IDSA News - September 2010
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EIN Update: Varicella-Zoster Virus and Acyclovir Resistance

The Emerging Infections Network (EIN) is a forum for infectious diseases consultants and public health officials to report information on clinical phenomena and epidemiological issues with public health significance. Any diagnostic or therapeutic recommendations and all opinions presented are those of the individual contributor. They do not necessarily represent the views of EIN, IDSA (EIN’s sponsor), or the Centers for Disease Control and Prevention (CDC), which funds EIN. The reader assumes all risks in using this information.  

EIN members recently discussed treatment options for a patient with acyclovir-resistant varicella-zoster virus (VZV).

A member in Ohio asked about a patient “with Hodgkin’s who is still getting new lesions all over her body and buccal mucosa after 10 days of 10 mg/kg acyclovir IV Q8h. Culture  was grown on day five of acyclovir (second specimen),” the member wrote. “This is her second episode of zoster; the first responded much better/faster to acyclovir.”

An EIN member from Washington, D.C., wrote, “Assuming VZV has been confirmed by DFA [direct fluorescent antibody] and/or culture and dosing of IV acyclovir is appropriate (1,500mg/m2 divided q8 hours), and there has been no response to therapy, there would be concern for resistant virus, particularly if there is any evidence of dissemination, such as elevated LFTs [liver function tests], etc.” The member suggested “consider[ing] empirically adding/changing therapy .”

A respondent in Michigan asked if the patient had secondary hypogammaglobinemia. “If so, IVIG [intravenous immune globulin therapy] may be an option.”

The original commenter noted that the patient “does have relative hypo IgM [immunoglobulin M] (32), and VZV-specific IgM is low (0.47). Foscarnet worked like magic for the old lesions: They crusted in two to three days and faded in five, but now she is still having one to two new scattered vesicular lesions daily. Now there is a shortage of foscarnet, and I cannot obtain it from anywhere, so I am stuck.”

A respondent from the Food and Drug Administration (FDA) commented that foscarnet is currently manufactured by Hospira Inc. “However, availability is limited due to manufacturing delays. For updates on foscarnet availability, you can visit FDA's drug shortage webpage."

An EIN member in California shared a response from the Centers for Disease Control and Prevention (CDC) that noted experts there had not heard of IVIG being given or recommended for treatment of herpes zoster. CDC suggested following up with experts who work with immunocompromised patients for additional guidance.

CDC also highlighted recently published guidelines on the management of opportunistic infections among HIV-infected persons. Available online (PDF), the guidelines provide information on treatment of herpes zoster, including treatment failure and acyclovir–resistant VZV. The CDC respondent also shared two journal articles—an October 2003 paper in The Journal of Infectious Diseases, and a Pediatric Infectious Diseases Journal article published in Oct. 2008—that discuss VZV resistance to acyclovir.

Updating the case, the original commenter noted that the patient had since been readmitted with new lesions. “No foscarnet is available,” the member wrote. “I am in the process of obtaining CMX001 from Chimerix.”


E-mail the Emerging Infections Network.
The Emerging Infections Network (EIN) is a provider-based sentinel network designed to help the public health community detect trends in emerging infectious diseases.

A joint project of IDSA and the Pediatric Infectious Diseases Society (PIDS) with funding from the Centers for Disease Control and Prevention (CDC), EIN tracks emerging infectious diseases and keeps the public health community up to date with new disease trends, difficult cases, and other issues affecting members’ clinical practices. The Network provides a great opportunity for members to share knowledge quickly across large geographical distances. Both IDSA and PIDS members are eligible to join. Click here for more information or to join EIN.

Drug Approvals, Recalls, Adverse Events Update

IDSA offers two e-mail services to help members stay informed of updates from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). Content includes a range of topics, including new drug approvals and warnings. Recent alerts have included:

IDSA members can sign up for these services online.  (You must be logged in to have access to this link.)


Is Your Facility Experiencing Antibiotic Shortages?
Report these to FDA and IDSA.

Additional Practice Guidelines Now Available for Mobile Devices

Two additional IDSA and HIVMA practice guidelines—on encephalitis and HIV primary care—are now available in a format designed for iPhones and other mobile devices. Visit IDSA’s website for instructions for downloading and using these guidelines on an iPhone or other mobile devices.

Pocket-sized quick reference guides also are available for guidelines on candidiasis, primary care management of HIV-infected patients, aspergillosis, community acquired pneumonia (CAP), influenza, immunization, and intra-abdominal infections. To view electronic previews and to order the 4-by-7-inch Pocketcards, visit IDSA’s website. IDSA members are eligible for a 35 percent discount when ordering.  Use discount code DCIDSA09

Clinical Practice Management Sessions at the IDSA Annual Meeting

The 48th Annual Meeting of IDSA, Oct. 21-24 in Vancouver, is just around the corner. Visit the meeting website to register and to find more information. You won’t want to miss these great clinical practice management sessions and presenters:

  • Billing and Coding Premeeting Workshop: Thursday, Oct. 21, 7-11 a.m., Room 8+15
    The Nuts and Bolts of E&M Coding: A Detailed Look at the Codes Used by ID Specialists
    Barb Pierce, CCS-P, ACS-EM
    A Detailed Look at How an Auditor Looks at Your E&M Codes
    Barb Pierce, CCS-P, ACS-EM
    Coding for Quality Reporting - How to Get Your 2 Percent
    Hugh Gunner Deery, MD, FIDSA
    Getting Paid For Your Work: Working in the Present While Preparing for the Future
    Russell Petrak, MD, FIDSA
  • Meet-the-Professor Session: Health Care Reform: How Do ID Specialists Fare?, Friday, Oct. 22, 7-8:15 a.m., Room 11-12
    Lawrence Martinelli, MD, FIDSA
  • Meet-the-Professor Session: Wound Care 101 and 102, Friday, Oct. 22,: 7-8:15 a.m., Room 118-120
    Eliot Godofsky, MD; Scott Stienecker, MD
  • Meet-the-Professor Session: Curbside Consults, Saturday, Oct. 23, 7-8:15 a.m., Room 217-219
    Thomas G. Slama, MD, FIDSA; Daniel Sexton, MD, FIDSA

Income for ID Physicians Dropped in 2009

Infectious disease physicians saw their income drop in 2009, according to data from the Medical Group Management Association (MGMA). The median compensation for ID physicians in 2009 was $201,543, compared with $211,149 in 2008.

ID physicians who practiced in single-specialty groups were more likely to have higher compensation ($206,177) than those in multi-specialty practices ($200,405), according to the MGMA data. The data indicate that ID physicians in the South ($223,550) fared better than their colleagues in other parts of the country.

The data is available on the IDSA website, along with guidance on how to negotiate equitable compensation arrangements for infection control and other ID services. You must be logged in to access this content.

Updated Infection Control Reimbursement Resources Now Online

IDSA recently updated its billing resources to help medical directors negotiate infection control reimbursement with their hospitals. ID physicians in consultation with their hospitals are free to establish fair market value reimbursements that are consistent with the market value of their infection control services in a given area. First log in to the IDSA website to gain access to the links to the reimbursement resources below:

Access these and other billing resources on IDSA's Clinical Practice Resources and Tools page. IDSA's Clinical Affairs Committee continues to explore ways to enhance ID physicians’ reimbursements for infection control and other non-patient care activities and would appreciate members’ comments or insights in this area. If you have comments or additional questions, please contact Jason Scull at jscull@idsociety.org.

Global Health Sessions at the IDSA Annual Meeting

The 48th Annual Meeting of IDSA, Oct. 21-24 in Vancouver, is just around the corner. Visit the meeting website to register and to find more information. You won’t want to miss these great global health sessions and presenters:

  • Special Plenary Session: Thursday, Oct. 21, 5:30-7:30 p.m., West Ballroom ABCD
    Research and Development of Countermeasures for ID Threats to Global Health: The Way Forward
    Anthony Fauci, MD, FIDSA
    HIV/AIDS: Response to an Epidemic, Implications for Global Health
    Eric Goosby, MD
  • Maxwell Finland Lecture: Friday, Oct. 22, 4:15-5 p.m., West Ballroom ABCD
    The Convergent Epidemics of TB, HIV, and Drug-Resistant TB: Etiology, Challenges, and the Way Forward
    Gerald Friedland, MD, FIDSA
  • Global HIV Prevention and Treatment Symposium: Sunday, Oct. 24, 8:45-10:45 a.m., East Ballroom ABC
    Biomedical Prevention (including PrEP, Microbicides, and Circumcision)
    Sharon Hillier, PhD
    Preventing HIV Spread Among Injection Drug Users
    Chris Beyrer, MD, MPH
    Prevention with Positives in Developing World Settings
    Jonathan Kaplan, MD, FIDSA
    Test and Treat
    Rochelle P. Walensky, MD, MPH, FIDSA

To learn about more HIV/TB-related sessions, please see the full HIV/TB Track for the meeting, available online.

Center Gives Hill Staff First-Hand View of HIV/AIDS in Africa

The Center for Global Health Policy hosted five congressional staff members on a trip to South Africa and Zambia in August. The Hill staff joined Christine Lubinski, IDSA’s vice president for global health, and other Center staff during visits to U.S. government-funded programs addressing HIV and tuberculosis (TB) to give them a first-hand view of the important strides these programs are making and the areas where additional support is needed.

Check the Center’s blog, Science Speaks, for extensive reports and photos from the trip. Highlights include: “A massive funding gap forecast in Zambia,” a post exploring the potential lack of financing needed to reach the country’s targets for expanded access to antiretroviral therapy, and “Zambia moving fast to scale up male circumcision,” where David Bryden, IDSA’s senior program policy officer for global health, describes a male circumcision site the group visited on their trip.

 

Film Screening, Panel Highlight Integrating Health Systems

Earlier this month, the Center for Global Health Policy joined the Global Health Council and other organizations to host an event looking at integrating health systems and how to achieve the sixth United Nations Millennium Development Goal: to have halted and to begin to reverse the incidence of HIV/AIDS, malaria, and other major diseases, including tuberculosis (TB), by 2015.

The event featured a screening of a 20-minute excerpt of “The Test,” a new film that demonstrates the principles of the Global Health Initiative at work on the ground, including how HIV testing is integrated with the prevention of other infectious diseases and the overall impact on a community and household.  (Check out the Center’s blog  for more information about the film, including a link to the film’s trailer.) A panel discussion among health experts followed, focusing on how best to integrate health programs while also ensuring sustainability and local buy-in.

IDSA/HIVMA member David Hoos, MD, MPH, of Columbia University’s International Center for AIDS Care and Treatment Programs (ICAP), one of the largest implementers of the President's Emergency Plan for AIDS Relief (PEPFAR), spoke on the panel, along with Elkanah Odembo, Kenyan Ambassador to the U.S.; Jean Roy, formerly with the Centers for Disease Control and Prevention (CDC) and the International Red Cross; and Paul Jensen of the ACTION Project. The Center’s Christine Lubinski, IDSA’s vice president for global health, moderated the panel discussion.

Visit the Center’s Science Speaks blog to read more coverage of the event. 

Clinical Research Fellows Educate Lawmakers on Value of Global HIV/TB Programs

Eleven current and former Fogarty International and Doris Duke clinical research fellows highlighted their research experience abroad and emphasized the value of U.S. investment in global HIV and tuberculosis programs during a visit to Capitol Hill earlier this month. Accompanied by Center for Global Health Policy staff, the group visited the offices of 15 key policymakers to discuss issues including linkages between HIV and cancer risks, the impact of HIV on maternal and child health, the value of international physician fellowship programs, and the education U.S. doctors acquire abroad and use to improve patient care in the U.S. when they return to this country.

The clinical research fellowships send medical students and young physicians with an interest in global health to sites in the developing world to perform a year of hands-on clinical research training. The U.S. fellows who participated in the Hill visits spent their year abroad either in Uganda, South Africa, Thailand, or Malawi. Their research projects ranged from monitoring antiretroviral treatment adherence among female South African patients with the use of text messaging and SMS, to evaluating treatment outcomes for Kaposi’s sarcoma patients undergoing combination chemotherapy for advanced or persistent disease in Malawi.

You can read more about the fellows and these fellowship programs on the Center’s blog, Science Speaks.

Policy and Advocacy Sessions at the IDSA Annual Meeting

The 48th Annual Meeting of IDSA, Oct. 21-24 in Vancouver, is just around the corner. Visit the meeting website to register and to find more information. You won’t want to miss these great policy-related sessions and presenters:

  • Special Plenary Session: Thursday, Oct. 21, 5:30-7:30 p.m., West Ballroom ABCD
    Research and Development of Countermeasures for ID Threats to Global Health: The Way Forward
    Anthony Fauci, MD, FIDSA

    HIV/AIDS: Response to an Epidemic, Implications for Global Health
    Eric Goosby, MD
  • Meet-the-Professor Session: Health Care Reform: How Do ID Specialists Fare?, Friday, Oct. 22, 7-8:15 a.m., Room 11-12
    Lawrence Martinelli, MD, FIDSA
  • Symposium: Influenza Vaccination of Health Care Personnel: Should Vaccination Be Mandatory?, Friday, Oct. 22, 2-4 p.m., East Ballroom ABC
    Arguments for Mandatory Influenza Vaccination of Health Care Personnel
    Edward Septimus, MD, FIDSA
    Employment Law Issues in Influenza Management
    Mark E. Edwards, JD
    Medical Issues
    Bill Borwegen, MPH
    Legal Issues Involved in Mandatory and Other Vaccination Programs in the Work Place
    Gene Mechanic, JD
  • Meet-the-Professor Session: What the ID Clinician Needs to Know about Public Reporting of Health Care-Associated Infections and Multidrug-Resistant Organisms, Saturday, Oct. 23, 7-8:15 a.m., Room 223-224
    Experience and Future Directions of Public Reporting in the U.S
    Stephen Ostroff, MD, FIDSA
    U.K. Success in Reducing MRSA Infections Through Public Reporting
    Gavin Barlow, MBChB, MD, FRCP, DTM&H
  • Edward H. Kass Lecture:  Saturday, Oct. 23, 9:15-10 a.m., West Ballroom ABCD
    The Co-Evolution of Infection Control and Antibiotic-Resistant Pathogens
    Richard Wenzel, MD, FIDSA
  • Symposium: Susceptibility Breakpoints – Controversies and Consensus, Saturday, Oct. 23, 10:30 a.m.-12 p.m., Parkview Terrace / 1-3
    The Food and Drug Administration (FDA)
    Katherine Laessig, MD
    The Role of the CLSI in Establishing and Revising Breakpoints
    James H. Jorgensen, PhD
    Industry
    Glenn Tillotson, PhD, FIDSA
  • Symposium: Anti-Infective Drug Development: Promises and Pitfalls, Saturday, Oct. 23, 2-4 p.m., Room 211-214
    Drug Development: Industry Hurdles
    Paul G. Ambrose, PharmD, FIDSA
    Drug Development: FDA Perspective
    Edward Cox, MD
    Novel Drugs and Targets in the Pipeline
    Paul Miller, PhD
    History of Antimicrobial Development
    George Eliopoulos, MD, FIDSA

IDSA, SHEA Strengthen HCW Influenza Immunization Policies

Groups call for influenza vaccination to be condition of employment

IDSA and the Society for Healthcare Epidemiology of America (SHEA) recently adopted stronger policies supporting universal influenza vaccination for health care workers (HCW), calling for influenza immunization to be a requirement of employment. Stressing HCW vaccination as a core patient safety issue and a professional and ethical responsibility, the groups now recommend exemptions to mandatory influenza immunization only in cases of medical contraindications.

IDSA strengthened its policy in July to specify that influenza vaccination should be a condition of employment and to remove declination for religious reasons. The current IDSA policy, created in 2007 and previously revised in 2009 (see Oct. 2009 IDSA News article), is available on the IDSA website. A SHEA position paper, which IDSA endorsed, outlining SHEA’s updated position appears in the October 2010 issue of Infection Control and Hospital Epidemiology. The paper updates a statement SHEA issued in 2005.

“The scientific evidence shows significant reductions in the risk of influenza in both acute and long-term care settings as a result of strong immunization policies and programs,” IDSA President Richard Whitley, MD, FIDSA, said in a SHEA/IDSA press release. “Vaccination of health care personnel saves patients’ lives and reduces illness. It also protects the individual worker from falling ill during influenza outbreaks and from missing work, which further impacts patient care.”

IDSA and SHEA both agree that mandatory vaccination should be part of a comprehensive influenza infection control program, including hand hygiene and cough etiquette, identifying and isolating infected patients, appropriate personal protective equipment, and restriction of ill health care personnel and visitors.

Last year’s influenza season highlighted the need for stronger policies for HCW influenza vaccination, particularly given the low immunization rates in many voluntary programs. Even with the greater concern surrounding influenza during the 2009 H1N1 pandemic, only 39 percent of health care professionals said they intended to get vaccinated, according to a 2009 RAND Corp. survey.

IDSA and SHEA are continuing to push for stronger HCW influenza immunization policies nationwide. In an Aug. 31 letter (PDF) to Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, we urged HHS to adopt the new position as its own: “Universal vaccination of [health care personnel] is the cornerstone to a comprehensive national effort to prevent the spread of influenza during a seasonal influenza outbreak or a pandemic,” the groups wrote.

In September, the American Academy of Pediatrics (AAP) announced a similar policy, recommending that all health personnel should be required to receive an annual influenza vaccine, except for medical exemptions. Unlike the IDSA and SHEA position, however, the policy allows for religious exemptions to influenza vaccination. The policy, available online (PDF), appears in the Oct. 2010 issue of Pediatrics.

FDA’s Guidance Doesn’t Go Far Enough to Limit Antibiotic Use on the Farm, IDSA Says

New draft guidance from the Food and Drug Administration (FDA) is a step in the right direction but doesn’t go far enough to limit the non-judicious use of antibiotics in food animals, IDSA told the agency in an August comment letter. Citing the clear link between antibiotic use on the farm and antibiotic-resistant infections in people, the Society called for FDA to issue regulations to eliminate non-judicious antibiotic uses and ensure that all remaining uses come under the direct supervision of a veterinarian.

IDSA argued that regulations, rather than the voluntary draft guidance FDA has proposed, will be more effective and expedite the timetable for ending non-judicious antibiotic uses on the farm. Regulations will also provide the leverage FDA needs to enforce the agency’s new public health approach for addressing this issue. FDA’s approach calls for phasing out the use of antimicrobials for growth promotion and feed efficiency and limiting other uses of these drugs in animal agriculture, so they are carried out under the supervision of a veterinarian and within the context of a valid veterinarian-client-patient relationship.

To download a PDF of IDSA’s letter, click here. For more information about FDA’s draft guidance, see FDA’s press release.

Other IDSA advocacy efforts include:

  • The Society suggested changes to the National Institute of Allergy and Infectious Diseases (NIAID) clinical trials infrastructure, in an August letter (PDF) to NIAID Director  Anthony Fauci, MD, FIDSA.  IDSA provided input on the future structure and objectives of clinical trial networks, including IDSA’s belief that an infrastructure addressing high-priority, life-threatening infections—similar to the National Cancer Institute’s (NCI) clinical trials network, which encompasses a spectrum of cancers—is urgently needed. 
  • IDSA recently shared input on the possible role of FDA in clinical trial networks and clinical trial designs for new antimicrobial agents with Janet Woodcock, MD, director of FDA’s Center for Drug Evaluation and Research. In a letter (PDF) following up on Dr. Woodcock’s Aug. 4 teleconference with IDSA leaders, the Society also provided input on acute bacterial skin and skin structure infections (ABSSSI) and the design of clinical trials for new antibiotics to treat these infections.
  • More than 40 physician groups, including IDSA, called for privacy and security safeguards for patient information that are practical, flexible, and affordable for health care providers. In a letter (PDF)  earlier this month to Department of Health and Human Services Secretary Kathleen Sebelius, the groups commented on proposed changes to Health Insurance Portability and Accountability Act (HIPAA) rules, also calling for rules that minimally impact the flow of necessary health information.

IDSA Urges Better Payments and Coverage for ID Services

Big changes are in store for physician payments, thanks to the Patient Protection and Affordable Care Act of 2010. The Centers for Medicare and Medicaid Services (CMS) have started implementing many of the law’s provisions in Medicare’s proposed physician fee schedule for 2011. IDSA is weighing in to ensure that ID physicians are appropriately paid and that key preventive services—such as immunizations and HIV testing—are covered.

In an Aug. 24 comment letter, IDSA once again urged Medicare to reverse its previous decision to eliminate payments for consultation codes—a decision that now seems unnecessary and ironic. IDSA believes it’s unnecessary, given that the new health reform law includes provisions to increase payments for primary care physicians (which was the justification for short-changing consultations). And it’s ironic because CMS is also adding coverage of follow-up inpatient telehealth consultations. (In a September e-mail, IDSA asked members to contact their Senators and ask them to sign onto a letter urging Medicare to reinstate the consultation codes. For more on IDSA’s position on consultation codes, see this June IDSA News article.)

The Society also urged CMS to work with Congress to reform the flawed Sustainable Growth Rate (SGR) payment formula, which—if not addressed—will result in a 30 percent payment cut for all physicians in 2011. At minimum, IDSA and other medical groups say, the SGR should be replaced by a formula that accounts for the actual annual increase in medical practice costs.

In addition, IDSA asked CMS to work with Congress to cover recommended vaccines under Medicare Part B (rather than Part D), because of the access, quality, and integrity concerns related to transporting Part D-covered vaccines from retail pharmacies to physicians’ offices for administration. This would add Part B coverage of vaccines for diphtheria, pertussis, herpes zoster, and tetanus.

Finally, IDSA urged CMS to exercise caution in tying physicians' payments to their performance (see related story).

For a PDF of IDSA’s extensive comment letter to CMS, click here:
IDSA Comments on the Proposed Rule of the 2011 Medicare Physician Fee Schedule (PFS)

For more on the proposed fee schedule, see the July/August issue of IDSA News.

IDSA Weighs in on Medicare’s Plans for Value-Based Payments

IDSA is providing ID physicians’ feedback to the Center for Medicare and Medicaid Services (CMS) on the agency’s plans to develop a system to pay physicians differentially based on the quality and cost of their care. The effort is one of many reforms included in the Patient Protection and Affordable Care Act that Congress passed last year.

Society members Steven Schmitt, MD, FIDSA, and Larry Martinelli, MD, FIDSA, represented IDSA at recent  “listening sessions” held by CMS. Among other things, the IDSA representatives warned against the possible unintended consequences of linking physicians’ payments to the cost and quality of their care.

For example, primary care physicians could be less likely to consult with subspecialists if they are concerned about higher costs appearing in their feedback reports. For that reason, IDSA believes that feedback reports must tie costs to patient outcomes, and the data should be further analyzed if a physician is shown to be a high-cost outlier.

IDSA also pointed out that ID physicians’ ability to participate in the Physician Quality Reporting Initiative (PQRI) is limited by CMS’s refusal to include more measures related to inpatient care. IDSA supports developing measures that recognize the role of ID specialists and other hospital-based physicians in the treatment of highly complex hospitalized patients. In addition, measures should take into account the ID specialist’s role in implementing system-wide practices that reduce the prevalence of hospital-acquired infections and prevent new disease outbreaks.

For copies of the IDSA statements, click here: 
http://www.idsociety.org/WorkArea/DownloadAsset.aspx?id=17022
http://www.idsociety.org/WorkArea/DownloadAsset.aspx?id=17023

IDSA Congratulates the 2010 Joint Research Award Winners

The IDSA Education and Research Foundation (ERF) and the National Foundation for Infectious Diseases (NFID) announce the winners of the 2010 IDSA ERF/NFID Joint Research Awards.

Merle A. Sande/Pfizer Fellowship Award in International Infectious Diseases

Christina S. Polyak, MD, MPH, an infectious disease fellow at the University of Washington, aims to examine the effect of discontinuing trimethoprim-sulfamethoxazole (TMP/SMZ) in HIV-infected adults in Kenya on highly active antiretroviral therapy (HAART) who have immune reconstituted with CD4 counts above 350 cells/mm3. While TMP/SMZ is relatively inexpensive, the overall cost to the health care system of providing the medication and monitoring toxicity and response is significant, warranting further exploration. 

 Astellas Young Investigator Awards

 

 

Suzanne Noble, MD, PhD, assistant professor in the Departments of Medicine (Division of Infectious Diseases) and of Microbiology and Immunology at the University of California, San Francisco (UCSF), will determine the logic of Candida albicans iron acquisition from the host. Her first aim is to identify the mechanisms of Sef1 regulation and to test the hypothesis that covalent modification of Sef1 results in its activation in low-iron environments. Her second aim is to determine whether selected components of the Sef1 regulon are themselves virulence effectors. Overall, her research will provide a better understanding of the set of pathogenic specializations and strategies that allow a human fungal commensal to survive and succeed in the host environment. 

Jennifer A. Philips, MD, PhD, assistant professor in the Departments of Medicine and Pathology at New York University Medical Center, will determine which host factors play an important role controlling bacterial growth in human macrophages and characterize the novel EsxH-Hgs pathogen-host interaction. To identify host defense pathways, her team performed an RNA interference (RNAi) screen in murine macrophages, looking for enhanced growth of Mycobacterium smegmatis. By fully exploiting RNAi and quickly embracing novel technologies, she hopes to make fundamental observations that will enable better therapeutics for tuberculosis.

 

 ASP Young Investigator Award in Geriatrics

 

Vera P. Luther, MD, assistant professor of medicine in the Section of Infectious Diseases at Wake Forest University School of Medicine, will conduct research to define specific physician decision factors, outside of medical knowledge, that influence the prescription of antimicrobials and the decision to de-escalate therapy in hospitalized elderly patients. A better understanding of the decision factors that result in physicians’ overprescribing antibiotics is needed to develop and target effective interventions to improve antimicrobial use among clinicians who treat older adults.

Pfizer Young Investigator Award in Vaccine Development 

 

Wendy W. Yeh, MD, an instructor of medicine at Harvard Medical School, will develop a SIV/rhesus monkey penile challenge model for the study of acute HIV-1 immunopathogenesis and the evaluation of candidate AIDS vaccines. Her proposed research will refine this in vivo model so that SIV infections can be transmitted more reliably and the rate of infection can be titrated to appropriately address specific scientific questions. She will validate this animal model for HIV-1 vaccine and pathogenesis research by characterizing the kinetics of viral replication and the transmitted/founder variants in SIV penile transmission, as well as the clinical outcome of SIV infection acquired via the foreskin. Dr. Yeh hypothesizes that this novel animal model of mucosal transmission will predict more accurately the ability of candidate vaccines and microbicides to block mucosal HIV-1 transmission in the male genital tract.

More information about the 2010 Joint Research Award Winners is available online.

Congratulations to the 2010 Medical Scholars Program Recipients

Teaser here

The IDSA Education and Research Foundation (ERF) announces the 2010 recipients of the Medical Scholars Program awards. The program offers scholarships to students in U.S. medical schools with mentorship by an IDSA member or fellow. IDSA members and fellows identify and solicit interested students. To learn more, please visit IDSA’s website.

2010 Medical Scholars Recipients and Mentors

Fatima Akrouh, Harvard Medical School
Establishing Best Practices for Obtaining Blood Cultures in Oncology Patients with Long-Term Indwelling Catheters
Mentor: Francisco Marty, MD, Brigham and Women's Hospital/Harvard Medical School

Michael April, Harvard Medical School
Cost-Effectiveness of Cryptococcus Screening
Mentor: Rochelle Walensky, MD, MPH, FIDSA, Massachusetts General Hospital

Defne Arslan, Case Western Reserve University
T Cell Function in Lung Transplant Patients with Hypogammaglobulinemia
Mentor: Lara Danziger-Isakov, MD, MPH, Cleveland Clinic

Malike Atmakuri, Penn State College of Medicine
Eco-Epidemiology of Chagas Disease Transmission
Mentor: Jose A. Stoute, MD, Penn State Hershey Medical Center

Assefa Ayalew, Mayo Medical School
Impact of CIED Infection Treatment Guideline on Clinical Practice at Mayo Clinic
Mentor: Larry M. Baddour, MD, FIDSA, Mayo Clinic

Rachel Bender, University of Iowa
Surveying Trends of Co-Infections with Hansen's Disease in Nova Cruz, Brazil
Mentor: Mary Wilson, MD, FIDSA, University of Iowa

Lindsay Boole, Emory University
Antiretroviral Therapy for Prevention of Heterosexual HIV Transmission in Zambia: Assessing Challenges in Exposure Classification
Mentor: Carlos del Rio, MD, FIDSA, Emory University

Patrick Bradley, Wayne State University
Epidemiology of Clostridium difficile Infection in Hematopoietic Stem Cell Patients
Mentor: George J. Alangaden, MD, FIDSA, Wayne State University

Kevin Bui, Saint Louis University
Review of ESBL-Producing Bacterial Infections in High-Risk Patients
Mentor: Matthew R. Leibowitz, MD, UCLA Department of Medicine

Timica Campbell, University of North Carolina
Re-Evaluation and Alteration of Standards and Practices of KCH Microbiology Laboratory
Mentor: Charles van der Horst, MD, FIDSA, University of North Carolina

Krisda Chaiyachati, University of Michigan
Introducing Cell Phones for Clinical Support, Monitoring, and Evaluating Adverse Events in a Community-Based MDR-TB Program in KwaZulu-Natal, South Africa
Mentor: Gerald Friedland, MD, FIDSA, Yale University School of Medicine

Elizabeth Chenoweth, University of Michigan
Regulation of Uterine Epithelial Cell Antimicrobial Peptide Expression by Lipid Mediators
Mentor: David M. Aronoff, MD, University of Michigan Health System

Victor Chow, University of Washington
Infections in Cord Blood Transplants
Mentor: Steven Pergam, MD, MPH, University of Washington

Jacqueline Chu, Cleveland Clinic at Case Western University
Optimizing Timing of Pretransplant Vaccination in Lung Transplant Recipients
Mentor: Robin Avery, MD, FIDSA, Cleveland Clinic

Michael Cronin, Tufts University
Microlab Dysfunction and Clinical Care
Mentor: Yoav Golan, MD, MS, Tufts Medical Center

Lilli Dash, Columbia University
Program in HIV Vaccine Clinical Research and Clinical ID
Mentor: Scott M. Hammer, MD, FIDSA, Columbia University Medical Center

Nneka Edwards-Jackson, Columbia University
Thai MSM HIV Disclosure Study
Mentor: Magdalena Sobieszczyk, MD, Columbia University Medical Center

Maria Garcia, Johns Hopkins School of Medicine
Patient Satisfaction and Retention in HIV Care and Treatment Centers in Dar-as-Salaam, Tanzania
Mentor: Lisa Hirschhorn, MD, MPH, FIDSA, Harvard Medical School

Annette George, Albany Medical College
Characteristics Shared Between HIV VLPs and Live Virus
Mentor: Karen Duus, PhD, Center for Immunology and Microbial Disease at Albany Medical Center

Mark Goldman, David Geffen School of Medicine at UCLA
Analysis of HIV Care at AHF Clinics in Rural China
Mentor: Thai C. Nguyen, MD, AIDS Healthcare Foundation

Qyana Griffith, Boston University
Host-Parasite Interaction Between CO23+ B Cells and Schistosomes
Mentor: Nikolaos Mavrogiorgos, MD, Boston University School of Medicine

David Taylor Hendrixson, University of Alabama at Birmingham
A Double-Blind, Placebo-Controlled, Virologic Efficacy Trial of Pleconaril in the Treatment of Neonates with Enteroviral Sepsis Syndrome
Mentor: David W. Kimberlin, MD, University of Alabama School of Medicine

Kanchana Herath, Penn State College of Medicine
Role of CRRY in the Pathogenesis of Cerebral Malaria in Mice Infected with Plasmodium berghei
Mentor: Jose A. Stoute, MD, Penn State Hershey Medical Center

Joshua Herigon, University of Kansas
Improving the Management of Community-Acquired Pneumonia through a Smartphone-Based Clinical Practice Guideline
Mentor: Jason Newland, MD, Children's Mercy Hospitals & Clinics

Jeffrey Hom, Harvard Medical School
Self-Rated Health and HIV Diagnosis in Durban, South Africa
Mentor: Ingrid V. Bassett, MD, MPH, Massachusetts General Hospital

Kara Johnson, Harvard Medical School
Secondary Influenza Infection Prevention in Urban Thai Household
Mentor: Edward O'Rourke, MD, Harvard Medical School

Eric Kalivoda, University of Vermont
Characterizing Cellular Immune Responses during Human S. typhi Infection
Mentor: Edward Ryan, MD, FIDSA, Massachusetts General Hospital

Zahir Kanjee, Yale University
TB Infection Control in Resource-Limited Settings
Mentor: Gerald Friedland, MD, FIDSA, Yale AIDS Program

Soofia Khan, University of Arizona
Reproducibility of EIA & ID Results Between Various Laboratories for Coccidioidomycosis 
Mentor: Rebecca Sunenshine, MD, Maricopa County Department of Public Health

Katherine Kudyba, Vanderbilt University
Breast Feeding and Acute Viral Respiratory Illness
Mentor: Natasha Halasa, MD, MPH, Vanderbilt University School of Medicine

Edward Churk Fung Lam, University of Hawaii
Infectious Disease Education of New Medical Students
Mentor: Alan Tice, MD, FACP, FIDSA, Infections Limited Hawaii

Jennifer Manne, Boston University
Durable Wall Lining in the Control of Trypanosoma cruzi in Arequipa, Peru: A Pilot Study
Mentor: Davidson Hamer, MD, FIDSA, Boston University School of Medicine

Peter McCaffrey, Johns Hopkins University
Electronic Medication Adherence Program (E-MAP)
Mentor: Khalil Ghanem, MD, Johns Hopkins University

Juliana Minak, University of Virginia
Developing Point of Care Tests to Diagnose Agents of Diarrheal Diseases and Determine Patient Condition and Severity of Disease in Dhaka, Bangladesh
Mentor: William A. Petri Jr., MD, PhD, FIDSA, Infectious Diseases and International Health

Aaloke Mody, Duke University
Severe Acute Malnutrition and HIV-1 Infection: An Observational and Metabolomic Analysis
Mentor: John A. Bartlett, MD, FIDSA, Duke University Medical Center

Shane Morriso, Stanford University
Cultural Adaptation of a Measure to Assess Medical Professionals’ Knowledge of and Attitudes Towards HIV/AIDS in Albania
Mentor: Yvonne Maldonado, MD, FIDSA, Stanford University

Scott Nabity, Duke University
Epidemiology of Rapid Diagnosis of Leptospirosis
Mentor: Christopher Woods, MD, MPH, FIDSA, Duke University School of Medicine

Nazlee Navabi, University of Pennsylvania
Engineering Beta-Galactosidase Expressing Strains of Trypanosoma cruzi for Drug Development
Mentor: Frederick Buckner, MD, University of Washington

Erica Nelson, University of Washington
Increasing HAART Adherence in Amharic Ethiopia through Cooperation with the Coptic Church
Mentor: Judd Walson, MD, University of Washington

Tashera Perry, University of Chicago
"Functional Circumcision": Metagenomic characterization of the Male Urogenital Microbiome
Mentor: John Schneider, MD, University of Chicago

Kate Poropatich, George Washington University
DC-SIGN Mediated Cell-Entry by Dengue Virus
Mentor: Stephen J. Thomas, MD, FACP, FIDSA, U.S. Army Medical Component

Nicholas Rademacher, University of Michigan
Parental Attitudes Towards Childhood Immunizations in Eastern Uganda
Mentor: Preeti Malani, MD, FIDSA, VA Ann Arbor HealthCare Systems

Stephanie Rolin, Dartmouth Medical School
The Promise Study: At Gheskio
Mentor: Peter Wright, MD, FIDSA, Dartmouth-Hitchcock Medical Center

Lauren Rosenberg, Columbia University
Using Case-Based Vignettes to Improve Adherence to Transmission Precautions in the Pediatric ICU
Mentor: Lisa Saiman, MD, Columbia University Medical Center

Natasha Schimmoeller, New York Medical College
Sensitivity of U.S. vs. European Serologic Test Kits for Detection of Borrelial Antibodies in Patients who Acquired Lyme disease in Europe vs. U.S.
Mentor: Gary Wormser, MD, FIDSA, New York Medical College

Sid Sheth, LECOM at Seton Hill University
Semen Protects Target CD4+ Cells from HIV Infection
Mentor: Timothy Lahey, MD, MMSc, Dartmouth-Hitchcock Medical Center

Andrea Shioleno, Penn State College of Medicine
Identification of Plasmodium Falciparum's Sialic Acid-Independent Red Cell Invasion Ligand
Mentor: Jose A. Stoute, MD, Penn State Hershey Medical Center

Jennifer Siu, University of Maryland, Baltimore
Summer Clinical Research in the Epidemiology of Antibiotic-Resistant Bacteria
Mentor: Anthony Harris, MD, MPH, FIDSA, University of Maryland, School of Medicine

Kelly Sloane, Johns Hopkins University
Electronic Medication Adherence Program (E-MAP)
Mentor: Khalil Ghanem, MD, Johns Hopkins University

Joanne Smucker, Penn State College of Medicine
Identification of Anthropological and Sociocultural Risk Factors for Cutaneous Leishmaniasis in Capira District, Panama
Mentor: Jose A. Stoute, MD, Penn State Hershey Medical Center

Michael Soule, Yale University
HIV Prevention and Treatment Policy Development in Ukraine
Mentor: Frederick Altice, MD, MA, Yale School of Medicine

Aimee Tang, New York Medical College
Sensitivity of U.S. vs. European Serologic Test Kits for Detection of Borrelial Antibodies in Patients who Acquired Lyme disease in Europe vs. U.S.
Mentor: Gary Wormser, MD, FIDSA, New York Medical College

Ryan Tansek, Wayne State University - Detroit Medical Center/Wayne St. University Medical Student ID Summer Training Program 
Mentor: Keith Kaye, MD, FIDSA, Detroit Medical Center/Wayne State University

Peter Thorson, University of Hawaii
MRSA in the Homeless of Hawaii
Mentor: Alan Tice, MD, FACP, FIDSA, Infections Limited Hawaii

Yu Ting, University of Alabama at Birmingham
Predictors of Clinical Outcomes in Neonatal Herpes
Mentor: Richard Whitley, MD, FIDSA, University of Alabama School of Medicine

Seth Vining, Medical University of South Carolina
Ability of an Active Surveillance Culture Program to Identify Patients Colonized with Community-Associated MRSA
Mentor: Cassadra Salgado, MD, MS, Medical University of South Carolina

Karina Vivar, New York University
Comparing Differences in Malaria Parasitemia by Real-Time Quantitative PCR in HIV-Infected Infants & Children on PI-Based HAART vs. NNRTI-Based HAART
Mentor: Charlotte Hobbs, MD, New York University

Annah Vollstedt, University of Iowa
Socioeconomic & Environmental Factors Contributing to Leprosy in Nova Cruz, Brazil
Mentor: Mary Wilson, MD, FIDSA, University of Iowa

Tyler Wahl, University of Alabama at Birmingham
HIV Peer Interventions in Medication and Clinical Visit Adherence
Mentor: Michael Mugavero, MD, Community Care Center

Welcome, New Members!

Members

Balakrishnan, Vijayalakshmi, MRCP
Chan, Adrienne, MD, MPH
Colton, Benjamin, PharmD
Fusco, Dahlene, MD, PhD
Glover, Dianne, MD
Graham, Chris, MD
Hermann, Laura, MD, PhD
Kattar, Mireille, MD
Kim, Min Ja, MD
Kristjansson, Mar, MD
Kwak, Eun Jeong, MD
Lessa, Fernanda, MD
Lester, Richard, MD
Masaba, Paul, MD, DTM&H, MPH
Miller, Alita, PhD
Mubareka, Samira, MD
Nahar, Uma, MD, MBBS
Navarro, Samuel, MD
Payne, Debra, PharmD
Petru, Ann, MD
Rhee, Elizabeth, MD
Rungnirattisai, Somkiat
Schuetz, Audrey, MD, MPH
Simon, Anna, MD, PhD
Smulian, Alan, BCh, MB
Stamos, Julie, MD
Stover, Kayla, PharmD

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Associates

Araujo, Valter, MD
Baculik, Tanya, MD
Bailey, Steven, MBA, MD, MPH
Batista, Gustavo, MD
Berger, Todd, PharmD
Bettinger, Julie, PhD
Chang, Sandra
Child, Jason, PharmD
Cross, Tracy, MD
DePestel, Daryl, PharmD
Dietz, Craig, DO
Eure, Stephen, RPh
Farmer, Suzanna, PA
Gillies, Robert, PharmD
Goff, Eric
Goldberg, Marcy, NP
Gradyletendre, Norah, MSN
Hansen, Glen, PhD
Heizer, Heather, PA-C
Huffman, Jeffrey, RPh
Hunkler, Robert
Jares, Tyler, MD
Kaleem, Fatima, MBBS
Kanda, Akio, MD
Lee, Colin, MD, MSc
Marie, Kathleen, NP
Marks, John, DCh
McLean, Thomas, MBA
Mui, Emily, PharmD
Neupane, Mahesh
Nguyen, Hang, PharmD
Onyiego, Sherri, PhD
Pai, Gitanjali, MD
Pierre-Antoine, Josette, BSN
Quezada, Vanessa, PharmD
Rene, Lisa, PharmD
Reuben, Jay, DrPH
Samai, Kathryn, PharmD
Schilling, Amy, PharmD
Somarriba, Maria, DMD
Tagliente-Wolf, Jeanne, BSN
Uja, Uzoamaka, RN
Yeh, Amy, MA, MPH
Zavoico, George, PhD

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Members-in-Training

Abandeh, Foad, MBBS
Abate, Getahun, MD, PhD
Abouanaser, Salaheddin, MD
Achar, Belle, MBBS
Agudelo Higuita, Nelson Ivan, MD
Alami, Negar Niki, MD
Alao, Omolara, MD
Aleem, Sarah, MD
Alraddadi, Basem, MD
Altamirano, Jessica, MD
Aoyagi, Yuki, MD, MA
Arnold, Ryan, MD
Arora, Rangolee, MD
Banach, David, MD
Baragi, Rashmi, MD
Barrett, Lisa, MD, PhD
Bhalla, Preeti, DO
Bhattacharyya, Roby, MD, PhD
Bhatti, Micah, MD, PhD
Blouin, Valerie, MD
Cahuayme-Zuniga, Lizbeth, MD
Calderwood, Michael, MD
Campo, Jose, MD
Cantey, Joseph, MD
Carpenter, Stephen, MD
Carr, Silvana, MD
Cassat, Jim, MD, PhD
Chikwendu, Obiageli, MD
Chong, Pearlie, MD
Coburn, Bryan, MD, PhD
Cojulun, Alicia, MD
Cookinham, Sarah, MD
Cowan, James, MD, MPH
Cox, Eric, MD
Dababneh, Ala, MD
Degaffe, Guenet, MD
Denkinger, Claudia, MD, PhD
Desai, Ankita, MD
Dewan, Deeksha, MD
Dierberg, Kerry, MD, MPH
Dilanchian, Paula, DO
Dow, Dorothy, MD
Drain, Paul, MD, MPH
Ebama, Nyabilondi, MD
Edwards, Amy, MD
El Helou, Gilbert, MD
Ellsworth, Misti, DO
Epstein, Lauren, MD
Fernando, Rajeev, MD
Fessler, David, MD
Fong, Kimberlee, DO
Footer, Brent, PharmD
Forcade, Nicolas, PharmD
Foxworth, Michael, MD
Francis, Gweneth, DO
Franco, Ricardo, MD
Georgescu, Anca, MD
Goodman, Julian, MD
Green, Andrea, MD
Gul, Zonaira, MD
Gupta, Purba, MD, MBBS
Haines, Charles, MD
Hariadi, Nurul, MD
Havers, Fiona, MD
Hayes, Lisa, MD
Hemmige, Vagish, MD
Hoang, Holly, MD
Hong, Jae, MD
Housman, Seth, PharmD
Huq, Nujhat Nadia, MD, MBBS
Jaber, Mohammad, MD, MSc
Jacobs, Samantha, MD
Jaijakul, Siraya, MD
Jones, Michelle, MD
Kalra, Lalit, MD
Kareliya, Hiten, MD
Katta, Joseph, DO
Kaushik, Ashlesha, MD
Kausuik, Parul, MD
Keller, Sara, MD
Kelly, Brendan, MD
Kibrea, S.M. , MD
Kobayaa, Hazar, MD
Kuma, Sophia, PharmD
La Hoz, Ricardo, MD
LaBella, Angelena, MD
Lamb, Sophia, BCh, MB, MRCP
Langevin, Stephanie, MD
Laowansiri, Panthipa, MD
LaSalvia, Mary, MD
Lease, Erika, MD
Ledtke, Christopher, MD
Letourneau, Alyssa, MD
Lewis, Gus, DO
Ling, Jennifer, MD
Lorica, Cherish, MD
Luizaga Coca, Gonzalo, MD
Majid, Adrian, MD
Makadzange, Azure, MD, PhD
Malik, Anuj, MD, MS
Mandapat, Aimee, MD
Maroun, Elias, MD
Martel-Laferriere, Valerie, MD
Mauriello, Clifford, MD
McCollum, David, MD
McElroy, Anita, MD, PhD
McNeil, Candice, MD, MPH
Melikian, George, MD, MPH
Milder, Edmund, MD
Miller, Sarah, MD
Modi, Jignesh, MD
Mohanraj, B., MD
Morency-Potvin, Philippe, MD
Muldoon, Eavan
Murphy-Aguilu, Ivette, DO
Nagpal, Avish, MBBS
Nallari, Mithun, MD, MPH
Narach, Tienchai, MD
Nasr, Georgina, MD
Nellore, Anoma, MD
Nienaber, Ju-hsien, MD
Noor, Salman, MD
North, Michael, PharmD
Norton, Thomas, MD
Nowak, Kristie, MD
Nussenblatt, Veronique, MD
Nwanguma, Victor, MD
Oboho, Ikwo, MD
Olson, Scott, MD
Ormesher, Brenda, MD
Patel, Nirav, MD
Patel, Nitin, MD
Patiag, Ronaldo, MD
Pinninti, Swetha Geetha, MD
Poudel, Mahendra, MD, MBBS
Prabaker, Kavitha, MD
Pupaibool, Jakrapun, MD, MS
Qureshi, Shahab, MD
Ramireddy, Sweeya, MD
Redel, Henry, MD
Reindel, Rebecca, MD
Rini, Elizabeth, MD
Rosas, Luis, MD
Sajo, Myrla, MD
Sarpel, Dost, MD
Sarvepaul, Satish, MD
Satlin, Michael, MD
Satyanarayana, Gowri, MD
Schafer, Katherine, MD
Shah, Atia, MD, MBBS
Sheth, Niyati, DO
Shirley, Daniel, MD
Shon, Alyssa, MD
Siddiq, Danish, MBBS
Siedner, Mark, MD
Singh, Sushma, MD
Singhatiraj, Ekachai, MD
Sklar, Marvin, MD
Smit, Michael, MD
Smith, Kevin, MD
Soma, Vijaya, MD
Sommers, Kimberly, MD
Song, Howard, MD
Spivak, Adam, MD
Sullivan, Liam, DO
Summers, Rebecca, MD
Suri, Joshan, MD
Suryadevara, Manika, MD
Syed, Madiha, MD
Tablang, Michael, MD
Tahir, Faiza, MD
Tariq, Farheen, MD
Tengsupakul, Supatida, MD
Thompson, Andrew, MD
Tillekeratne, Gayani, MD
Trivedi, Manish, MD
Trost, Margaret, MD
Trotter, Andrew, MD
Uppal, Priyanka, MD
Vaidya, Sagar, MD,PhD
Vaughan, Stephen, MD
Vijayan, Tara, MD
Weston, Adam, MD
Wong, Emily, MD
Wood, Brian, MD
Zuniga, Jorge, MD

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In Memoriam

Washington, John, MD

IDSA Offers Social Networking Tools

As the 48th Annual Meeting of IDSA, Oct. 21-24 in Vancouver, nears, the Society has developed a set of social networking resources to help members and meeting attendees correspond and interact more effectively with IDSA and each other. We hope these resources will facilitate collaboration, allow us to engage more effectively with members, and help create an online community of ID specialists.

The new tools include:

  • IDSA on Twitter: Look for important announcements, schedule changes, and answers to your meetings-related questions through IDSA’s Twitter account. To see what people are saying about the Annual Meeting on Twitter, search for the #ID2010 tag to find out. Need help? IDSA has created a tutorial to explain the basics of using Twitter.
  • IDSA’s Flickr account: See photos of your colleagues or take a sneak peek at the Vancouver Convention Centre before the Annual Meeting begins. We’re hoping to grow our collection of event photos: If you attend the meeting and take pictures, please tag your photos with “#ID2010” when posting them on the Flickr site.  
  • IDSA’s Facebook page: For help getting started, IDSA has created a tutorial describing how to create an effective Facebook account and offering tips for medical professionals using Facebook. If you already have a Facebook account, please click “Like” on the IDSA Facebook page to receive real-time announcements from the Society.
  • IDSA’s LinkedIn group: If you’re looking for a more professional networking experience, IDSA has set up an official Society group on LinkedIn. By creating a profile based on your résumé or CV, LinkedIn can help you find colleagues in the ID field.

We hope that members will find these tools valuable in collaborating with their colleagues and with IDSA before, during, and after the Annual Meeting. Feel free to browse our social networking page, Connect at the Annual Meeting, for more information about these resources. If you have any questions or comments, please e-mail socialmedia@idsociety.org

ID/HIV Career Center at the 2010 Annual Meeting

Still looking for the perfect candidate to fill your open position? Or are you searching for that perfect position? Find them through the ID/HIV Career Center at the 48th Annual Meeting of IDSA, Oct. 21-24, in Vancouver.

Meeting time means increased candidate activity—both online and on-site—so make sure your jobs are posted! Utilize our Conference Connection™ tool online to let job seekers know that you’ll be at the meeting this year, and how to reach you, or contact candidates who have indicated they will be attending.

Break free from traditional advertising. The ID/HIV Career Center not only offers you the ability to recruit wall-to-wall, but also offers:

  • A 30 percent discount to IDSA members on job postings
  • E-mail notification of job seekers matching your posted positions
  • Pre-screened, qualified candidates
  • Personal customer support

If you are looking for a position, use Conference Connection™ to let employers know that you’ll be in Vancouver and how to reach you to make the most of your time at the meeting this year.

Through the ID/HIV Career Center, job seekers can:

  • post your résumé
  • sign up for e-mail alerts of new job postings that match your criteria
  • utilize other career tools through the ID/HIV Career Center and our partnership with HEALTHeCAREERS Network

To learn more, please visit the online ID/HIV Career Center and the on-site Career Center at the Annual Meeting in Vancouver, which will be located in the IDSA booth near registration. Or contact your ID/HIV Career Center HEALTHeCAREERS Network representative to find ideal candidates today at info@healthecareers.com or (888) 884-8242.

From the President: Looking Back, Looking Ahead

As my term as IDSA president nears its end, I want to tell each of you what an honor it has been to serve as your president during this year of important milestones for the Society. I am happy to report that IDSA’s commitment to work for the greater good of our patients, public health, and our members remains strong and continues to grow.

As my term as IDSA president nears its end, I want to tell each of you what an honor it has been to serve as your president during this year of important milestones for the Society.  I am happy to report that IDSA’s commitment to work for the greater good of our patients, public health, and our members remains strong and continues to grow.

A brief look at some noteworthy developments from the previous year—and what’s ahead—underscores how IDSA continues to serve the needs of its diverse membership and ensure that the expertise of ID physicians is continually presented to governmental and public health authorities. Members are IDSA’s most valuable asset, and I thank all of you for your involvement in the Society’s important work. Without you, these efforts simply would not be possible.  I also want to personally thank the many of you who provided outstanding suggestions and advice for future directions.

In April 2010, a special independent Review Panel unanimously agreed that no changes need to be made to IDSA’s 2006 Lyme disease guidelines, bringing an end to an important chapter in this controversial issue (see April 2010 IDSA News article). The extraordinary review, which took more than a year to complete, was expensive and time consuming. But it was absolutely necessary to defend evidence-based medicine and the safety of patients. Carol Baker, MD, FIDSA, did an outstanding job chairing this panel.

As I noted in my last column, IDSA continues to advocate for adequate federal funding for influenza preparedness and to support mandatory influenza vaccination for health care workers (HCWs). IDSA and the Society of Healthcare Epidemiology of America (SHEA) recently adopted stronger policies in this regard, calling for influenza vaccination to be a requirement for employment for HCWs (see related article). One thing is clear: Health providers have a professional and ethical obligation to protect themselves and their patients by getting immunized against influenza every year.

The Society also has initiated a major effort to demonstrate the value that ID specialists add to the nation’s health care system. As health care reform is implemented, the need to support ID specialists’ important role is more important than ever. Look no further than the Centers for Medicare and Medicaid Services’ (CMS) decision in 2009 to eliminate payments for inpatient and outpatient consultation services codes, a decision IDSA and many other internal medicine subspecialties opposed and continue to work to reverse (see related article).

IDSA’s support for a broad strategy to address antibiotic resistance remains strong as well, including the Society’s 10 x ’20 initiative, calling for the development of 10 new antibiotics by 2020. We have significantly expanded our outreach to Congress the Food and Drug Administration (FDA), the National Institute of Allergy and Infectious Diseases (NIAID), and other important partners to highlight the problem and potential solutions, including passage of the Strategies to Address Antimicrobial Resistance (STAAR) Act, an end to inappropriate antibiotic use in food animals, implementation of effective antimicrobial stewardship programs, and the development of a global strategy to address antibiotic resistance.

As a recent example, the Society held a joint workshop in July with FDA and NIAID, two federal agencies critical to addressing the antibiotic resistance problem. The two-day forum brought together key researchers, physicians, and government officials to discuss the science around antibacterial resistance and drug and diagnostics development as well as strategies to enhance the pipeline of new drugs (see July/August 2010 IDSA News article). The workshop is just the latest example in our ongoing initiative to foster the development of new antimicrobials, starting with IDSA’s “Bad Bugs, No Drugs” report, published in 2004, and which has continued to gain momentum under the tireless and dedicated leadership of John G. Bartlett, MD, FIDSA, and David Gilbert, MD, FIDSA.

The HIV Medicine Association (HIVMA) continues its leadership role in promoting quality in HIV care as founded upon a science-based approach to all aspects of HIV/AIDS, underscored by HIVMA’s recent selection by the International AIDS Society (IAS) as one of two local scientific partners—along with the National Institutes of Health (NIH)—for the 2012 International AIDS Conference in Washington, D.C. Importantly, the Center for Global Health Policy, a project of IDSA and HIVMA, has become a growing influential voice as well in promoting the effective use of U.S. funding to address the global HIV/AIDS and tuberculosis epidemics in the developing world.

Looking ahead, the new year will mark the beginning of a new publishing partnership for IDSA’s highly cited and internationally prestigious journals, Clinical Infectious Diseases and The Journal of Infectious Diseases. Oxford Journals, a division of Oxford University Press, will assume publication of both journals starting Jan. 1, 2011, creating an excellent fit with Oxford Journals’ strong medicine collection and complementary titles in the ID field. Readers and authors will benefit from exciting new resources and tools as well.  We are fortunate that our current editors, Sherwood Gorbach, MD, FIDSA, and Martin Hirsch, MD, FIDSA, will help us manage this transition.

At the Annual Meeting, James Hughes, MD, FIDSA, will assume the role of president of our Society.  I am confident that his leadership will push forward the aggressive agenda that we have established.

To hear more about these and other important Society developments, please join me at the IDSA Business Meeting at the IDSA Annual Meeting on Saturday, Oct. 23, at the Vancouver Convention Center. The meeting is part of a great program for this year’s Annual Meeting, Oct. 21-24. (see related article.) Thank you once again for allowing me to serve you.  See you in Vancouver!

IDSA Annual Meeting Update

The premier meeting in the infectious diseases field is almost here. If you attend only one ID event this year, make it the 48th Annual Meeting of IDSA. The in-depth program is filled with the latest, cutting-edge updates on influenza, antibiotic resistance, emerging infections, HIV/AIDS clinical advances, global health issues, and more.

The premier meeting in the infectious diseases field is almost here. If you attend only one ID event this year, make it the 48th Annual Meeting of IDSA.

The in-depth program is filled with the latest, cutting-edge updates on influenza, antibiotic resistance, emerging infections, HIV/AIDS clinical advances, global health issues, and more. The meeting will bring together physicians, scientists, and other health care professionals involved in research, patient care, public health, disease prevention, and education in the field of ID in Vancouver, Oct. 21-24. Register online here

Use IDSA’s Interactive Program Planner to search for specific sessions and speakers you don’t want to miss, creating your own day-by-day, personalized itinerary for the meeting. You can download these itineraries to your mobile device as well. It’s a great way to make the most of your time at the meeting.

Space is still available for all premeeting workshops at the Annual Meeting. Avoid lines in Vancouver by registering now for these workshops (additional costs may apply):

Wednesday, Oct. 20, 7 a.m.-5 p.m.

  • Implementing Antimicrobial Stewardship Programs: A Workshop on Development, Maintenance, and Measuring Success
  • Vincent T. Andriole ID Board Review Course

Thursday, Oct. 21, 7 a.m.-11 a.m.

  • Billing and Coding Workshop
  • Fellows' Day Workshop
  • Infectious Diseases ABIM Recertification: Self-Evaluation of Medical Knowledge Modules — IDSA General Infectious Diseases and HIV Modules
  • Pediatric Fellows’ Day 2010
  • STD Management in the HIV Care Setting: New Guidelines and Challenging Cases

Thursday, Oct. 21, 8 a.m.-11 a.m.

  • Update on the Diagnosis and Treatment of Tuberculosis
  • How to Talk to the Media

To register for a premeeting workshop, go to the IDSA 2010 registration page and enter your last name and customer ID number from your confirmation. Once you land on the Booking Summary page, click the VIEW/MODIFY button next to your name. This will bring you to the Registration Summary page. Scroll down and click the ADD ITEMS button in the Pending Purchases box.

IDSA has developed a set of social networking tools to help members and attendees collaborate and interact with IDSA and each other in Vancouver. See this IDSA News article for details on how to take advantage of the new resources. Job seekers and employers can also make the most of the Vancouver meeting using ID/HIV Career Center’s Conference Connection™ tool to help them find that perfect position and qualified candidates. Click here for more information.

Thinking about next year’s Annual Meeting already? Submit session suggestions for the 2011 Annual Meeting in Boston via the IDSA website. The deadline for submissions is 5 p.m. EST, Friday, Oct. 29.

IDSA Journal Club

This month: Studies investigating cellulitis in the time of MRSA; ceftaroline versus vancomycin plus aztreonam in the treatment of cSSSI; rapid detection of tuberculosis and rifampin resistance; and associations between exposure to acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and risk of major birth defects.

In this feature, a panel of IDSA members identifies and critiques important new studies in the current literature that have a significant impact on the practice of infectious diseases medicine.

For a review of other recent research in the infectious diseases literature, see “In the Literature,” by Stanley Deresinski, MD, in each issue of Clinical Infectious Diseases.

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Cellulitis in the Time of MRSA
Reviewed by Jonathan Li, MD

Non-culturable cellulitis, defined as cellulitis without abscess, wounds, or ulcers, was historically attributed mainly to streptococcal infection. In a study published in the July 2010 issue of Medicine, the authors investigate whether this still holds true in a time of increasing methicillin-resistant staphylococcal aureus (MRSA) skin and soft-tissue infections and the need for empiric MRSA antibiotic coverage.   

The authors conducted a prospective evaluation of 179 patients admitted with non-culturable cellulitis between 2004 and 2007. Using anti-streptolysin-O (ASO) and Anti-DNase-B (ADB) antibody titers, an estimated 73 percent of individuals with non-culturable cellulitis had an infection by a β-hemolytic streptococci. These individuals had a 97 percent response rate to β-lactam antibiotic treatment. Of the 82 patients who received blood cultures prior to antibiotics, cultures were positive in eight patients with only one showing MRSA. Interestingly, of the 48 individuals without antibody evidence of streptococci infection, 23 were treated with a β-lactam regimen that did not cover MRSA. The vast majority of those individuals (91 percent) had a good clinical response. 

The results suggest that almost three-quarters of non-culturable cellulitis are caused by a streptococcal infection. Even in those without evidence of streptococcal infection by ASO and ADB serologies, β-lactam antibiotics alone appear to be quite effective. This suggests that the remainder of infections are likely attributable to either Group B streptococci, which does not induce ASO or ADB antibodies, or methicillin-susceptible staphylococcal aureus (MSSA). The empiric choice of antibiotics for cellulitis is increasingly complicated by the perceived need for MRSA coverage. However, this entails prescribing additional antibiotics or using broad-spectrum agents, which increases costs and the risk of side effects. This study provides some reassurance that MRSA appears to play a very minor role in non-culturable cellulitis and that empiric treatment with β-lactam agents with close clinical follow-up remains a reasonable option.

(Jeng et al.  Medicine.  2010; 89:217-226.)

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Ceftaroline versus Vancomycin plus Aztreonam in the Treatment of cSSSI
Reviewed by George R. Thompson III, MD

Methicillin-resistant Staphylococcus aureus (MRSA) and Streptococcus pyogenes are the most frequent pathogens associated with complicated skin and skin-structure infections (cSSSI).  Currently available antimicrobials, however, can be limited by their narrow spectrum of activity, resistance, and the need for therapeutic drug monitoring. New treatment options that are both safe and effective are urgently needed. 

In the Sept. 15 issue of Clinical Infectious Diseases, investigators describe the results of a phase III, international, multicenter, randomized, double-blind trial comparing ceftaroline  (a fifth generation cephalosporin with activity against MRSA)  (600mg every 12 hours) to vancomycin plus aztreonam (1gm every 12 hours) in the treatment of cSSSI.  

This study included 1,378 patients with cSSSI randomly assigned to one of the above treatment arms. Cellulitis, cutaneous abscesses, and infected wounds were the most common types of infection and did not differ by treatment group. Diabetes mellitus and peripheral vascular disease were the most common underlying comorbidities in both groups. Clinical cure rates were high in both groups and similar for ceftaroline compared to vancomycin plus aztreonam in the clinically evaluable and modified intention-to-treat populations and in patients infected with MRSA.  Adverse event rates, drug discontinuation, serious adverse events, and death were also similar between treatment groups. 

Vancomycin plus aztreonam demonstrated a higher microbiologic response rate than ceftaroline against gram-negative infections. Although this difference was not statistically significant, prior in vitro studies have suggested decreased efficacy of ceftaroline against Pseudomonas aeruoginosa and Proteus mirabilis isolates. Additionally, there was a trend towards a higher clinical cure rate in patients with bacteremia treated with vancomycin plus aztreonam than those treated with ceftaroline. Further study will undoubtedly clarify the role of this new agent in bacteremia.

These findings support the notion that ceftaroline monotherapy is safe, well tolerated, and associated with high clinical cure rates in the treatment of cSSSI, and has the potential to provide a monotherapy alternative. 

(Corey et al.  Clin Infect Dis.  2010;51(6):641-650.)

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Rapid Detection of Tuberculosis and Rifampin Resistance
Reviewed by Jason Weinberg, MD

A molecular assay is a rapid, sensitive, and specific method to both detect Mycobacterium tuberculosis (MTB) and identify rifampin resistance, according to a study published in the Sept. 9, 2010 edition of The New England Journal of Medicine.

The investigators tested the performance of the Xpert MTB/RIF assay, an automated molecular test that integrates sample processing with real-time polymerase chain-reaction amplification and probing of the MTB rpoB gene. Sputum samples were collected from a diverse set of 1,462 HIV-negative and HIV-positive patients with symptoms suggestive of active pulmonary tuberculosis. MTB/RIF assay results were then compared to results from standard techniques for detecting MTB (microscopy, culture, antigen detection, and nucleic acid amplification) and rifampin resistance (culture-based and molecular genotyping).

The overall sensitivity of the MTB/RIF assay in culture-positive patients was 97.6 percent. Importantly, sensitivity in culture-positive patients whose sputum smears were negative was 72.5 percent when a single specimen was tested and 90.2 percent when three specimens were tested. The overall specificity of the MTB/RIF assay was 99.2 percent when a single specimen was tested and 98.1 percent when three specimens were tested. The MTB/RIF assay had a similarly high sensitivity (97.6 percent) and specificity (98.1 percent) for detection of rifampin resistance.

The limited availability of this costly technology, particularly in low-income countries with a high burden of tuberculosis, will likely limit widespread implementation of the assay.  The authors suggest, however, that MTB/RIF testing could ultimately be less costly than standard culture and drug-susceptibility testing in some settings. The assay’s excellent sensitivity and specificity are encouraging. Other clear benefits include the assay’s simplicity and its ability to rapidly (in less than two hours) identify the presence of MTB and provide information about drug resistance. Altogether, this study highlights the potential for a powerful diagnostic tool to improve tuberculosis management.

(Boehme et al. N Eng J Med 2010; 363:1005-1015.)

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Acyclovir, Valacyclovir, and Famciclovir During First Trimester Not Associated with Birth Defects
Reviewed by Sara Cosgrove, MD

Exposure to acyclovir, valacyclovir, and famciclovir during the first trimester of pregnancy does not appear to be associated with birth defects. The findings, from a study evaluating 837,795 live births in Denmark between 1996 and 2008, were published in the Aug. 25 edition of the Journal of the American Medical Association.

Researchers analyzed data from several large national databases, including the Medical Birth Register, which contains information on all deliveries in Denmark; the Prescription Drug Register, which has individual-level data on prescriptions filled at all outpatient pharmacies (but not inpatient prescriptions); and the National Patient Register Data, containing data on inpatient admissions, including ICD-9 codes (but not outpatient data).

Major defects were diagnosed in 19,960 of 837,795 live births (2.4 percent). There was no difference in the percentage of patients who were exposed to acyclovir (n = 1561), valacyclovir (n = 229), or famciclovir (n = 26) in the first trimester and had a major defect (40/1804, 2.2 percent) and the percentage of those who were not exposed (19,920/835,991, 2.4 percent). After adjustment for several potential confounding maternal factors (e.g., smoking, other drug exposure, diabetes), exposure to the above antiviral agents was not associated with an increased risk of major birth defects (POR 0.89; 95 percent CI 0.65-1.22).  Additional analyses evaluating acyclovir and valacyclovir separately, and evaluating 13 different subgroups of birth defects, also showed no associations between antiviral exposure and birth defects.
 
This study provides additional evidence that exposure to antiviral agents during pregnancy is likely of low risk to the developing fetus. It is important to note that acyclovir was by far the most commonly used antiviral; thus, the data are the most robust for this agent. In addition, while the results do not show an increased signal for birth defects across the population, there still may be birth defects associated with antiviral therapy that were not detected because they were very rare or due to limitations in the available data set.

(Pasternak and Hviid. JAMA 2010; 304(8):859-66.)

 

For a review of other recent research in the infectious diseases literature, see “In the Literature,” by Stanley Deresinski, MD, in each issue of Clinical Infectious Diseases:

Oct. 15

  • Does Tropheryma whipplei Cause Acute Gastroenteritis?
  • Two More Causes of Travelers’ Diarrhea?
  • Breast Prosthesis Infection

Oct. 1

  • Paranasal Sinus Mycetomas
  • Subversive Antibodies: The Increased Risk of Salmonella Infection in Human Immunodeficiency Virus (HIV)–Infected Patients Is Related to High Serum Concentrations of Ineffective Antibody That Impair the Activity of Bactericidal Antibody
  • Asymptomatic Systemic Leishmanial Infection