas share insights from their recent studies, followed by a discussion on the challenges of adherence in clinical settings. Dr. Rupp presents additional data to round out the discussion. At the conclusion of today’s episode, each expert offers a practical tip for healthcare professionals considering ISDD implementation in their institutions.

On this episode of The ICHE Podcast, we dive into research priorities in healthcare-associated infections (HAIs) and antimicrobial stewardship (AS) with experts Robin Jump, Jennie Kwon, Daniel Livorsi, Lona Mody, and Eli Perencevich. The discussion explores the importance of publishing research agendas to stimulate focused research, guide researchers in prioritizing critical topics, and inform funding decisions. By addressing these goals, the panel aims to align research efforts with pressing clinical challenges, foster innovation, and bridge gaps between research and implementation. The guests also discuss the structured methodologies used to draft these research agendas, detailing how key priorities were identified and refined to address the most urgent needs in the field.

The panel reviews three recently published agendas in ICHE: A Call to Action: The SHEA Research Agenda to Combat Healthcare-Associated Infections, Research Agenda for Transmission Prevention within the Veterans Health Administration, 2024–2028, and Research Agenda for Antibiotic Stewardship within the Veterans Health Administration, 2024–2028. Key topics include addressing antimicrobial resistance, improving diagnostic tools, and tackling HAIs in vulnerable populations. The conversation further examines the applicability of findings from VA-specific agendas to non-VA healthcare settings, concluding that many insights are broadly relevant.

Listeners will gain a clearer understanding of the research landscape and actionable ways to contribute to advancements in patient safety and healthcare quality. For further details, explore the full articles discussed in this episode at Cambridge.org/ICHE.

In this episode of the ICHE Podcast, guests discuss the prevention and management of infections in obstetrical populations, with a focus on Group A Streptococcal (GAS) infections. Hosted by ICHE Editor-in-Chief, Dr. David Calfee, the episode features Dr. John Conly, Dr. Shandra R. Day, and Dr. Kiran M. Perkins. The discussion begins with an overview of GAS infections in healthcare settings, particularly in the peripartum period, highlighting the unique challenges associated with these infections. The guests explore strategies for healthcare-associated GAS infection prevention, including practical approaches and solutions to overcome implementation barriers. Each expert shares insights from their recent research, addressing questions their studies aimed to answer, the methods they used, key findings, important limitations, and the broader implications of their work for infection prevention. Together, they emphasize the importance of understanding risks specific to labor and delivery units and the critical need for evidence-based practices to mitigate these risks. The episode concludes with actionable advice from each guest, providing concrete steps facilities can take to assess and reduce the risk of GAS infections in obstetrical settings. Following the episode, be sure to visit cambridge.org/iche to access the research featured in this episode.

In this episode of the ICHE podcast, we explore the theme of respiratory culturing appropriateness in pediatric patients, emphasizing diagnostic stewardship's role in optimizing patient outcomes. Host David Calfee, MD, MS and guest experts, Kathleen Chiotos, MD, MSCE and Edward Lyon, DO, MA, share insights on how stewardship practices can refine respiratory testing in pediatric intensive care units (PICUs), where evidence suggests these tests are often overused without clinical benefit. They examine challenges in implementing stewardship, including barriers like resistance to change and logistical issues, and discuss practical strategies to overcome these obstacles.

The conversation highlights two recent studies published in ICHE: Dr. Lyon's work on repeat tracheal aspirate cultures in PICUs, which analyzes their frequency, resistance patterns, and impact on antimicrobial use, and Dr. Chiotos's study on a tracheal aspirate culture stewardship intervention, examining its effect in a tertiary PICU. Both authors discuss their studies' methodologies, findings, limitations, and implications for future practice.

To wrap up, each expert offers actionable recommendations for healthcare professionals interested in improving respiratory culturing practices at their institutions, providing practical steps to enhance safety and care efficiency. Full versions of the articles discussed in this episode are available in the September issue of ICHE.

In this episode of The ICHE Podcast, we explore the use of mathematical modeling to understand the impact of different infection prevention strategies in healthcare settings. Our expert panel, featuring Daniel K. Sewell, Rachel B. Slayton, and Samuel Cincotta, delves into how modeling studies can inform healthcare decision-making by evaluating the effectiveness of various prevention approaches.

The discussion covers the basic principles of modeling, commonly used methods, and the key limitations healthcare professionals need to consider when interpreting these studies. Additionally, we examine the CDC’s Modeling Infectious Diseases in Healthcare Network (MInD-Healthcare) to understand the role of this initiative in improving infection prevention strategies.

Key topics include understanding what mathematical modeling is, how to read and interpret modeling studies, the basic methods and terminology used, and the limitations of modeling. Our panelists also walk through individual research studies, addressing research questions, methods, findings, and limitations.

Tune in for practical insights into how mathematical modeling is shaping the future of infection prevention in healthcare settings.

In this episode of the ICHE Podcast, we delve into the topic of Staphylococcus aureus (S. aureus) and Methicillin-resistant Staphylococcus aureus (MRSA), focusing on healthcare-associated infections and transmission. Our expert panel of authors from recently published ICHE papers includes Anthony Harris, MD, MPH, Elise Martin, MD, MS, and Philip M. Polgreen, MD, MPH. Listen as they discuss the prevalence of these infections, the risks they pose, and the strategies that can be employed to reduce transmission in both healthcare settings and households. At the conclusion of today’s episode, each participant offers a practical, actionable recommendation for listeners.