Andrea

Glad to see the just published fruit of a multicentric collaboration in #Italy led by @AndreMarino91, wherein a #casual framework approach, along with #DOOR, to assess the impact of mono vs combo as for #cef_avi against #KPC infections. @SpringerNature link.springer.com/article/10.100…

▶️UTI in patients with stones and stents: rocks and hard LEITNERLorenz, Switzerland Excellent talk by urology surgeon 🚫JJ stents mimic UTI JJ stent # Infection Enterococci👀 #ESCMIDGlobal2026

🧫Staphylococcus coagulasa- en hemocultivos ¿infección o contaminación? Desarrollamos una CALCULADORA: 📊≤4 puntos → contaminación 📊≥7 → infección. ✔️Alta concordancia ❗Zona gris (5–6): aún a optimizar ➡️Potencial para estandarizar decisiones 👉microbiologyhcuv.shinyapps.io/calc_scn/

On IDSA’s & @HIVMA’s Science Speaks blog: A study in @jac_amr examined differences in the in vitro activity of ampicillin-sulbactam and amoxicillin-clavulanate in several Enterobacterales species. Read IDSA’s Journal Club review by Aldon Li, MD, FIDSA. idsociety.org/science-speaks…

La principal causa de que una bacteria “evolucione” de SENSIBLE✅ a RESISTENTE 🛡️es la EXPOSICIÓN a #Antibioticos 💊💉así que úsalos #adecuadamente para evitarlas y en caso de duda 🙋🏻 consulta con tu #stewardship/#EnfInfecciosas de confianza😉

🆕🔥Excellent review article Severe community-acquired pneumonia: current concepts and controversies #IDXposts link.springer.com/article/10.100…

How fortunate that two of the things I love the most in life are associated with prolonged survival. Plus, a very important "recent" paper. (Link in next tweet⬇️)

🚀Eleven clinical trials that will shape medicine in 2026 👉nature.com/articles/s4159… #science #research #MedX @1989_mariab @World_Data_A @OncoAlert @DeryaTR_

Missed the biggest ID research of 2025?Here’s your chance to catch up! 🆕🔥Year in Review –Top ID Articles from 2025! All the most important infectious diseases research in one place! 🤝Huge appreciation to @IDstewardship for helping bring this together! 🔗idstewardship.com/year-in-review…

IDSA declined to endorse the 2025 ATS CAP guidelines over concerns about empiric antibiotics in viral CAP. The message is clear: most viral pneumonias lack bacterial coinfection. Precision, not reflex antibiotics, should guide care. doi.org/10.1093/cid/ci…

Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In the latest episode of Beyond Journal Club, a collaboration between @COREIMpodcast and NEJM Group, we walk through the BALANCE trial and use it as a lens to revisit how the factors of host, organism, and source should guide treatment; when is shorter really enough, and when isn’t it? 🎧 Listen to the full episode: nej.md/3XNgajK 📖 Further reading  Original Article by N. Daneman et al.: Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections nej.md/3Z5bTJD

🔥🔥 NEW 🔥🔥 Year In Review: Top Infectious Diseases Articles From 2024 Our new post, a great collaboration with my friend 🌟 @IDstewardship 1️⃣6️⃣⚡️🆔 RCTs @JAMA_current @TheLancet ✨ 7️⃣Syst Reviews/Meta 3️⃣🌏Guidelines @Wiki_Guidelines ✨️ #idxposts idstewardship.com/year-review-to…

🆕⚡🩺💨 Hospitalized Viral CAP: Antibiotics Don’t Move the Needle—Time to Revisit ATS CAP Guidelines!, CID, 2025 🚀 What they did • 🏥 Retrospective cohort: 6,779 hospitalized patients with possible CAP + positive respiratory virus (2015–2024, 5 hospitals) • 💊 Compared 0–2 days vs 5–7 days of antibiotics • 📊 Propensity-weighted: 2,614 patients (1,720 short-course, 894 longer-course) • 🔬 Outcomes: hospital LOS, ICU admission after 48h, in-hospital mortality, 30-day hospital-free days • 🦠 Sub-analyses: influenza alone, non-SARS-CoV-2 viruses, ICD-10 confirmed pneumonia 🔥 Key findings • 🛏️ LOS similar: 11.7 vs 11.1 days (OR 1.05) • 🏥 ICU after 48h: 28.3% vs 28.2% (OR 1.01) • ⚰️ In-hospital mortality: 9.5% vs 9.8% (OR 0.97) • 📅 30-day hospital-free days: 16.9 vs 17.0 (OR 0.99) • 🔁 Results were consistent when restricted to non-SARS-CoV-2 viruses and to influenza alone, when comparing 0 vs 5-7 days of antibacterials. ⚠️ Limitations • ⏳ Retrospective → possible residual confounding • 🔍 Cannot capture all clinical decisions • ⚖️ Observational → limited causal inference 💡 Takeaway Antibiotics don’t improve outcomes in most hospitalized CAP patients with confirmed respiratory viruses. Short courses—or even withholding therapy—may be safe. Strong reminder for antibiotic stewardship! academic.oup.com/cid/article/do…

📚#Molecular Epidemiology of #Resistance #Genes 😊Edited by Dr. Stefano Stracquadanio, Dr. Andrea Marino (@AndreMarino91), Dr. Maddalena Calvo 📆Submission Deadline: 30 June 2026 🔗Find out more at: mdpi.com/journal/antibi…

🆕⚡🧬🧩 The Sepsis Puzzle: Precision Immunotherapy Finds a Missing Piece | ImmunoSep RCT | JAMA, 2025 🚀 What they did • 🧪 RCT (double-blind, double-dummy, placebo-controlled) across 🌍 6 countries • 👥 276 adults with Sepsis-3 + immune dysregulation • 🔍 Stratified by immune phenotype:   • 🔥 MALS (ferritin >4420) → 💉 IV anakinra   • 💤 Immunoparalysis (low HLA-DR) → 💉 IFN-γ • 🏥 Standard care ➕ precision immunotherapy vs standard care ➕ placebo • 🎯 Primary endpoint: SOFA ↓ ≥1.4 points by day 9 🔥 Key findings • 📉 Organ dysfunction improved by day 9: 35.1% vs 17.9% (+17.2% over placebo) • ⚰️ 28-day mortality: ❌ no significant difference • ⚠️ AEs common:   • 🩸 More anemia with anakinra   • 💉 More bleeding with IFN-γ • 🧬 Matching therapy to immunotype = driver of benefit ⚠️ Limitations • ⏳ Benefit measured only to day 9 • ❌ No mortality signal • 🧫 Requires ferritin & HLA-DR → not widely available • 💉 High AE burden 💡 Takeaway Precision immunotherapy (anakinra for MALS, IFN-γ for immunoparalysis) delivers an early organ-function boost, but without a mortality benefit and with notable safety risks. A promising step toward personalized sepsis care—not practice-changing yet. #IDXposts jamanetwork.com/journals/jama/…

@BradSpellberg @ABsteward I strongly agree with you

@ABsteward I’m not at all convinced that vanco requires drug monitoring/dose adjustment unless renal function is changing. Classic case of over processing. People have built academic careers around this practice, which is unneeded at best, and has led to harmful overdosing at worst.

Vancomycin – ~70 years old, but not retiring anytime soon. @BradSpellberg 👉Vancomycin was first approved for use in 1958,and to date, 🌟no other agent has been demonstrated to be superior to vancomycin in the treatment of MRSA bacteremia🌟. 👉Nonetheless, vancomycin is not straightforward to use, requiring therapeutic drug monitoring to ensure sufficient levels while mitigating the risk of nephrotoxicity. 👉The long history, familiarity, and low drug cost of vancomycin have contributed to vancomycin continuing to be the most used antibiotic for MRSA bacteremia. In a recent global survey, 89% (1456 of 1641) of respondents selected vancomycin as their first-choice antibiotic.

🆕🔥State of art review article by 🌟 s @DrToddLee @syctong Navigating the Challenges in Staphylococcus aureus Bloodstream Infection: A Practical Guide to Management "Further subgroup analyses from SNAP will clarify whether the CzIE differentially impacts outcomes with cefazolin versus ASPs. In the meantime, cefazolin should be broadly considered the preferred treatment for most MSSA bacteremia" Thanks @Inox94 #IDXposts sciencedirect.com/science/articl…

Three antibiotic myths that simply refuse to die — penicillin allergies, the “must finish every dose” rule, and the idea that antibiotics help colds. New post -- link on next tweet👇

Our latest paper about: West Nile Virus: Insights into Microbiology, Epidemiology, and Clinical Burden mdpi.com/3580442 #mdpiamh via @MDPIOpenAccess

Everyone has opinions. Science has evidence. 511 studies, one conclusion: Vaccines for COVID-19, RSV, and influenza save lives - safely. Truth doesn’t need volume. Just verification.