🆕💥🔴 Review Article @PharmacoJournal Cefepime-Zidebactam: Leveraging β-Lactam Enhancement Against Difficult-to-Treat and Metallo-β-Lactamase-Producing Gram-Negative Pathogens #idxposts accpjournals.onlinelibrary.w…

🆕🔥Excellent Review by @ErinMcCreary + many 🌟s Global epidemiology and treatment of metallo-β-lactamase-producing gram-negative pathogens #idxposts #NDM #MBL academic.oup.com/jacamr/arti…

The third RCT on rapid diagnostics today! Rapid diagnostics ≠ automatically better clinical outcomes. 🆕💥🔴Open-label multicenter RCT, adding FilmArray Pneumonia Panel to conventional microbiology did not significantly increase targeted antimicrobial therapy at 24 h in suspected VAP/vHAP. But look closer: 35.1% vs 23.6% — an absolute difference of 11.5% (95% CI −3.0 to 26.2; P=0.13). With only 146 patients, the study may have been underpowered to detect a clinically meaningful difference. Interestingly, among culture-confirmed pneumonia, the difference was 55.3% vs 31.0% (24.2%; P=0.048). So is this a negative trial—or simply a small trial showing a potentially meaningful signal? And importantly, No significant differences in 28-day mortality, ICU mortality, ventilator-free days, or MDR acquisition. #idxposts link.springer.com/article/10…

🆕🔥🟢 PROGRESS Trial | Prospective multicenter RCT 1,373 patients randomized 3:1 to droplet digital PCR (ddPCR) vs standard care for suspected sepsis. 🔺Pathogen detection: 54.1% vs 21.6% (P < 0.0001) 🔺Higher sensitivity: Gram-negative 87.8% vs Gram-positive 35.8% or fungi 47.8% 🔺Positive results → antibiotic modification: 14.54% vs 6.49% (P = 0.0087) 🔺Negative results → no significant difference in subsequent antibiotic management 🔺Effective pathogen coverage: 12.89% vs 6.06% (P = 0.0039) 🔺Turnaround time: 6.6 h vs 5 days for blood culture 🔺Pathogen load declined faster than CRP/PCT, suggesting an earlier marker of infection control 🔺Pathogen-covering therapy within 0–3 days was associated with better outcomes (P = 0.026) 🔺Clinical outcomes: No significant differences in 28-/90-day mortality, SOFA change, hospital/ICU stay, organ-support requirements, or EQ-5D-5L 💡 Bottom line: ddPCR enabled faster, more sensitive pathogen detection and earlier targeted antimicrobial optimization, but did not improve overall clinical outcomes. #IDXPosts nature.com/articles/s41467-0…

🆕💥🟢 Prospective RCT #CID Integrating the BioFire BCID2 panel + antimicrobial stewardship into SOC testing for bloodstream infections reduced the median time to the first effective antimicrobial modification by 41.3 h (23.2 vs. 64.5 h; P < 0.001). ⛔ No significant differences in 30-day mortality or length of stay. 🔺 Gram-negative: 54.0% overall 🔺 Gram-positive: 45.2% overall 🔺 ESBL Enterobacterales: 21.4% overall 🔺 CRE: 8.3% overall #IDXposts academic.oup.com/cid/article…

The guidance on interpreting single-positive S. lugdunensis blood cultures remains inconsistent! 🆕💥🟢Clinical implications of a single Staphylococcus lugdunensis-positive blood culture: true bacteremia vs. contamination This retrospective review spanning 9 years at a large health system Using the Souvenir criteria, a single-positive blood culture set with S. lugdunensis is likely to represent contamination compared to the multiple-positive set group (81.3% vs. 32.6%, P < 0.01) Of patients categorized as having significant bacteremia by the Souvenir criteria, 96.8% had an intravascular device, while only 7.9% of those categorized as contamination had a device journals.asm.org/doi/10.1128…