Helmi Sulaiman Profile picture
Mar 31 10 tweets 3 min read Twitter logo Read on Twitter
Another gem from IDWeek 2022

Increased incidence of colorectal cancer in Veteran Health Administration hospital patients with pyogenic liver abscess

#IDTwitter
The rationale and the lit review
Methodology:
Demographics
The risk was higher for CRC in patients with PLA, esp. in the first two years after the liver abscess
However, patients with PLA were more likely to get a colonoscopy, likely accounting for the "heightened" risk for CRC
The organisms that caused the PLA in this cohort:

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More from @edenhelmi

Mar 30
In Ceftriaxone-resistant HECK-Yes (esp E. cloacae, C. freundii, and K. aerogenes) with a Cefepime MIC of ≤ 4 mg/L

What is your Rx of choice?

@stevenlimcl @andrewchangID @shaharudeen @HanzHc @SazaliBasri @adammashraff @fikreeahmad @ummuafeera
@stevenlimcl @andrewchangID @shaharudeen @HanzHc @SazaliBasri @adammashraff @fikreeahmad @ummuafeera The answer is not straightforward it seems
cc @afranahdia

This letter to the editor argued Cefepime/FEP shudn't be used for such isolates

Data: Lee et al. data (Taiwan)
ESBL E cloacae were identified even when the FEP MIC ≤ 2 mg/L (44% of them)

dropbox.com/s/36uokdwqyygo…
Counterpoint by Tamma et al. (OFID)
They performed a similar assessment in a US cohort
P: CRO-resistant ampC (N =77)
Results: ESBL genes at different MIC levels:
MIC ≤ 2 mg/L: 7%
4-8: 0%
≥16: 67%

Therefore, the answer is region specific

academic.oup.com/ofid/advance-a…
Read 5 tweets
Nov 2, 2022
Myth: Bactericidal Agents Are Necessary for the Treatment of BSI at #idweek2022

A nice and easy-to-follow account of bactericidal vs. bacteriostatic agents and activity
@SyamhaninA @fikreeahmad @adammashraff @shaharudeen @andrewchangID @Rasidah @suraya_sudenia @cllau888
@SyamhaninA @fikreeahmad @adammashraff @shaharudeen @andrewchangID @Rasidah @suraya_sudenia @cllau888 Cidality is NOT an intrinsic property of an antibiotic
e.g., for the same drug (TMP-SMX), we have 2 different properties against 2 different organisms:
1) Static against Steno
2) Cidal against E. coli
Read 7 tweets

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