Our newest study of #emergingfungalinfections

Covid-assoc #aspergillosis reportedly occurs in <1/3 ICU patients, but dx is rarely biopsy confirmed

By reviewing autopsy studies, we found proven invasive mould infections occur in 2% of decedents w covid

sciencedirect.com/science/articl…
Major caveat is that most autopsies included were from first wave, pre-#RECOVERYtrial and use of steroids and other immunomodulation likely increase risk of #CAPA.

NB to know your local epi, which may differ; for eg of centers reporting >>> rates, see link.springer.com/article/10.100… &👇
Big congratulations to Dr Brittany Kula (@ScrofKula), ID fellow extraordinaire @UofA_ID and soon @UAlberta_ICU fellow, for doing a wonderful job leading this study. Brittany is pictured in the first tweet, and here is her cat Gladys
Many thanks also to collaborators @ClancyNeil and Hong Nguyen @mhn5pittedu1. This was a companion / complementary study to one Neil led on bacterial superinfections detected on autopsy (which is much more difficult to determine conclusively) academic.oup.com/ofid/article/8…

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More from @GermHunterMD

24 Dec 20
I was today years old when I learned about “human wine decanting” 😱

Infectious diseases is NEVER boring! Image
This 🐇 🕳 😂 Image
@skepticalIDdoc we need to spice up Adult ID Notes a bit more, a la “Reflections of an ID Specialist”
Read 4 tweets
18 Oct 20
Confused about remdesivir in light of the Solidarity trial?

Some experts say the data prove no general mortality benefit. Others say the study was flawed.

Fortunately there have been thoughtful analyses on Twitter from smart & respected ID experts which I’ve threaded together👇
Firstly, how did we get here? A review of the timeline of remdesivir studies and their findings by @zchagla
Thoughtful analysis in the conflicting data from Dr Paul Sax, one of the most respected ID minds around
Read 8 tweets
11 Oct 20
How it started How its going ImageImage
How it started How it’s going ImageImage
How it started How it’s going ImageImage
Read 54 tweets
9 Oct 20
Undisputed champion of “Worst name in the history of naming organisms since Linnaeus”:

Myxococcus
llanfairpwllgwyngyllgogerychwyrndrobwllllantysiliogogogochensis

(Yes really)
If you can pronounce it, you will win a prize
Read 4 tweets
8 Oct 20
🔥 🔥 Long-awaited final data from ACTT-1! 🔥 🔥

#Remdesivir decreased time to discharge but had no statistically significant mortality benefit at day 29.

Benefit seems limited to patients on supplemental oxygen (but not ventilated)

nejm.org/doi/full/10.10… Image
My conclusion: clearly there is a clinically meaningful benefit in patients who require supplemental oxygen but not higher levels of respiratory support.

Personally I would also use it in critically severe disease *if supply was not a constraint*. But unfortunately it is.
Thanks to the US “me-first” approach to hoarding remdesivir, minuscule supplies are available in Canada.

We were allocated 30 courses for the *entire province* (4.5 million people) outside of a clinical trial (which is not an option at most hospitals)
Read 4 tweets
4 Jun 20
Origin story of the HCQ PEP trial.

I have learned a ton from working with @boulware_dr and @DrToddLee and team on this trial.

Most important lesson:

Don’t let the details (like funding for example) get in the way of doing something important.
This trial was run on a shoe-string using innovative internet-based recruitment and follow up with centralized depot and administration
A reminder of how the 🇺🇸🇨🇦 HCQ PEP trial came to be through #IDTwitter.

We didn’t have any details of how or if this would work... Todd just decided to get it done, adapting David’s protocol to Canada with support from colleagues in Manitoba & Alberta.

Read 8 tweets

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