Thursday, November 16, 2017

Raising Awareness of Antibiotic Resistance- Locally

Although I commonly do media interviews representing VCU on infectious diseases, yesterday was  the first time that I addressed antibiotic resistance on camera.

It am encouraged that awareness of antibiotic resistance and overuse is getting greater local attention. It certainly cannot hurt the cause of antibiotic stewardship. 

The interview and video clip can be accessed here.

Monday, November 13, 2017

What is trending in Infection Control? Seek Diverse Sources for a Greater Perspective

Read on and seek diverse sources......
What is hot infection control and where should you seek information?

This article, which was recently published in Infection Control and Hospital Epidemiology, explores trending topics and information sources in infection prevention. 

As expected, peer-reviewed journals play an important gatekeeping, elite role in the dissemination of knowledge. The material in published journals is not sensationalized, more rigorous, and, in theory, less biased. 

Websites, including advocacy sites, are unfettered from the peer review process and promote views or topics that trigger a more emotive response (i.e deadly superbugs.)

Blogs are a less elite mechanism for publication and information dissemination. These have a role particularly when an academic prospective is employed. Of course, these too can be biased. I strive to make my medical blog as academic as possible within the framework of my own professional perspective (or bias). One of the best infection prevention blogs is the one by my friends and colleagues- Controversies in Hospital Infection Prevention.

So read on my friends and seek diversity in sources.

Sunday, November 12, 2017

Happy 90th Birthday-Feliz Cumpleaños Professor Enrique Gerstzen

Happy 90th birthday to Professor Enrique Gerstzen, colleague and argentine compatriot at VCU Medical Center. We should all be so lucky to be thriving and working at 90 years of age. A true living legend.

Feliz cumpleaños (90) al Profesor Enrique Gerstzen, colega y compatriota argentino en el centro médico VCU. Todos debemos ser tan afortunados de estar prosperando y trabajando a los 90 años de edad. Una verdadera leyenda viviente.

Images below

Wednesday, November 8, 2017

3rd Annual Gordon Archer Research Day- In Pictures

Today we hosted the 3rd Annual Gordon Archer Research Day at the VCU Medical Campus. 

The collaborative program highlights research in infectious diseases, allergy/immunology and microbiology. The diversity of topics included transplant infectious diseases, infection prevention, HIV care, global health, antimicrobial stewardship and bench research in microbiology and allergy/immunology. Presentations were at the podium and in poster format.

Thank you to Drs. Larry Schwartz (Allergy/Immunology) and Dennis Ohman (Microbiology) for their enthusiastic support and participation.

A very special thanks, always, to my assistants Krystle Shaw and Peggy Andrews. Without them, none of these projects and programs would be possible.

Images are below.

Dr. Salma Abbas

VCU Infection Prevention Nurses:L-R Amie Patrick and Michele Fleming

Graduate Student Kyle Rodino

Dr. Lawrence Schwartz- Allergy and Immunology Chairman

VCU Medical Student Karthryn Osei-Bonsu

VCU medical student Ian Lovern and VCU Infection Prevention Nurse Ginger Vanhoozer

Pharm D Resident Payal Kakadiya
L-R: Krystle Shaw and PeggyAndrews

With Nadia Masroor, MPH- VCU Infection Prevention Research Coordinator
Poster Session

Tuesday, November 7, 2017

Ebola and Emerging Infectious Diseases Preparedness Forum: Quote of the Day

I am spending the day on the campus of the University of Virginia at the Virginia Department of Health (VDH) directed Ebola and Emerging Infectious Diseases Preparedness Forum. Represented were UVA, VCU and other Virginia hospitals. Always a pleasure to dialogue on all things related to infectious diseases with colleagues, including Dr. Costi Sifri, my homologue at UVA.

To quote Dr. Marissa Levine, VDH Commissioner: Critical partnerships and collaborations are the secret sauce of emergency preparedness.

I agree, that's why we are here.

The best preparedness is when you believe that you are not yet ready.

Dr. Lisa Brath- VCU critical care specialist and director of our Unique Pathogens Unit

Monday, November 6, 2017

Infectious Diseases Physicians Add Value to Patient Care, Just In Case You Did Not Know.

As division chair I am commonly asked to justify program expansion with arguments such as RVU generation, improved quality, safety, outcomes etc. As a result, I am always on the lookout for articles to support any of these angles.

It is now well accepted that infectious diseases specialists improve outcomes with respect to Staphylococcus aureus bacteremia. I read this article in Clinical Infectious Diseases about the positive impact on reduced mortality (from 39% to 29%) of a dedicated ID sepsis consult team for an emergency department. Not unexpectedly, 24/7  infectious diseases consultation resulted in  greater compliance with the Surviving Sepsis Campaign bundle, including the prescription of appropriate and timely antibiotics. 

So, a dedicated infectious diseases consult service for patients with sepsis/ septic shock in the emergency department can improve outcomes.  

This sounds great, however, who really wants to staff sepsis consults in the emergency department 24/7?  

This may not be feasible in the long-term and may not play out to scale in the real world.

Thursday, November 2, 2017

Goalkeeping and Medicine: Don't Just Do Something, Stand There!

The Blogger-slightly left of center-front row-as a goalkeeper on the Colgate University Men's Soccer Team

As a lifelong soccer player and goalkeeper this unique perspective in JAMA comparing soccer goalkeeping with medical decision making resonated with me.  

During penalty kicks, many of us reflexively pick a side and dive. Goalkeepers may be better off standing in the center of the goal, first reading the eyes, hip and feet of the shooter and then reacting to the kick. Without a doubt, quality goalkeepers develop a proficiency in positioning and reading the intentions of attackers. Good keepers hold their ground and react deliberately.

Much of modern medicine is practiced reflexively. A symptom or complaint results in a battery of tests readily ordered with the computer mouse in the electronic medical record. 

We should hold our ground, 'dive' less reflexively when evaluating patients and strive for a more thoughtful approach to diagnosis. 

Of course, this takes time, practice and reflection, just like the mastery of any skill, like soccer goalkeeping.