Editors in Conversation

This is a special live recording of Editors in Conversation at the 2025 ASM Global Research Symposium in Bengaluru, India. We explore the evolving landscape of drug-resistant pathogens—from the intracellular survival strategies of Salmonella to the global rise of multidrug-resistant fungi like Candida auris. This conversation highlights the urgent need for integrated, One Health solutions to combat AMR across human, animal, and environmental domains.

Watch this episode: https://youtu.be/G1KtS6MSjHs 

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I almost can't believe that we are wrapping up yet another year on the podcast this month, which has been going strong for 6 years now! And it has been another exciting year in the world of Clin Micro as well with improvements and new assays available for some of our bread and butter tests, but the year also brought about significant developments in the application of AI and digital imaging, use of NGS methods, and probably some cool AST stuff in there too among other things, with many of these advancements published in JCM. And so, as has become...

Prosthetic joint infections (PJI) remain among the most devastating complications in orthopedic surgery, with increasing incidence paralleling the growth in arthroplasty procedures worldwide. While treatment protocols are well-established, evidence supporting current approaches is lacking, and outcomes remain suboptimal, highlighting the need for improved therapeutic strategies. AAC recently published a minireview of randomized controlled trials and emerging evidence for the management for these difficult to treat infection. Today, we discuss with one of the authors of the manuscript and an ID doctor specialized in PJI infections the findings of such paper.

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It's that time of year, folks! No, not leaf-peeping season, or pumpkin spice season or even apple picking season – I'm talking respiratory virus season! The symphony of sniffles and coughs is just around the corner! It's the time of year that clinical laboratories are stocking up on supplies, developing testing algorithms and putting out communications to try to convince people that every kid with the sniffles does not, in fact, warrant a highly-multiplexed respiratory virus panel test.

The diagnostic landscape for respiratory viruses has evolved dramatically in the last five years, with widespread institution of molecular te...

Treponema pallidum, the causative agent of syphilis, has been around for what seems like forever, causing major outbreaks throughout the millennia and continuing to spread at high rates, globally, into today. When it comes to diagnostic testing, some tests like RPR and VDRL have stood the test of time, having been implemented in the late 1930s and 1940s, and are now used in combination with contemporary methods like EIAs and chemiluminescent assays as the reference standard method to diagnosis syphilis cases. New approaches to screening and diagnosis are needed, however, to increase test access and ultimately case identification and...

The launch of ChatGPT three years ago brought the concept of artificial intelligence into the daily conversation. Today, it seems all industries, including lab medicine, are integrating AI with the promise of making our lives easier. How do we best navigate implementing this technology into clinical microbiology? How will it be regulated? … and, what is AI anyway?

Watch this epsiode: https://youtu.be/2B_JJEFJv7I

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The Journal of Clinical Microbiology has a great tradition of publishing mini-reviews on topics that are important to the clinical microbiology community. Minireviews provide "up to the minute" updates on topics pertinent to clinical microbiologists and serve as fabulous training tools for medical professionals, trainees, and researchers across all disciplines. Dr. Humphries and Dr. Ledeboer discuss what makes a great mini-review, and their favorite mini-reviews published in JCM.

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

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM...

Antimicrobial resistance is one of the largest threats to global public health, compromising all other advances in modern medicine. At the forefront of detecting AMR is the clinical laboratory. 

However, walk into any clinical microbiology laboratory today and you will find this important task being accomplished using techniques that barely evolved from the methods proposed by Alexander Fleming, nearly 100 years ago. 

Bacteria are exposed to antimicrobials, in an in vitro culture system, and growth inhibition is measured after overnight incubation. In the time of laboratory automation, molecular testing and artificial intelligence – are we ready for an a...

Measles is becoming an important public health problem and it is important to recognize and understand the origins of this problem and how it can affect the population of our country. At the same time, it is critical to have updated and scientifically accurate information on the clinical presentations, risk factors and countermeasures. Today, we will discuss this topic with experts in field. 

Watch this episode: https://youtu.be/oQDaa8J9v5w

Topics:

 • Define measles as an important public health threat
 • Explain the origin of the epidemic
 • Accurate information on countermea...

With Alex's departure to new pastures, which include things like being the incoming President of ASM, we now have a new JCM Editor-in-Chief, Dr. Romney Humphries!

Dr. Humphries is currently Director of the Division of Laboratory Medicine and Medical Director of the Microbiology Laboratory at Vanderbilt University, as well as a Professor of Pathology, Microbiology and Immunology. She is an absolute powerhouse in the AST world as we all know, and as of this month, is the new Editor in Chief of JCM.

In this episode, we find out Dr. Humphries's vision and new ideas...

A common description of antibiotic action aims to classify them between "bactericidal" or "bacteriostatic". Although these phenomena have robust in vitro foundations, the clinical translation of these concepts is sometimes difficult to ascertain. This controversial topic has important conceptual ramifications to treat severe infections. Today, we will discuss this topic with an expert in field. 

Watch the video version here: https://youtu.be/3z4BItBrzbk

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Oversight and guidance for performing antibiotic susceptibility testing can be bewildering. There is an alphabet soup of agencies and bodies involved: FDA, CLSI, and USCAST, to name a few here in the US. How does the Food and Drug Administration, which has regulatory authority over AST, work with a nimble group like the Clinical Laboratory Standards Institute?

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In the last decade, there have been major changes in the approach of the treatment of pneumonia, in particular, with the availability of new diagnostic tools. Additionally, new drugs have been approved for the treatment of pneumonia. We discuss the approach to the management of pneumonia with a person who has spent most of his professional career working on this topic.

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Picture this, you wake up one morning with nausea, body aches, abdominal pain, and despite sleeping all night, you are exhausted. You then find yourself running to the restroom with watery and somewhat explosive diarrhea. You think to yourself – what could this be? Well, if the year was 2023, in the summer and you happen to live in Texas, chances were somewhat high that you had probably had cyclosporiasis.  And today, we are going to talk about this particular parasite and focus in on what our options are for detecting it given that it is not routinely picked up on O&P...

The past year in Clinical Microbiology, as seen through the lens of the Journal of Clinical Microbiology. Four JCM editors have each selected a paper they consider to be among the "best" we published in 2024. Of course there are no objective criteria for what makes a paper the "best." So, by "best," we mean "a paper that I find exciting."

View this episode: https://www.youtube.com/watch?v=fK9ZqZUrDiY

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2024 was a very active year on research in antimicrobial resistance, highlighted by an impactful and high level political declaration to combat antimicrobial resistance by the United Nations. In this episode, trainees from NIH-funded training program (T32) on antimicrobial resistance will help me discuss the most relevant research on the field in the year 2024. Welcome to editors in conversation!

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Looking for a dynamic and rewarding career? Learn what it means to be a Clinical Microbiology Laboratory Director and the necessary steps to get there. It's a diverse job encompassing infectious diseases diagnostic testing, patient care, teaching, and research. This episode is geared for those who are interested in pursuing (or already have) a Ph.D. or M.D.

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This episode of Editors...

Lack of access to antibiotics including those with enhanced activity against multidrug-resistant organisms is a major barrier to combat antimicrobial resistance, particularly in the developing world. Furthermore, discovering and making available new antimicrobial agents against the most pressing antibiotic-resitant organisms is a challenge due to multiple barriers.

The Global Antibiotic Research & Development Partnership (GARDP) accelerates the development and access of treatments for drug-resistant bacterial infections. Together with public, private and non-profit partners, GARDP works to preserve the power of antibiotics for generations to come. We discuss the important role that GARDP is playing in the worldwide fight...

So you want validated, at-home, self-collected swabs for STI testing… Here's what you need to know! 

Sexually transmitted infection rates continue to climb across the US and while testing for these diseases is widely available, for the most part it requires the patient to go to a local clinic to collect and submit their sample for testing. But, is that really necessary, especially from a test accuracy perspective?

Today's guests answer that exact question. And I'm sure that many, if not all of us would agree that the ability for patients to collect samples outside of...

The second High-Level Meeting on Antimicrobial Resistance (AMR) took place in New York on 26 September 2024 as the principal official, health-focused event during the UN General Assembly high-level week. The intergovernmental negotiations for the declaration were co-facilitated by Malta and Barbados. A political declaration for the meeting was produced highlighting the fact that AMR will cause even more global suffering, particularly in low- and middle-income countries. In this episode we will debrief and analyze the possible impact of these meetings and consequences for the future of AMR research and antimicrobial development. 

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The American Society for Microbiology is launching a new journal, ASM Case Reports. The journal is already accepting submissions and will begin publishing in January of 2025. We discuss ASM Case Reports and what you can expect from this new journal.

Watch this episode: https://youtu.be/zHdZL0PYTuE

Some of the questions we will discuss include:

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Learn more about ASM...

Duration: 00:30:27

Heteroresistance is a phenomenon that has been well characterized for many years. However, we are only now starting to understand its mechanistic basis. Indeed, the manner how bacteria respond to antibiotics is complex and phenomena such as persistance, tolerance may be overlapping with heteroresistance. Furthermore, heteroresistance seems to be common in real clinical scenarios and understanding its basis is likely to open new avenues on how we deploy antibacterials in clinical practice., Today, we have experts in the field to discuss this important topic.

Watch this episode at https://youtu.be/qcIcyn1bIHU.

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Duration: 00:42:54

Join Dr. Ben Pinsky and Dr. Greg Berry as they dissect recent news stories, including the USDA's testing for H5N1 in ground beef and a surprising bubonic plague case in Oregon. They also tackle the resurgence of measles in the U.S., the local reappearance of malaria, and a curious study on Neosporin's potential to prevent viral infections.

Overview:

The pipeline of antibiotic discovery is a major necessity due to the continuous evolution of resistance to currently used antimicrobials. This pipeline faces important challenges due to the lack of investment on antimicrobial research in the private sector and an economic model that discourages investment. In the last few years, however, encouraging signs are occurring but major gaps still remain. The World Health Organization has regularly assessed the preclinical and clinical antibacterial development pipeline and the latest report is now available in the journal, lets discuss it!

Watch this episode: https://youtu.be/IgqWmHDIx-0

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Duration: 00:38:20

The European alchemists of the 12th century sought to find the philosopher's stone, a substance that would transmute base metals, such as lead, into precious metals, such as silver and gold. Today, we discuss whether data analysis, including machine learning, can transmute base laboratory data into precious clinical tools. We will use antimicrobial susceptibility testing as a case-study for new applications of data analysis. Some of the questions we will address include:

Antimicrobial resistance is a priority public health problem with complex roots and connotations. However, due to a lack of focus on this topic, research training programs, specifically those focused on AMR are limited. Additionally, scientific meetings that particularly highlight the science of antimicrobial resistance are scarce. We recently published a commentary that evaluates the state-of-the-art of the training programs in AMR in the US. We discuss this topic with the leading author and discussed the issue with leaders in the field.

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Rhodococcus infections are uncommon, however they can cause serious disease in certain patients. There are a number of challenges though when dealing with Rhodococcus infections, including the fact that much of what we know around their susceptibility profiles and the clinical management of infected individuals actually comes from a number case series and in some situations, from the veterinary literature.  So today, our two guests are going to tell us about their experiences with Rhodococcus over a 10-year period and bring us up-to-speed on things like:

Phage therapy has gained a lot of traction but the challenges created by this approach have not been properly assessed at a big scale. We often read about therapy successes on isolated cases but, rarely, we read or hear about failures. AAC recently published a case series of patients who failed phage therapy. Today, we will discuss this topic with the principal investigator on the research.

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The protozoan Lophomonas has been reported to be a pathogen of humans in a large number of case reports and case series. Most of these case reports describe infections of the respiratory tract. Editors in Conversation is joined by two experts to discuss this possible parasite.

Some of the questions addressed include:

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Duration: 00:34:33

Tuberculosis is one of the most deadly infectious diseases that still causes significant burden of disease, particularly in the developing world.  The emergence of resistance to first line agents severely limits the therapeutic options and threaten the ability to control dissemination of this disease. Fortunately, new drugs and regimens are now emerging as important alternatives against these organisms.  Today, we will discuss this topic with outstanding experts in the field. Welcome to the editors in conversation.

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A new generation of B-lactamase inhibitors is likely to reach the market in the upcoming year. These broad-spectrum inhibitors exhibit activity against the most feared class B metallo-B-lactamases maintaining the inhibition of other enzymes. Recently AAC has published three papers that describe the mechanistic bases of taniborbactam resistance among metallo-enzymes. This knowledge is crucial to understand the limitation of these compounds in clinical practice. Today, we will discuss this topic with some of the authors of the mentioned papers. Welcome to the editors in conversation.

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We managed to make it through 2023 without a major epidemic or pandemic, and as we get into the holiday spirit and look forward to the new year, some of us took a look back and picked out one of our favorite JCM paper published in 2023, which I will tell you, was no easy task as there were many of good ones to choose from! And personally, after looking through all the issues over the last year, it never ceases to amaze me the variety of topics that we publish on in JCM – including unique things like the evaluation of a...

Gonorrhea remains one of the more common sexually transmitted infections. In North America, the number of reported cases has generally risen for over ten years, with interruptions in the early days of the COVID-19 pandemic, followed by returns to rising rates of infection. Under the selective pressure of antimicrobial treatment, antimicrobial resistance has risen, which has led to limited options for treatment

Today, we will be discussing antimicrobial resistance in N. gonorrhoeae, including these questions:
    •    How accurate is gradient diffusion susceptibility testing when compared to agar-dilution results?
    •    Should we use analysis of whole genome sequencing results or agar...

In the last few years we have witnessed the rise of very resistant fungal species some of them likely influenced by environmental conditions and climate change. Fortunately, there has been a bit of an explosion in the development of new antifungals and the pipeline has been strengthened in the last decade. We will have the ability to have new molecules with distinct and novel mechanisms of action in the near future that may contribute to combat recalcitrant fungal infections.

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Despite the many advances in diagnostic testing for infectious diseases, detection of Coccidoides infections continues to rely on serologic assessment for anti-fungal antibodies, and what is perhaps more astonishing is that the serologic methods we use today, such as complement fixation and immunodiffusion, were first developed about a century ago. These assays are technically challenging to maintain and perform, and as a result few labs offer this testing, and even if performed on-site, testing can take up to 3 days complete, so there is definitely room for improvement.

So today, we are talking about a study that aimed...

Climate change is possibly the major threat that planet earth is experiencing in this century with potential catastrophic consequences. As the planet warms, the change in weather patterns is affecting the microbial ecology in such a manner that humans are facing new health threats including emerging diseases and facing species of organisms that are more likely to survive these new climatic conditions and resist clinically useful antimicrobials.

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Fungi that are resistant to antifungal drugs have been very much in the news and even the subject of the hugely popular television program, The Last of Us. We talk with two experts in mycology and fungal susceptibility testing about the recent descriptions of terbinafine-resistant dermatophytes in the United States.

Some of the questions we will address include:
 • What are the manifestations of infections caused by terbinafine-resistant dermatophytes?
 • What species, including novel species, of dermatophytes are more commonly resistant to terbinafine?
 • How common is terbinafine resistance in dermatophytes in the U.S.?

Guests:<...

Artificial intelligence (AI) has the potential to change the way we practice medicine and public health. The tools and AI approaches can substantially impact a broad range of fields from the manner we approach patient care to strategies to discover new antimicrobials, track pandemics and deploy public health measures.

AAC recently published a commentary on the impact of AI in infectious diseases and we have a conversation with the lead author of the manuscript and a expert guest who is applying these concepts in real time. 

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Dr. Elli Theel and Dr. Alex McAdam discuss recent viral outbreaks with expert virologists. Recorded before a live audience at ASM Microbe 2023.

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In response to the global burden of antimicrobial resistance (AMR) and the critical role antimicrobial stewardship plays in optimizing antibiotic use and reducing the subsequent emergence of AMR, Antimicrobial Agents and Chemotherapy is excited to add a new section to the journal focused on antimicrobial stewardship studies. Combatting the devastating burden of AMR requires novel, multipronged approaches from clinicians and scientists alike. Launching this new section is an important step in disseminating cutting-edge research that will have notable implications in the global fight against antimicrobial-resistant pathogens.

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The combination of aztreonam with ceftazidime-avibactam is increasingly used for treatment of antimicrobial-resistant Gram-negative bacilli. Clinical laboratories are asked to perform susceptibility testing using this combination, but many laboratory directors have been unsure how to approach this. Today, we'll discuss a recent paper in the Journal of Clinical Microbiology in which the investigators evaluated a promising method for testing this combination of two antimicrobials and a beta-lactamase inhibitor. We will also discuss the rational for combining these agents, as well as what lab directors should consider before validating and offering this susceptibility testing.

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Recorded at ASM Microbe 2023, Cesar has a conversation with Dr. Maria Elena Bottazzi about the role of minority women in science and discovery, the journey of Hispanic women in science and the current challenges posed by society to deliver science and global health equity.

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This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan...

As many of you are likely aware, May is recognized as Women's Health Care Month by the National Cervical Cancer Coalition, and this year, the CDC has identified the week of May 14th as National Women's Health Week. So, what better way to recognize these national events on the podcast than to talk about diagnostics for a number of extremely common and uniquely female issues – of course, I'm talking about infectious causes of vaginitis and vaginosis. Classically, diagnosis of these infections has been done at the point-of-care using wet mount microscopy and assessment for various clinical criteria, all approaches as...

As the number of immunocompromised patients rise in our hospitals, the presentation of severe infections caused by HSV and CMV are rising. Most importantly, lack of response and documented resistance are becoming more frequently observed.

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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...

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

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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...

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.

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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...

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

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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...

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.

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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

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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...

There are a number of regulatory proposals under consideration which could have important effects on clinical microbiology labs, and clinical labs more generally. First, the VALID act would change how clinical tests are regulated with particularly important implications for laboratory-developed tests. Second, the Centers for Medicare and Medicaid Services has proposed changes to the educational requirements for lab directors under CLIA and additional changes that would increase the fees that clinical labs pay to CMS. If you have been waiting for someone to explain these changes and how they could affect your lab, you've come to the right podcast.<...

Infections caused by Mycobacterium abscessus appear to be increasing in frequency among the immunocompromised population and are challenging to treat. Antibiotic options in these cases are scarce, prolonged therapy is required and new options are needed. We will discuss this important topic with experts in the field.

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The inoculum effect of antibiotic susceptibility testing is often discussed at playgrounds and infectious diseases conferences, but many of us don't really have a clear definition of what it is or a good understanding of its importance.

We'll be talking about the inoculum effect and susceptibility testing of Staphylococcus aureus with cefazolin.

Some of the questions we'll discuss are:
• What exactly is the inoculum effect and how is it measured?
• Does the inoculum effect have clinical significance?
• How common is the inoculum effect with Staph aureus and cefazolin?

As July 26, the world has documented 19,188 cases of monkeypox, with 3,591 cases in the US alone, making the US the country with the most known infections amid the global outbreak. The WHO has declared monkeypox a public health emergency. Although this disease has been known for years, certain features suggest that we are facing a unique outbreak of monkeypox with the potential for worldwide spreading.

In this special podcast edition of Editors in Conversation we will discuss the diagnosis and treatment of monkeypox with experts in the field who have dealt with significant number of cases in the...

Dr. Bobbi Pritt aka @parasitegal, creator of the blog Creepy Dreadful Wonderful Parasites, is a pathologist and clinical microbiologist with specialty interests in parasitic and vector-borne infections, and the pathology of infectious diseases.

Dr. Pritt discusses her career and how she became an expert in clinical parasitology, her work internationally and how others can participate in global health work and how technology (digital pathology, AI, automation, etc.) will affect the lab and technicians in the future.

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by J...

Infections caused by Stenotrophomonas maltophilia appear to be increasing in frequency among the immunocompromised population and are challenging to treat. Moreover, resistance to traditional drugs used against these organisms is now becoming more common. Antibiotic options in these circumstances are scarce and new options are needed. We discuss this important topic with experts in the field. Recorded live in Washington DC at ASM Microbe 2022.

Topics

• Stenotrophomas maltophilia as an opportunistic pathogen and
• The intrinsic ability of Stenotrophomonas maltophilia to resist common antimicrobials
• Common mechanisms of resistance in Pseudomonas aeruginosa
• Debate on treatment approach...

We are just back from the Molecular Virology Workshop in West Palm Beach. This is a terrific meeting that is organized by the Pan-American Society for Clinical Virology or PASCV. The workshop immediately precedes the Clinical Virology Symposium that ASM organizes and many of us like to attend both. Today we'll be talking about some of the high points of the Molecular Virology Workshop, with two members of the organizing committee from PASCV.

Guests:

...

Infections caused by multidrug-resistant Pseudomonas aeruginosa are considered a major public health problem. Antibiotic options are scarce but new drugs are emerging and more maybe available in the near future.

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Guests:

It is estimated that anywhere from 575,000 to 677,000 bloodstream infections occur annually in North America, with approximately 40,000 of those directly linked to patient mortality in the United States, making bloodstream infections the 11th most common cause of death in the US according to the Centers for Disease Control and Prevention. The detection of bloodstream infections and subsequent identification of the etiologic agent or agents is an essential role played by all clinical microbiology laboratories, day-in and day-out for routine patient care. So, today, we are going to dive into a recently published study in JCM, looking at organism-specific bloodstream infection...

This episode is dedicated to the memory of the late George A. Jacoby, who was a pillar in the B-lactamase research community and a leader in the field of antimicrobial resistance.

Assigning names to b-lactamase variants has been inconsistent and has led to confusion in the published literature. The common availability of whole genome sequencing has resulted in an exponential growth in the number of new b-lactamase genes. In November 2021 an international group of b-lactamase experts met virtually to develop a consensus for the way naturally-occurring b-lactamase genes should be named.

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Antibiotic susceptibility testing is too slow. Faster identification of microorganisms is now common, as many laboratories use MALDI-TOF or molecular technologies for quick and definitive identification of bacteria. Improvements in susceptibility testing have lagged, as we continue to use tests that take a day for results, and which have not significantly changed in decades. Rapid phenotypic testing has can only be done on limited sample types, using a dedicated platform, and it has not been widely adopted. Tests for rapid genotypic testing usually include only a few genes and require confirmation by phenotypic testing. What are the prospects for...

Bacteriophages are interesting viruses that target bacteria and have been used for therapeutic purposes. Recently, the emergence of antibiotic resistance has spurred a renewed interest in using these viruses or their products as therapeutic tools against recalcitrant human pathogens. AAC has also published a recent manuscript from ARLG to guide the use of phages in clinical practice. We will discuss with experts in the field the state-of-the-art in phage therapy.

Objectives:

• Understand the use of bacteriophages and their products for therapeutic purposes
• Discuss the clinical applications of phages
• Debate the barriers for developing of pha...

When most of us hear the word 'CAPA', these days we more than likely immediately start thinking about SARS-CoV-2 variants, trying to remember how important this particular one was in the grand scheme of the COVID-19 pandemic. But, that is not the 'kappa' we will be talking about today. Instead, we'll be discussing the other CAPA, or COVID-19 Associated Pulmonary Aspergillosis, and we will cover a few areas on this topic, including:

- Defining what CAPA is and how prevalent it is among ICU patients with COVID-19
- Discuss why identification of invasive aspergillosis in...

AAC just published a review from the WHO advisory panel on the antibacterial pipeline analyzing 'traditional' and 'non-traditional' antibacterial agents and modulators in clinical development current on 30 June 2021 with activity against the WHO priority pathogens, mycobacteria and Clostridioides difficile. Today, we will dissect this important publication

Objectives:

• Understand the role of the WHO in antimicrobial resistance
• Discuss the analysis of the antibacterial pipeline
• Deliberate on important highlights from the review and the future of antibacterial research.

Guests:
- Dr. Peter Beyer, Senior Advisor for the Antimicrobial Resistance Division at the World...

In less than two months since it was discovered, the omicron variant of SARS-CoV-2 has become the dominant variant of the virus, causing an unprecedented rise in the number of cases of COVID-19 in the U.S. and elsewhere. The emergence of this variant has quickly led to some surprising claims about diagnostic testing for omicron and a renewed appreciation of the importance of sequencing the viral genome for typing purposes. We will address several questions about testing for omicron, including:

• Are rapid antigen tests sensitive for detection of omicron? And should people swab their throats to in...

As we round out yet another year of this pandemic, clinical microbiologists have not slowed down. We have not slowed down in our response to the pandemic or other day-to-day testing needs, despite the constant reagent backorders and personnel shortages, and equally as important, we have not slowed down in publishing high quality, informative and clinically relevant papers, which have really spanned the gamut of clinical microbiology - from antimicrobial susceptibility testing, to next generation sequencing assays and AI, to evaluation of new high throughput assays for a variety of pathogens, the field continues to expand at an impressive...

Infections caused by carbapenem-resistant Acinetobacter spp. are considered an urgent public health problem. Antibiotic options are scarce but new drugs may be available in the near future. We discuss this important topic with experts in the field.

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Guests:

Is sequencing the SARS-CoV-2 genome useful for patient care? What about institutional infection control? And if clinical labs decide to perform SARS-CoV-2 sequencing, how should they do it? How should they report the results? And will they get paid?

Until recently, sequencing of SARS-CoV-2 genomes has mainly been done in public health or research laboratories. Now, there is increasing interest in sequencing the viral genome in healthcare settings for uses in patient care and infection control. We'll be talking about a new guideline that can help clinical labs and institutions decide whether to perform SARS-CoV-2 sequencing.

Candida auris is an urgent and high-priority antimicrobial resistant organisms. COVID-19 appears to have increased the identification of this pathogen in vulnerable patients. We discuss with experts the emergence of Candida auris and its relationship with COVID-19.

Guests:

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...

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...

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.

...

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 Bo...

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.

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 Medici...

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.

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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:

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...

The incidence of fungal infections is rising in immunocompromised people, and the morbidity and mortality of these infections are high. Recent threats include multi-drug resistant Candida auris, however antifungal resistance is rising in other species as well, such as Aspergillus fumigatus. But have advances in diagnostic testing kept up with the accelerating threats of fungal infections?

Guests: Dr. Esther Babady, Dr. Sean Zhang, Dr. Shawn Lockhart

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

During the pandemic researchers who focus on the microbiology of built environments suddenly found themselves at the center of attention.

Understanding how SARS-CoV-2 may be spreading indoors became incredibly important to ensure we can operate indoors in a safe manner.

We now know that SARS-CoV-2 transmits through the air in droplets and as particles, and this information has helped us to provide comprehensive advice on how people should manage the indoor environment.

Last year my guests published a review in mSystems: 2019 Novel Coronavirus (COVID-19) Pandemic: Built Environment Considerations To Reduce Transmission. This is...

Developing non-traditional antibiotics promises novel strategies to combat multidrug-resistant organisms but would they work? Are they feasible to develop?

Topics discussed: 

• The notion of non-traditional antibiotics as potential therapeutics against MDR organisms 

• Increasing our understanding on the clinical efficacy of non-traditional antibiotics 

• Regulatory pathways for approval of such compounds


Guest: Dr. John Rex, Chief Medical Officer, F2G Ltd. | Editor-in-Chief, AMR.solutions

Visit https://aac.asm.org to browse issues and/or submit a manuscript.

Fermentation is a wonderful thing! Thanks to new technologies and cheaper sequencing we are now able to dig deep into the microbial friends that supply fermentation for so many wonderful foods and drinks.

Topics discussed:

Links mentioned:

Blood cultures for bacteria and yeast are among the most clinically important and high-volume tests performed by clinical microbiology labs. Because these cultures are so important to clinical care, we want to make sure that blood cultures are performed as quickly and accurately as possible, and that they are ordered, collected and utilized appropriately. We are going talk about two recent papers. The first is about diagnostic stewardship for improving utilization of blood cultures and the second is about reporting blood culture results more quickly.

Guests: Maria Valeria Fabre, M.D., Eric Ransom, Ph.D.

What influential research outside of COVID-19 was published in AAC in 2020?

Objectives:

• Discuss pathways of young scientists in antimicrobial resistance
• Highlight important papers in AAC in 2020 that were not related to COVID-19
• Stimulate discussion in important topics related to antimicrobial agents

I want to welcome my co-host Dr. Maria Fernanda Mojica who is the host of the ASM Journal Club focused on Antimicrobial Agents and Resistance. Dr. Mojica is a Postdoctoral Scholar at Case Western Reserve University.

Joining us to discuss their experiences and top paper of AAC in 2020 are:<...

Susceptibility testing for staphylococci other than S. aureus, or SOSA, has become increasingly complicated, as more laboratories use MALDI-TOF to routinely identify these bacteria to the species level. In particular, accurate identification of methicillin resistance has become more complex as the different species are distinguished by the accuracy of different susceptibility testing methods and breakpoints for interpreting MICs and zone sizes.  Some of the questions we'll discuss include:

What is Synthetic Microbiology and why is systems biology central to the development of this exciting scientific discipline?

Topics discussed:

Guests:

Visit msystems.asm.org to read articles and/or submit a manuscript.

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The speed of development of vaccines for COVID-19 has been unprecedented, exceeding expectations. A reflection of the process and lessons for the future. A conversation with Dr. Carol Baker. 

Topics discussed:

Guest:

2020 was a great year… for research in clinical microbiology. The COVID-19 pandemic presented unprecedented challenges, including challenges to clinical laboratories. Clinical microbiologists rapidly created a variety of tests for SARS-CoV-2, figured out innovative ways to collect and transport samples for SARS-CoV-2 testing, and also continued their research in areas outside of the pandemic. In this episode of the podcast, three editors of JCM are each going to discuss three of the most important papers published in the journal during 2020.

Links:

Dr. Simner's Selections

The emergence COVID-19 changed the entire world, a look back to one of the most difficult years for public health in modern history.

Objectives:
• Summarize the key events leading to the COVID-19 pandemic
• Discuss the missteps and successes on the COVID-19 fight in the US
• Comment on the future and what 2021 is likely to bring in relation t the COVID-19 pandemic
Guest:
• Dr. Jeanne Marrazzo: The C. Glenn Cobbs Professor in Infectious Diseases and Director, Division of Infectious Diseases, UAB | The University of Alabama at Birmingham.

Visit https://aac.asm.org to r...

The COVID-19 pandemic has brought more media attention to clinical laboratories than at any time in recent history. Today we'll talk about media coverage of diagnostic testing for COVID-19 with two experts. Some of the questions we'll discuss include:

ARLG is changing the field of clinical research in antimicrobial resistance. We will talk with the Principal Investigators of the ARLG to discuss their strategy

Objectives:

• Review the history and accomplishments of ARLG
• Discuss the missions of ARLG including training new clinical investigators focused on antibiotic resistance
• Comment of the future of ARLG and clinical research on antibiotic resistance

Joining me to talk about ARLG are the principal investigators of this ambitious effort:

• Dr. Vance Fowler: Professor of Medicine, Florence McAlister Distinguished Professor of Medicine, Professor in Molecular Genetics and Micr...

Let's talk about total laboratory automation in the clinical microbiology laboratory. Highly automated systems are fairly common in the clinical chemistry and hematology labs, and they are increasingly common in clinical microbiology. Here are some of the questions we'll answer today.

AAC Launches a new section. New perspectives on antimicrobial agents seeks to provide a clinically-oriented, concise summary supported by emerging clinical trial and/or real-world data. Our first article will be focused on remdesivir

Objectives:

• Review the rationale for the use of remdesivir against SARS-CoV-2
• Discuss the clinical data supporting the use of remdesivir for COVID-19

• Elaborate on future studies and knowledge gaps for the use of remdesivir

New Perspectives on Antimicrobial Agents are brief invited reviews (limit of 4,000 words, exclusive of references) of antimicrobial agents that have been recently introd...

Laboratory testing for COVID-19, what's new since we talked about this in August? A lot. Here are some of the questions we'll talk about.
• Do positive antibody tests indicate that people are immune to infection by SARS-CoV-2, the virus that causes COVID-19?
• What sample types might replace the dreaded nasopharyneal swab for more comfortable sample collection?

• What are the new rapid tests for COVID-19, and how should they be used?

Alex is joined by two expert guests to discuss diagnostic testing for SARS-CoV-2.

- Dr. Melissa Miller, who is the Di...

How are we discovering new antibiotics in the 21st, How is science responding to the antibiotic crisis?

Objectives:

• Discuss the challenges on discovering new antibiotics in the modern era
• Debate the current strategies to find new molecules against the most recalcitrant pathogens
• Understand the multiple approaches that could lead to antibiotic development.

Visit aac.asm.org to read the latest issue of Antimicrobial Agents and Chemotherapy.