The winner takes it all  for S. aureus

As usual, some of the most interesting presentations at ECCMID were in the late-breakers “clinical trials” session. Four of 5 presentations were on treatment or prevention of S. aureus infection, the other one on oral treatment in patients with refractory fungal disease. With all respect to fungi, the meat was in the aureus, with nothing less than a Shakespearian tragedy. Continue reading

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The continuous need of outcome data of continuous beta-lactam infusion (or not?)

When I received this invitation for a PRO-CON, I accepted within 1 minute. Only later to realize that it was on “Optimised dosing according to PK/PD principles in patients – does it improve the efficacy of antibiotics?” Luckily I was given the CON, but I was in a poor position upfront: In a twitter poll 93% of voters were PRO (bias not excluded) and my opponent was Jason Roberts. So, this was my line of reasoning: Continue reading

From crowded house to ESBL-free house

A few weeks ago, Jon Otter blogged about a novel risk factor for ESBL Enterobacterales (ESBL-E) carriage, a “crowded house”, based on his work recently published in CMI: among 1,633 subjects in the catchment area of South-East London a crowded house, was associated with ESBL-E carriage, with an odds ratio of 1.5 (95% CI 1.1-2.2). Jon hinted towards future community-based interventions to reduce ESBL-E carriage and his blog naturally reached our research meeting. Continue reading

What urine can tell you

Urine should not be seen as a useless excretion product. Doping experts know, as do clinical microbiologists. In two recently published studies zillions of urine cultures were drained from computer systems and linked to primary care data, yielding very interesting findings. One study from Israel quantified the effects of direct and indirect fluoroquinolone use on antibiotic resistance in E. coli, see also our comments to that study. The second comes from the UK, the country that has an ambition to reduce Gram-negative bacterial bloodstream infection rates by 50%, because of increasing BSI rates. This study may provide both the reason for the problem and the direction to meet that ambition. Continue reading

Reflections IPC pre-ECCMID event

“How do we communicate our scientific results, beliefs and doubts to our peers, policy makers and the lay men?”

Posting blogs on Reflections on Infection Prevention and Control is a possibility. For the occasion of the ECCMID 2019 meeting in Amsterdam, the “Reflections on IPC blog team” and UMCU PhD students invite you to this pre-ECCMID event, on the Friday before ECCMID (April 12th) in Amsterdam.

We have a high-quality entertaining program and hope to meet you in a most pleasant atmosphere. Jop de Vrieze is a prominent Dutch science journalist with a great interest in infectious diseases. He writes for Science, de Groene Amsterdammer and Volkskrant, to name a few. Miquel Ekkelenkamp is a clinical microbiologist with a PhD in day-time, but at night he writes (real) novels and razor-sharp columns. Muge Cevik is an infectious diseases registrar from the United Kingdom, who worked on an analysis of all the tweets sent during the ECCMID 2018 conference in Madrid.  Martin Kiernan, a Visiting Clinical Fellow at the Richard Wells Research Centre of the University of West London and distinguished IPC blog writer will present the top 10 reflections on IPC. And Rinze Benedictus from the UMC Utrecht will end the program with explaining the concepts of Science in Transition, an international movement to change several aspects of the current academic system, such as the pressure to publish as much as possible in journals with high impact factors, and where that all can lead to.

Now, since this all happens in the Netherlands we must obey to Dutch rules. One of them is that you need to sign up and pay €25,– AIOS/PhD and €45,–. for medical specialists. This is an evidence-based intervention to reduce the “no-show rate” from 80% (with free entrance) to at most 10%, and to prevent us ending the evening with loads of uneaten “bitterballen”. We can host about 70 guests!

Venue: Cafe Weesper, Weesperzijde 144, Amsterdam

18.00-19.00     Wellcome
19.00-19.20     Jop de Vrieze: Science and communication
19.20-19.40     Miquel Ekkelenkamp: the art of science
19.40-20.00     Muge Cevik: Science in tweets
20.00-20.30     Break with Dutch cuisine and drinks
20.30-20.50    Martin Kiernan: The Top Ten Reflections on IPC
20.50-21.15    Rinze Bendictus: Science in Transition

Happy gathering. Hope to see you there.

You can sign in here: https://webshop.umcutrecht.nl/umcutrecht/nl/Products.aspx

The antibiotic resistance crisis resolved by bateriophages (part 5)

Yesterday we had another episode on the miracles of bacteriophage therapy on Dutch television. In the show I asked our minister of Health to modify the Dutch law, in order to make scientific evaluation of this approach in patients possible. Yet, the reasons why we need this change were not broadcasted. As several patients explained how they had been treated across Europe, this must have bee confusing, people not understanding why I – the knucklehead – failed to do studies. Let me explain. Continue reading

“Why Dutch hospitals are so good at beating superbugs”

It is with great pleasure that I ask your attention for this article that appeared in the Economist. Yes, we still have low resistance rates in our hospitals and if you’re interested in how that happened, read it. The prosaic composition contains two parts; a very realistic thriller-like opening, followed by a second part with a rather unrealistic explanation. Both parts are separated by a short sentence of absolute nonsense. Time for a review. Continue reading