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Michael Calderwood, MD, MPH Profile picture
Michael Calderwood, MD, MPH
@CalderwoodMD
Infectious Diseases Physician, Chief Quality Officer @DHMCandClinics, Associate Professor of Medicine @GeiselMed
Oct 22, 2022 • 10 tweets • 4 min read
1/10 Most influential infection prevention papers presented at #IDWeek2022 (non-COVID). 1. In >300 HCP caring for monkeypox patients, only 23% wore all recommended PPE, yet no HCP infections in 21 days. Risk of transmission in health care settings is low. pubmed.ncbi.nlm.nih.gov/36136939/ 2/10 Near ZERO viral detection when swabbing nostrils of HCWs exposed to a nebulized virus in a sealed clinical room for 40 mins wearing a fit-tested N95 (that passed) plus HEPA filtration. Wearing a non-fit-tested or failed fit-tested N95 not protective. pubmed.ncbi.nlm.nih.gov/35535021/
Oct 21, 2022 • 8 tweets • 3 min read
1/8 Most influential stewardship papers presented at #IDWeek2022. 1. Women in rural settings MORE LIKELY to get antibiotic treatment for uncomplicated UTI for a duration longer than recommended by guidelines, compared with urban settings. pubmed.ncbi.nlm.nih.gov/33622432/ 2/8 Why does this matter? "Each day of antibiotic therapy was associated with 4% increased odds of experiencing an adverse event." pubmed.ncbi.nlm.nih.gov/34775072/
Oct 21, 2022 • 4 tweets • 3 min read
Machine learning for identifying patients at risk of severe sepsis. Talk by @suchisaria at #IDWeek2022. Input + Output -> Rules. pubmed.ncbi.nlm.nih.gov/32166234/ This table highlights why we are not going to accurately identify sepsis in real-time without machine learning. pubmed.ncbi.nlm.nih.gov/31939780/ #IDWeek2022 @suchisaria Image
Oct 21, 2022 • 8 tweets • 3 min read
Clinical trials in bacterial diseases that may change your practice. #IDWeek2022 1. De-escalation of antibiotics for VAP based on Gram stain was non-inferior to waiting for culture. pubmed.ncbi.nlm.nih.gov/35394515/ 2. Obtaining follow-up blood cultures in patients with Gram negative bacteremia associated with decreased mortality. pubmed.ncbi.nlm.nih.gov/36136334/
Oct 21, 2022 • 4 tweets • 2 min read
At #IDWeek2022, @hboucher3 presented data that ~1.3 million deaths were directly attributable to antimicrobial resistance in 2019. pubmed.ncbi.nlm.nih.gov/35065702/ Although @IDSAInfo 10 by ‘20 initiative resulted in 14 new ID drugs coming to market, “the majority…have been modifications of existing chemical classes of antibiotics [and] larger pharmaceutical companies continue to abandon the field.” Nobody’s buying. pubmed.ncbi.nlm.nih.gov/30715222/
Oct 20, 2022 • 4 tweets • 4 min read
1/4 Dr. Klompas presented at #IDWeek2022 on a big change in the @SHEA_Epi Compendium for VAP Prevention. STOP oral care with chlorhexidine and switch to oral care with toothbrushing. pubmed.ncbi.nlm.nih.gov/35589091/ Image 2/4 Data from double-blind RCTs doesn't show lower VAP rates with chlorhexidine oral care, there is no reduction in ICU length of stay or duration of mechanical ventilation, and there is concern about higher mortality. pubmed.ncbi.nlm.nih.gov/24663255/, pubmed.ncbi.nlm.nih.gov/24687313/ ImageImageImageImage
Dec 7, 2021 • 8 tweets • 4 min read
1/8 Let's talk New Hampshire. We need to have an honest dialogue about how bad things are right now with #COVID19. We currently are averaging more cases per day than at any point in the pandemic (66x higher than last summer). @SteveAhnen @NHHospitals @NHMedSociety @DartmouthHitch 2/8 The PCR positivity rate is back to where it was in April 2020, with 3 counties/cities reporting PCR positivity rates >15% (Coos, Sullivan, Nashua) and some clinics in the south of the state are at 25%. As this increases, true >> reported infections.