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Communicable
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Communicable

by CMI Communications

NewCommunicable E66: Diagnostics in the AMR eraNovember 2, 2026 · 51 min
Episodes
67
Released
every two weeks
Latest episode
Nov 2, 2026
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About the podcast

Communicable takes on hot topics in infectious diseases and clinical microbiology. Hosted by the editors of CMI Communications, the open-access journal of ESCMID, the European Society of Clinical Microbiology & Infectious Diseases.

Episodes 67

  1. Communicable E66: Diagnostics in the AMR era

    51 minSeason 3 · Episode 66

    Ahead of World Antimicrobial Resistance Awareness Week (WAAW), Communicable presents a special episode exploring the role of diagnostics within the space of antimicrobial resistance (AMR). Hosts Thomas Tängdén …

    Show notes

    Ahead of World Antimicrobial Resistance Awareness Week (WAAW), Communicable presents a special episode exploring the role of diagnostics within the space of antimicrobial resistance (AMR). Hosts Thomas Tängdén and Annie Joseph are joined by experts Betsy Wonderly Trainor of CARB-X (USA) and Marc Mendelson of Groote Schuur Hospital (South Africa) to discuss how diagnostics can help address the AMR crisis by guiding targeted treatment and reducing unnecessary antibiotic use. They explore the limitations of current diagnostic tools, the challenges of implementing them across different healthcare settings, and the need for incentives to encourage investment in diagnostic innovation.

    Further reading:

    • Gigante V, et al. Diagnostics for priority bacterial pathogens: global gaps and research needs for curbing antimicrobial resistance in low-resource settings. Lancet Microbe 2026. DOI: 10.1016/j.lanmic.2026.101385
    • Miller M, et al. Clinical Utility of Advanced Microbiology Testing Tools. J Clin Microbiol 2019. DOI: 10.1128/jcm.00459-19

  2. Communicable E65: Quarterly catch-up (October 2026 edition)

    49 minSeason 3 · Episode 65

    In this episode of Communicable, Emily McDonald returns for another ‘Quarterly catch-up’ and is joined by Angela Huttner as co-host. Together, they review four recent randomised clinical trials, focusing on …

    Show notes

    In this episode of Communicable, Emily McDonald returns for another ‘Quarterly catch-up’ and is joined by Angela Huttner as co-host. Together, they review four recent randomised clinical trials, focusing on antibiotic treatment duration and different treatment approaches across a range of infections and patient populations [1–4]. They discuss the results and weigh in on their implications for clinical practice.

    References

    1. Johnson, et al. Vancomycin Taper and Pulse or Fidaxomicin for Recurrent C. difficile Infection. NEJM Evid. DOI: 10.1056/EVIDoa2600016
    2. Bundgaard, et al. Response-Tailored or Standard-Duration Antibiotic Treatment for Infective Endocarditis (POET II). NEJM. DOI: 10.1056/NEJMoa2607887
    3. Bielicki, et al. Oral step-down, optimal drug, and total duration of antibiotic treatment in African children hospitalised with severe community-acquired pneumonia (PediCAP): a factorial randomised controlled trial. Lancet 2026. DOI: 10.1016/S0140-6736(26)00879-2
    4. Carlsen, et al. Individualized Duration of Antibiotic Treatment in Culture-Negative Early-Onset Sepsis in Late Preterm and Term-Born Neonates in Denmark: A Multicenter, Open-Label, Randomised, Controlled Non-Inferiority Trial. Lancet Child Adolesc Health. DOI: 10.1016/S2352-4642(26)00118-5

  3. Communicable E64: Getting micro on macrolides for community-acquired pneumonia

    50 minSeason 3 · Episode 64

    In this episode of Communicable, hosts Emily McDonald and Marc Bonten are joined by Sylvain Lother and Valentijn Schweitzer for a discussion on the use of macrolides in community-acquired pneumonia. Together …

    Show notes

    In this episode of Communicable, hosts Emily McDonald and Marc Bonten are joined by Sylvain Lother and Valentijn Schweitzer for a discussion on the use of macrolides in community-acquired pneumonia. Together, they examine the evidence for adding a macrolide to beta-lactam therapy, which patients may benefit from combination treatment, and how available evidence can inform clinical practice.

    Resources:

    Further reading

    • Postma DF, et al. Antibiotic Treatment Strategies for Community-Acquired Pneumonia in Adults (CAP-START). NEJM 2015. DOI: 10.1056/NEJMoa1406330
    • Qian ET, et al. Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection: the ACORN Randomized Clinical Trial. JAMA 2023. DOI: 10.1001/jama.2023.20583
    • Schweitzer VA, et al. Narrow-spectrum antibiotics for community-acquired pneumonia in Dutch adults (CAP-PACT): a cross-sectional, stepped-wedge, cluster-randomised, non-inferiority, antimicrobial stewardship intervention trial. Lancet Infect Dis 2022. DOI: 10.1016/S1473-3099(21)00255-3
    • van Daalen FV, et al. Management of community-acquired pneumonia in adults: Practice Guideline from The Dutch Working Party on Antibiotic Policy and Dutch Association of Chest Physicians. CMI Comms 2026. DOI: 10.1016/j.cmicom.2026.105206

  4. Communicable E63: Does oseltamivir harm critically ill patients? The REMAP-CAP results

    1 h 3 minSeason 3 · Episode 63

    At the Critical Care Reviews meeting in Belfast in June this year, REMAP-CAP investigators presented results suggesting that oseltamivir may be harmful in critically ill patients with influenza, upending a …

    Show notes

    At the Critical Care Reviews meeting in Belfast in June this year, REMAP-CAP investigators presented results suggesting that oseltamivir may be harmful in critically ill patients with influenza, upending a long-standing clinical practice in intensive care [1]. In this fourth collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Josh Davis are joined by Steve Webb (Monash University), senior REMAP-CAP investigator and 'godfather of adaptive trial design', and Steve Tong (University of Melbourne), esteemed clinical trialist and friend of both podcasts. Together, they walk through the trial domain’s design, outcomes and results, also highlighting how these findings demonstrate the importance and clinical impact of randomised clinical trials.

    At the time of this episode recording in August, the results discussed were available as a preprint version [1].

    Resources

    • REMAP-CAP: A Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia, https://www.remapcap.org/

    References

    1. Murthy S, et al. Oseltamivir for Critically Ill Patients with Influenza: A Randomised Trial. Lancet 2026. Preprint http://dx.doi.org/10.2139/ssrn.7172531

  5. Communicable E62: The 'prose' and cons of the POET trial – early oral antibiotic switch for endocarditis

    52 minSeason 3 · Episode 62

    In this episode of Communicable, Emily McDonald and Josh Davis host Henning Bundgaard and Sami El-Dalati for a discussion on early oral antibiotic switch for endocarditis, focusing on the POET trial, led by …

    Show notes

    In this episode of Communicable, Emily McDonald and Josh Davis host Henning Bundgaard and Sami El-Dalati for a discussion on early oral antibiotic switch for endocarditis, focusing on the POET trial, led by Bundgaard, and its clinical impact seven years after the results were first published in 2019 [1]. The episode also covers the ‘prose’ and cons of early oral switch therapy, as well as broader challenges of implementing new evidence in practice when it goes against long-standing dogma.

    References

    1. Iversen K, et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis, NEJM 2018. DOI: 10.1056/NEJMoa1808312

    Further reading:

  6. Communicable E61: We will make you love PK/PD, part 3

    53 minSeason 3 · Episode 61

    In this episode of Communicable, Amy Legg (Brisbane, Australia), Rekha Pai Mangalore (Melbourne, Australia) & Angela Huttner (Geneva, Switzerland) return for the third part of the ‘We will make you love PK/PD’ …

    Show notes

    In this episode of Communicable, Amy Legg (Brisbane, Australia), Rekha Pai Mangalore (Melbourne, Australia) & Angela Huttner (Geneva, Switzerland) return for the third part of the ‘We will make you love PK/PD’ series. The hosts are joined by two experts, Amanda Gwee (Melbourne, Australia) & Sebastian Wicha (Hamburg, Germany), to dive into an important application of PK/PD: model-informed precision dosing (MIPD), and how it allows for more informed, individualised dosing decisions. The episode also covers the open-access educational tools, KidsCalc and TDMx, developed by Gwee and Wicha respectively, and the steps clinicians can take to put MIPD into practice, keeping the individual patient at the centre of dosing decisions.

    Resources

    Further reading

    • Broeker A, et al. Towards precision dosing of vancomycin: a systematic evaluation of pharmacometric models for Bayesian forecasting. CMI 2019. DOI: 10.1016/j.cmi.2019.02.029
    • Brusamarello C, et al. How important are MIC determination methods when targeting vancomycin levels in patients with Staphylococcus aureus infections? J Antimicrob Chemother 2021. DOI: 10.1093/jac/dkab065
    • De Cock PA, et al. Bedside model-informed precision dosing of vancomycin in severely ill neonates and children in Belgium (the BENEFICIAL trial): a multicentre, randomised controlled trial. Lancet Child Adolesc Health 2026. DOI: 10.1016/S2352-4642(25)00385-2
    • Gwee A, et al. Identifying a therapeutic target for vancomycin against staphylococci in young infants. J Antimicrob Chemother 2022. DOI: 10.1093/jac/dkab469
    • Haiping X, et al. Model-informed precision dosing of vancomycin in children 3 months to 18 years of age using Australia-wide data. Antimicrob Agents Chemother 2026. DOI: 10.1128/aac.01840-25
    • Harwood K, et al. Refining Absolute GFR Estimation in Children: Development and Validation of the GROW-GFR Equation. Front Pharmacol 2026.
    • Minichmayr IK, et al. Model-informed precision dosing: State of the art and future perspectives. Adv Drug Deliv Rev 2024. DOI: 10.1016/j.addr.2024.115421
    • Starp J, et al. Towards model-informed precision dosing of intravenous linezolid: a multicentre external evaluation of pharmacokinetic models in critically ill adults. CMI 2026. DOI: 10.1016/j.cmi.2025.08.032
    • Wilkins AL, et al. Individualized vancomycin dosing in infants: prospective evaluation of an online dose calculator. Int J Antimicrob Agents 2023. DOI: 10.1016/j.ijantimicag.2023.106728
    • US National Kidney Foundation for different equations for kidney function estimates as related to drug dosing – estimating kidney function for medication related decisions: Frequently Asked Questions | National Kidney Foundation

  7. Communicable E60: Quarterly catch-up (August 2026 edition)

    49 minSeason 3 · Episode 60

    In the second edition of 'Quarterly catch-up', CMI Communications editors Emily McDonald and Erin McCreary round-up the biggest news in infectious diseases and review clinical microbiology and infectious …

    Show notes

    In the second edition of 'Quarterly catch-up', CMI Communications editors Emily McDonald and Erin McCreary round-up the biggest news in infectious diseases and review clinical microbiology and infectious diseases studies published in the second quarter of 2026 [1-4]. From Pneumocystis jirovecii pneumonia in solid-organ-transplant recipients to a double-blind randomised controlled trial reporting a new antibiotic for complicated urinary tract infections, Erin and Emily highlight four articles they found particularly noteworthy, and comment on whether the results can and should change clinical practice.

    References

    1. Alanio A, et al. Pneumocystis jirovecii pneumonia in solid organ transplant recipients: a prospective observational cohort study, J Infect 2026. DOI: 10.1016/j.jinf.2026.106794
    2. Ramendra R, et al. Procalcitonin to guide 7 versus 14 days of antibiotics in bloodstream infections: a secondary analysis of the BALANCE trial, JAMA Netw Open 2026. DOI: 10.1001/jamanetworkopen.2026.20973
    3. Pai MP, et al. Challenging weight-tiered antibiotic prophylaxis in obese patients undergoing colorectal surgery using CT-derived body composition, CID 2026. DOI: 10.1093/cid/ciag383
    4. Takahashi S, et al. Efficacy and safety of cefepime–nacubactam and aztreonam–nacubactam compared with imipenem–cilastatin for complicated urinary tract infection or acute uncomplicated pyelonephritis (Integral-1): a double-blind, randomised phase 3 trial. Lancet 2026. DOI: 10.1016/S0140-6736(26)00596-9

    Further reading

    • The SNAP Trial Group. Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia. NEJM 2026. DOI: 10.1056/NEJMoa2506905
    • The SNAP Trial Group. Benzylpenicillin versus flucloxacillin or cloxacillin for the treatment of penicillin-susceptible Staphylococcus aureus bacteraemia (SNAP): an international, multicentre, open-label, non-inferiority randomised controlled trial. Lancet 2026. DOI: 10.1016/S0140-6736(26)00761-0
    • McCreary EK, et al. Communicable episode 26: SNAP out of it – rethinking anti-staphylococcal penicillins for S. aureus bacteremia, the SNAP trial PSSA/MSSA results. Communicable Podcast 2025. https://share.transistor.fm/s/2a3c3bb4
    • Ilges D, et al. Anticalcitonin: limited utility of a context-dependent biomarker demonstrated in another real-world data set, CID 2026. DOI: https://doi.org/10.1093/cid/ciag396
    • Spellberg B. Procalcitonin–An enigmatic anxiolytic biomarker, JAMA Netw Open 2026. DOI: 10.1001/jamanetworkopen.2026.20978

  8. Communicable E59: 'Ask me anything' – EUCAST and CLSI leadership explain

    1 h 9 minSeason 3 · Episode 59

    In this episode of Communicable, Nav Narayanan and Thomas Tängdén kick off the first 'Ask me anything' episode, inviting EUCAST and CLSI leadership Sören Gatermann, Christian Giske and Amy Mathers to answer …

    Show notes

    In this episode of Communicable, Nav Narayanan and Thomas Tängdén kick off the first 'Ask me anything' episode, inviting EUCAST and CLSI leadership Sören Gatermann, Christian Giske and Amy Mathers to answer questions from our listeners. Together, they discuss the roles and operations of both organisations, similarities and differences between EUCAST and CLSI, how breakpoints and guidance documents are developed, set the record straight about the 'I' category, explain which data inform breakpoint decisions, and much more.

    This episode was edited by Communicable's executive producer, Angela Huttner.

    Further reading

    Documents/resources:

    Articles (alphabetical):

    • Bixby ML, et al. Fosfomycin Disk Diffusion Testing among Klebsiella pneumoniae Results in Frequent Inner Colonies and Categorical Disagreement Based on Conflicting Breakpoint Organization Recommendations. Microbiol Spectr 2023. DOI: 10.1128/spectrum.03363-22
    • DeMarco MG, et al. Impact of media brand on cefiderocol disk diffusion results. J Clin Microbiol 2025. DOI: 10.1128/jcm.01648-24
    • Giske CG, et al. Aminoglycoside breakpoints-the EUCAST approach and what this means for the clinician. CMI 2025. DOI: 10.1016/j.cmi.2025.08.015
    • Mouton JW, et al. MIC-based dose adjustment: facts and fables. J Antimicrob Chemother 2018. DOI: 10.1093/jac/dkx427
    • Narayanan N, et al. Amoxicillin-Clavulanate Breakpoints Against Enterobacterales: Rationale for Revision by the CLSI. Clin Infect Dis 2024. DOI: 10.1093/cid/ciae201
    • Narayanan N, et al. Amoxicillin-Clavulanate Breakpoints Against Enterobacterales: Rationale for Revision by the Clinical and Laboratory Standards Institute. Clin Infect Dis 2024. DOI:
    • Pham Thanh D, et al. A novel ciprofloxacin-resistant subclade of H58 Salmonella Typhi is associated with fluoroquinolone treatment failure. eLife 2016. DOI: 10.7554/eLife.14003.001
    • Smekal A. Swedish multicentre study of target attainments with β-lactams in the ICU: which MIC parameter should be used? J Antimicrob Chemother 2023. DOI: 10.1093/jac/dkad327
    • Turnidge J, et al. How to: the application and analysis of categorical agreement in antimicrobial susceptibility testing using EUCAST breakpoints. CMI 2026. DOI: 10.1016/j.cmi.2025.12.018
    • Turnidge J, et al. Rationale for contemporary antimicrobial treatment of Stenotrophomonas maltophilia: a narrative review. CMI Comms 2025. DOI: 10.1016/j.cmicom.2025.105082
    • Weinstein M, et al. The CLSI Subcommittee on Antimicrobial Susceptibility Testing: Background, Organization, Functions, and Processes. J Clin Microbiol 2020. DOI: 10.1128/jcm.01864-19

  9. Communicable E58: Reducing hospital-acquired pneumonia – the HAPPEN trial and how it happened

    54 minSeason 3 · Episode 58

    In this episode of Communicable, Angela Huttner and Josh Davis are joined by Brett Mitchell, Aline Wolfensberger and Lauren Clack to discuss the HAPPEN trial to prevent hospital-acquired pneumonia led by …

    Show notes

    In this episode of Communicable, Angela Huttner and Josh Davis are joined by Brett Mitchell, Aline Wolfensberger and Lauren Clack to discuss the HAPPEN trial to prevent hospital-acquired pneumonia led by Mitchell--and the important studies leading up to it [1-3]. The episode also explores trial designs used in their research that are both creative and practical, such as stepped-wedge and implementation trials, and how these approaches can bridge the gap between research and real-world practice.

    References

    1. Mitchell B, “The hospital acquired pneumonia prevention (HAPPEN) study: a multi-centre randomised controlled trial” in ESCMID Global 2026. https://online.escmid.org/media-6348-hospital-and-ventilator-associated-pneumonia-new-insights-on-prevention-diagnosis-and-treatment (Presentation).
    2. White NM, et al. Effectiveness of oral care for the prevention of non-ventilator hospital-acquired pneumonia (HAPPEN): a multicentre, stepped-wedge, cluster-randomised trial in Australia. Lancet Infect Dis 2026. DOI: 10.1016/S1473-3099(26)00235-5.
    3. Wolfensberger A, et al. Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness–implementation trial. Lancet Infect Dis 2023. DOI: 10.1016/S1473-3099(22)00812-X.

    Further reading

    • HAPPEN study website: Study overview and resources www.happenstudy.com
    • Cassini A, et al. Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study. PLoS Med 2016. DOI: 10.1371/journal.pmed.1002150.
    • Pronovost P, et al. An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU. NEJM. DOI: 10.1056/NEJMoa061115.
    • Bion J, et al. ‘Matching Michigan’: a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England. BMJ Quality & Safety 2013. DOI: 10.1136/bmjqs-2012-001325.
    • Dixon-Woods M, et al. Explaining Matching Michigan: an ethnographic study of a patient safety program. Implementation Sci 2013. DOI: 10.1186/1748-5908-8-70.
    • Clack L, et al. Hybrid effectiveness-implementation studies in infection prevention and infectious diseases: a narrative review. CMI 2025. DOI: 10.1016/j.cmi.2025.10.022.
    • Hospital Acquired Pneumonia Prevention (HAPPEN) Study: Statistical Analysis Plan
      https://www.medrxiv.org/content/10.1101/2025.08.14.25333719v1
    • Oral care practices and hospital-acquired pneumonia prevention: A national survey of Australian nurses
      https://pubmed.ncbi.nlm.nih.gov/38724299/
    • Nurses' experiences of providing oral care to hospitalised patients: A qualitative study
      https://pubmed.ncbi.nlm.nih.gov/40450434/

  10. Communicable E57: We will make you love PK/PD, part 2

    47 minSeason 3 · Episode 57

    In this episode of Communicable, Thomas Tängdén and Rekha Pai Mangalore return for part 2 of the ‘We will make you love PK/PD’ series. In this round, they are joined by Iris Minichmayr (Austria) and Phil Selby …

    Show notes

    In this episode of Communicable, Thomas Tängdén and Rekha Pai Mangalore return for part 2 of the ‘We will make you love PK/PD’ series. In this round, they are joined by Iris Minichmayr (Austria) and Phil Selby (Australia) for a deep dive into how PK/PD data and principles can be used as integral clinical tools to support dosing decisions. They break down technical concepts of pharmacometrics such as population PK models, Monte Carlo simulations, probability of target attainment (PTA), and cumulative fraction of response (CFR), helping to make these approaches more accessible to everyday clinical practice.

    This episode was edited by Kathryn Hostettler. The executive producer of Communicable is Angela Huttner.

    Further reading

  11. Communicable E56: Frequentist vs Bayesian for clinical trial analysis – 99% probability you’ll want to listen to this

    1 h 5 minSeason 3 · Episode 56

    In this episode of Communicable, Emily McDonald and Josh Davis are joined by Roger Lewis (USA) and Ian Marschner (Australia) to compare and contrast Bayesian and frequentist statistical approaches. The panel …

    Show notes

    In this episode of Communicable, Emily McDonald and Josh Davis are joined by Roger Lewis (USA) and Ian Marschner (Australia) to compare and contrast Bayesian and frequentist statistical approaches. The panel discusses the fundamental principles of both methods, common misconceptions, and the extent to which they are often more similar than many realise. Together, they explore their use in clinical trial design, analysis, and reporting, including adaptive trials and sequential learning. Additional topics include sample size misconceptions, regulatory versus clinical thresholds, and the challenges of interpreting post hoc reanalyses of negative trials.


    This episode was edited by Kathryn Hostettler and the executive producer of Communicable is Angela Huttner.

    Further reading:

  12. Communicable E55: Bonus episode – Bundibugyo ebolavirus outbreak

    57 minSeason 3 · Episode 55

    In this bonus episode of Communicable, hosts Anne-Grete Märtson and Angela Huttner invite Martin Grobusch (University of Amsterdam; ESCMID Emerging Infections Subcommittee) and Daniel Bausch (National …

    Show notes

    In this bonus episode of Communicable, hosts Anne-Grete Märtson and Angela Huttner invite Martin Grobusch (University of Amsterdam; ESCMID Emerging Infections Subcommittee) and Daniel Bausch (National University of Singapore, London School of Hygiene & Tropical Medicine, and Geneva Graduate Institute) to discuss the Bundibugyo ebolavirus outbreak currently ongoing in the Democratic Republic of Congo and Uganda. Clinical and virological differences between Bundibugyo and Zaire ebolaviruses are discussed, as are the particular challenges for diagnosis, treatment, and prevention confronting healthcare workers of this outbreak. The episode accompanies two new publications in CMI Communications and CMI:

  13. Communicable E54: ESCMID Global Late Breakers, part 2

    56 minSeason 3 · Episode 54

    Our editors – Marc Bonten, Erin McCreary, Anne-Grete Märtson, Angela Huttner, and Josh Davis – are back for part two of the ESCMID Global Late Breakers series, summarising five more late-breaking trials …

    Show notes

    Our editors – Marc Bonten, Erin McCreary, Anne-Grete Märtson, Angela Huttner, and Josh Davis – are back for part two of the ESCMID Global Late Breakers series, summarising five more late-breaking trials presented at ESCMID Global 2026. They discuss the trials' strengths and weaknesses, and whether their results should change practice.

    The five trials presented in this half of the series are listed below, and links to their respective sessions can be watched and rewatched on the ESCMID Global Virtual Platform. Links to corresponding abstracts and publications where available are provided as well.

    Conflict of interest/involvement in the trials:

    • Marc Bonten was the chair of the E.mbrace trial's steering committee
    • Josh Davis is global co-lead of the SNAP trial
    • Josh Davis was a site investigator on the E.mbrace trial
    • Angela Huttner was an independent/unpaid member of the E.mbrace trial's steering committee and an investigator on the precursor phase 1 trial testing the E. coli vaccine


    PROCALBAN trial (Late-breaking clinical trials in sepsis management)

    • Chowdhury F, et al. Use of Procalcitonin Point-Of-Care Testing to Guide De-Escalation of Antibiotic Therapy in Adult Sepsis Patients in a Tertiary Hospital in Bangladesh: A Randomised Controlled Open-Label Trial, Preprints with The Lancet, doi: 10.2139/ssrn.6541698

    BENEFICIAL trial (Late-breaking clinical trials in sepsis management)

    • De Cock PA, et al. Bedside model-informed precision dosing of vancomycin in severely ill neonates and children in Belgium (the BENEFICIAL trial): a multicentre, randomised controlled trial. Lancet Child Adolesc Health, doi: 10.1016/S2352-4642(25)00385-2

    SNAP trial (Late-breaking clinical trials in sepsis management)

    • Bowen A. Adjunctive clindamycin for treatment of Staphylococcus aureus bacteraemia: a randomised controlled trial within the S. aureus Network Adaptive Platform (SNAP), abstract

    Adjunctive betamethasone treatment of hypoxemic adults hospitalised with Mycoplasma pneumoniae community-acquired pneumonia: an open-label, multicentre, randomised, controlled trial (Late-breaking research from The Lancet)

    • Hagman K, et al. Adjunctive betamethasone treatment of hypoxaemic adults hospitalised with Mycoplasma pneumoniae community-acquired pneumonia: an open-label, multicentre, randomised, controlled trial. Lancet 2026, doi: 10.1016/j.lanepe.2026.101610

    E.mbrace trial (Vaccines: landmark trials and preventive immunisation)

    • Cohen CA, et al. Randomised phase III trial of a 9-valent vaccine (ExPEC9V) for prevention of invasive Escherichia coli disease (IED) in older adults (E.mbrace), abstract


    The Swiss multicentre phase 1, first-in-human trial testing the conjugate E. coli vaccine:

    • Huttner A et al. Safety, immunogenicity, and preliminary clinical efficacy of a vaccine against extraintestinal pathogenic Escherichia coli in women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo-controlled phase 1b trial. Lancet Infect Dis 2017: May;17(5):528-537


  14. Communicable E53: ESCMID Global Late Breakers, part 1

    1 hSeason 3 · Episode 53

    The ESCMID Global Late Breakers series returns to Communicable! Five CMI Communications editors – Marc Bonten, Josh Davis, Angela Huttner, Anne-Grete Märtson, and Erin McCreary – handpicked five late-breaking …

    Show notes

    The ESCMID Global Late Breakers series returns to Communicable! Five CMI Communications editors – Marc Bonten, Josh Davis, Angela Huttner, Anne-Grete Märtson, and Erin McCreary – handpicked five late-breaking trials presented at ESCMID Global 2026 to summarise their findings and discuss whether the results will change their practice. This is part one of the two-part series.

    Trials presented are listed below and links to their respective sessions can be watched and rewatched on the ESCMID Global Virtual Platform. Links to corresponding publications, if available, and mentioned related articles are provided as well.

    The FAST trial (Late-breaking research from JAMA)

    • Banerjee R, et al. Fast Antimicrobial Susceptibility Testing for Gram-Negative Bacteremia. The FAST Randomized Clinical Trial, doi: 10.1001/jama.2026.5487
    • Srinivasan A. A Multinational Trial of Rapid Antimicrobial Susceptibility Testing. Is FASTer Better?, doi: 10.1001/jama.2026.5504

    The CEFMEC trial (Poster session)

    • Hayakawa K, et al. Effectiveness of cefmetazole versus meropenem for invasive urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli, Antimicrob Agents Chemother 2023, doi: 10.1128/aac.00510-23

    The COBRA trial (Late-breaking trials in surgical infection prevention)

    • Overdevest AG, et al. Antibiotic treatment for 1 day versus 4-7 days in patients with acute cholangitis after adequate endoscopic biliary drainage (COBRA): study protocol for a randomized controlled trial. Trials, doi: 10.1186/s13063-026-09524-7

    The DOTS trial, a secondary analysis (Late-breaking research from JAMA)

    • Lodise, TP, et al. Pharmacokinetics of Dalbavancin in Complicated Staphylococcus aureus Bacteremia: A Secondary Analysis of the DOTS Randomized Clinical Trial, JAMA 2026, doi: 10.1001/jamanetworkopen.2026.11652
    • Walls G, et al. Patient-reported Perceptions, Experiences, and Preferences Around Intravenous and Oral Antibiotics for the Treatment of Staphylococcus aureus Bacteremia: A Descriptive Qualitative Study, Clin Infect Dis 2026, doi: 10.1093/cid/ciaf522
    • Turner NA , et al. Dalbavancin for treatment of Staphylococcus aureus bacteremia: the DOTS randomized clinical trial. JAMA 2025, doi: 10.1001/jama.2025.12543

    Maribavir for clinically significant cytomegalovirus infection in hematopoietic cell transplantation: a real-world retrospective international study of the Infectious Disease Working Party of EBMT (Late-breaking research from The Lancet)

    • Paviglianiti A, et al. Maribavir for clinically significant cytomegalovirus infection in haematopoietic cell transplant recipients in Europe: a real-world multicentre retrospective registry study. Lancet 2026. doi: 10.1016/S1473-3099(26)00144-1

  15. Communicable E52: ESCMID Global Trials, PETER PEN and ASTARTE

    1 hSeason 2 · Episode 52

    In this collaborative episode of Breakpoints and Communicable, the hosts revisit the “trial run” session from ESCMID Global, a format designed to facilitate critical discussion of major infectious diseases …

    Show notes

    In this collaborative episode of Breakpoints and Communicable, the hosts revisit the “trial run” session from ESCMID Global, a format designed to facilitate critical discussion of major infectious diseases trials. This episode focuses on two studies addressing bloodstream infections caused by third‑generation cephalosporin-resistant Enterobacterales [1].

    Mical Paul (Rambam Health Care Campus, Israel) joins the podcast to discuss the PETER PEN trial [1,2], comparing piperacillin/tazobactam with meropenem, including its design, interim analyses, and interpretation alongside prior data such as MERINO. The episode also features Jesús Rodríguez‑Baño (University of Seville, Spain), who presents a post hoc analysis of the ASTARTE trial [1,3], comparing temocillin and carbapenems.

    This episode was edited by Lacy Worden and was peer reviewed by Jeanette Bouchard (Duke Antimicrobial Stewardship Outreach Network (DASON) Durham, NC, USA).

    References

    1. Paul, M., & Rodríguez-Baño, J. (2026, April 20). The trial run: treatment of ESBL bacteraemia - off to never-never land. [Presentation]. ESCMID Global 2026, Munich, Germany. ESCMID Global Virtual Platform.
    2. Bitterman R, Koppel F, Mussini C, et al. Piperacillin-tazobactam versus meropenem for treatment of bloodstream infections caused by third-generation cephalosporin-resistant Enterobacteriaceae: a study protocol for a non-inferiority open-label randomised controlled trial (PeterPen). BMJ Open. 2021;11(2):e040210. Published 2021 Feb 8. doi: 10.1136/bmjopen-2020-040210
    3. Marín-Candón A, Rosso-Fernández CM, Bustos de Godoy N, et al. Temocillin versus meropenem for the targeted treatment of bacteraemia due to third-generation cephalosporin-resistant Enterobacterales (ASTARTÉ): protocol for a randomised, pragmatic trial [Internet]. BMJ Open. 2021 Sep 27;11(9):e049481. doi: 10.1136/bmjopen-2021-049481

    Further reading

    • Harris PNA, et al. Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial. JAMA. 2018;320(10):984–994. doi: 10.1001/jama.2018.12163.

  16. A message to listeners, 4 May 2026

    1 minTrailer

    This is a short message to Communicable listeners to inform them that the next episode will be released on Friday, 8 May, as it is a collaboration episode with Breakpoints, the podcast of the Society of …

    Show notes

    This is a short message to Communicable listeners to inform them that the next episode will be released on Friday, 8 May, as it is a collaboration episode with Breakpoints, the podcast of the Society of Infectious Diseases Pharmacists. It will cover the two trials presented in Munich during ESCMID Global's late-breaker Trial Run session.

  17. Communicable E51: We will make you love PK/PD, part 1

    48 minSeason 2 · Episode 51

    Communicable is launching a new series on everything related to pharmacokinetics (PK) and pharmacodynamics (PD). Kicking off this series are hosts Thomas Tängdén, Erin McCreary and Angela Huttner, and invited …

    Show notes

    Communicable is launching a new series on everything related to pharmacokinetics (PK) and pharmacodynamics (PD). Kicking off this series are hosts Thomas Tängdén, Erin McCreary and Angela Huttner, and invited guests Amy Legg and Rekha Pai Mangalore. They walk us through key parameters and terms of PK/PD, such as volume of distribution, minimum inhibitory concentration (MIC), epidemiological cut-off value (ECOFF), and PK/PD indices, laying the foundation to better comprehend clinical applications such as setting a clinical breakpoint and how it guides therapeutic drug monitoring (TDM). This first episode encompasses a broad scope across PK/PD theory, preparing the listener for subsequent episodes that will explore these topics with greater depth and make you love PK/PD.

    This episode was peer-reviewed by Ummu Afeera Zainulabid of the International Islamic University, Kuantan, Malaysia.

    Terms and definitions

    • ADME, a drug’s journey through the body: absorption, distribution, metabolism, excretion
    • Volume of distribution, a parameter describing the theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasma
    • Clearance, the volume of blood cleared of drug per unit time
    • Half-life, the time required for the concentration of a drug to decrease to half of its initial amount in the body
    • Loading dose, a larger initial dose designed to rapidly bring drug levels into the therapeutic range
    • Steady state, an equilibrial condition in which the rate of input of a drug is equal to the rate of its output
    • MIC, minimum inhibitory concentration
    • ECOFF, epidemiological cut-off value: the highest MIC value of isolates that are not known to have resistance and are therefore considered representative of wild-type bacterial isolates
    • Clinical breakpoint setting, takes into account drug dosing, PK/PD, site of infection, clinical data; what we think is the breakpoint for the lab to call a bacterial organism susceptible to a drug
    • PK/PD index, a parameter that describes the observed antimicrobial activity of an antimicrobial; there are three different indices:
      1. T>MIC (bacterial killing depends on the drug concentration’s remaining higher than the MIC over time)
      2. Cmax/MIC (bacterial killing depends on the drug’s peak concentration)
      3. AUC/MIC (bacterial killing depends on the area under the curve over the MIC)
    • TDM, therapeutic drug monitoring

    Further reading

    • Mouton JW, et al. MIC-based dose adjustment: facts and fables. J Antimicrob Chemother 2018. doi:10.1093/jac/dkx427
    • Märtson A, et al. The pharmacokinetics of antibiotics in patients with obesity: a systematic review and consensus guidelines for dose adjustments. Lancet Infect Dis 2025. doi: 10.1016/S1473-3099(25)00155-0
    • Eagle H and Musselman AD. The rate of bactericidal action of penicillin in vitro as a function of its concentration, and its paradoxically reduced activity at high concentrations against certain organisms. J Exp Med 1948. doi: 10.1084/jem.88.1.99

  18. Communicable E50: Quarterly catch-up (April 2026 edition)

    59 minSeason 2 · Episode 50

    This is the first episode of the 'Quarterly catchup' series, in which CMI Communications editors discuss important and useful articles that have come out in the last 3 months to understand their results and …

    Show notes

    This is the first episode of the 'Quarterly catchup' series, in which CMI Communications editors discuss important and useful articles that have come out in the last 3 months to understand their results and potential clinical impact. In this inaugural episode of 'Quarterly catchup', Emily McDonald (Canada), Thomas Tängdén (Sweden) and Navaneeth Narayanan (USA) convene to discuss clinical microbiology and infectious diseases studies published in the first quarter of 2026 [1-6]. From Wolbachia-infected mosquitoes reducing dengue infection to exploration of antibiotic combination therapies against multidrug-resistant organisms, our hosts summarize six articles they found the most interesting, and discuss whether they can and should change clinical practice.

    This episode was peer reviewed by Connor Prosty of McGill University, Montréal, Canada.

    References

    1. Lim JT, et al. Dengue suppression by Male Wolbachia-Infected mosquitoes. NEJM 2026. doi: https://doi.org/10.1056/NEJMoa2503304
    2. Escrihuela-Vida F, et al. Adjunctive Fosfomycin for the Treatment of Staphylococcus aureus Bacteremia: A Pooled Post Hoc Analysis of Individual Participant Data From 2 Randomized Trial. Clin Infect Dis 2026. doi: https://doi.org/10.1093/cid/ciaf387
    3. Baldanzi G, et al. Antibiotic use and gut microbiome composition links from individual-level prescription data of 14,979 individuals. Nat Med 2026. doi: https://doi.org/10.1038/s41591-026-04284-y.
    4. Quentin Vallé, et al. Evaluating the antibacterial activity of ceftazidime/avibactam and aztreonam combinations against multidrug-resistant Stenotrophomonas maltophilia complex isolates in a hollow fibre infection model. Clin Microbiol Infect 2026. doi: https://doi.org/10.1016/j.cmi.2026.02.010
    5. Rana AI, et al. Cabotegravir plus Rilpivirine for Persons with HIV and Adherence Challenges. NEJM 2026. doi: https://doi.org/10.1056/NEJMoa2508228
    6. Donovan J, et al. Genotype-stratified adjunctive dexamethasone for tuberculous meningitis in HIV-negative adults: a randomized controlled phase 3 trial. Nat Med 2026. doi: https://doi.org/10.1038/s41591-025-04138-z

    Further reading

  19. Communicable E49: Outbreaks & how to handle them

    55 minSeason 2 · Episode 49

    In this episode of Communicable, hosts Angela Huttner and Marc Bonten invite two members of the ESCMID Emerging Infections Subcommittee, Martin Grobusch (Amsterdam, Netherlands) and Pikka Jokelainen …

    Show notes

    In this episode of Communicable, hosts Angela Huttner and Marc Bonten invite two members of the ESCMID Emerging Infections Subcommittee, Martin Grobusch (Amsterdam, Netherlands) and Pikka Jokelainen (Copenhagen, Denmark), to discuss infectious disease outbreaks. Sparked by the Subcommittee's beloved 'Epi Alert', which identifies and tracks outbreaks around the world, the episode covers common missteps and underestimated challenges in handling new outbreaks, the effects of climate change, and what 'One Health' really means.

    This episode was peer reviewed by Ummu Afeera Zainulabid of the International Islamic University Malaysia, Kuantan, Malaysia.

    Further reading

  20. Communicable E48: International Women's Day - are infections & AMR really different in women?

    39 minSeason 2 · Episode 48

    Yesterday was International Women's Day. In light of that, Communicable prepared a special episode in which hosts Erin McCreary and Annie Joseph are joined by Esmita Charani (South Africa) and Annette Westgeest …

    Show notes

    Yesterday was International Women's Day. In light of that, Communicable prepared a special episode in which hosts Erin McCreary and Annie Joseph are joined by Esmita Charani (South Africa) and Annette Westgeest (Netherlands) for a discussion on gender- and sex-dependent patient-care disparities in the infectious diseases space. Together they review recent research findings that identified gender and sex as important determinants influencing patient outcomes and even decision making by prescribers. They also explore how societal and cultural norms may introduce further nuance and complexities. The panel remains optimistic in reaching equal healthcare for all, reflecting also on progressive steps such as increasing recognition by international organisations like the WHO, which published guidance on gender inequalities in national plans on AMR in 2024.

    This episode was peer reviewed by Casandra Bulescu at the Dr. Victor Babes Clinical Hospital of Infectious and Tropical Diseases in Bucharest, Romania.

    References

  21. Communicable E47: Drawing the line - the writing, reach, and limits of guidelines

    1 hSeason 2 · Episode 47

    In this third collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma …

    Show notes

    In this third collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma (Philadelphia, USA) and Benedikt Huttner (WHO, Geneva, Switzerland) [1-3]. Together, they deconstruct the complex landscape of developing and implementing guidelines into digestible components: they discuss why different organizations develop guidelines and what need they hope to fulfil, the framework including the GRADE methodology under which guidelines are written, and major barriers in the uptake of guidelines. The conversation also details the distinction between guideline and guidance as well as the art and science behind formulating recommendations or suggestions, with a few anecdotal cases sprinkled in from the panel.

    This episode was edited by Kathryn Hostettler and Lacy Worden. It was peer reviewed for Breakpoints by Lacy Worden and for Communicable by Ljiljana Lukić of University Hospital for Infectious Diseases in Zagreb, Croatia.

    References

    1. WHO handbook for guideline development, 2nd Edition
    2. The WHO AWaRe (Access, Watch, Reserve) antibiotic book
    3. IDSA 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections

    Further reading

  22. Communicable E46: Steroids for pneumocystis pneumonia

    55 minSeason 2 · Episode 46

    In this episode of Communicable, Navaneeth Narayanan and Josh Nosanchuk invite Virginie Lemiale and Elie Azoulay (Paris, France) as well as fellow editor Emily McDonald (Montreal, Canada)—this time as guest—to …

    Show notes

    In this episode of Communicable, Navaneeth Narayanan and Josh Nosanchuk invite Virginie Lemiale and Elie Azoulay (Paris, France) as well as fellow editor Emily McDonald (Montreal, Canada)—this time as guest—to discuss adjunctive steroid therapy for pneumocystis pneumonia (PCP) in HIV-negative individuals. In 2025, Lemiale and Azoulay published results from their double-blind, randomised controlled trial investigating steroid treatment for severe Pneumocystis jirovecii pneumonia (PIC trial) in the Lancet Respiratory Medicine [1]. At first glance, one might dismiss the study’s clinical impact due the ‘negative' result of the primary outcome, mortality at 28 days, which just missed a statistically significant difference between groups. There was a clinical difference, however, and all other outcomes, including 90-day mortality, were significantly different between groups. Understanding how pivotal these results were to clinical practice, McDonald and colleagues sought to contextualise the results of the PIC trial through a Bayesian analysis in a follow-up publication [2]. While the discussion provides useful clinical commentary, it also helps both to demystify Bayesian analysis and to call attention to what might be lost with strict or overly concrete interpretations of traditional frequentist analyses.

    This episode was peer reviewed by Arjana Zerja from the Mother Theresa University Hospital Center, Tirana, Albania.

    References

    1. Lemiale V, et al. Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. 2025;13(9):800-808. doi:10.1016/S2213-2600(25)00125-0.
    2. Lee TC, Albuquerque AM, McDonald EG. Contextualizing the use of corticosteroids in severe Pneumocystis jirovecii pneumonia through a Bayesian lens. CMI Commun. 2025;2(4):105141. doi:10.1016/j.cmicom.2025.105141.

  23. Communicable E45: Top infectious diseases papers in 2025

    39 minSeason 2 · Episode 45

    In this episode of Communicable, Josh Davis (Newcastle, Australia) and Emily McDonald (Montreal, Canada), plus invited guest, Steven Tong (Melbourne, Australia)—all practicing physicians and clinical …

    Show notes

    In this episode of Communicable, Josh Davis (Newcastle, Australia) and Emily McDonald (Montreal, Canada), plus invited guest, Steven Tong (Melbourne, Australia)—all practicing physicians and clinical trialists—assemble to discuss some of their ‘top infectious diseases papers published in 2025’. Bassam Ghanem (Jeddah, Saudi Arabia), whom one might know better as Antibiotic Steward on social media, was also invited to share his favourite publications of 2025.

    Six papers that were most consistently picked by the panel are presented, explaining why they were picked and how they have shifted paradigms or changed their practice. This episode complements the previous episode, which presented ‘top clinical microbiology papers in 2025’, and was peer reviewed by Akshatha Ravindra of Kasturba Medical College, Manipal, India.

    Resources

    Papers presented (in order of presentation)

    1. Turner NA, et al. Dalbavancin for Treatment of Staphylococcus aureus Bacteremia. JAMA
    2. Meya DB, et al. Trial of High-Dose Oral Rifampin in Adults with Tuberculous Meningitis. NEJM
    3. Vodstrcil LA, et al. Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis. NEJM
    4. Kreimer A, et al. Noninferiority of One HPV Vaccine Dose to Two Doses. NEJM
    5. Guglielmetti L, et al. Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis. NEJM
    6. Ross JDC et al, Oral gepotidacin for the treatment of uncomplicated urogenital gonorrhoea (EAGLE-1). Lancet

    ‘One liners’ (in order of presentation)

    1. Burdet C et al. Cloxacillin versus cefazolin for meticillin-susceptible Staphylococcus aureus bacteraemia (CloCeBa). Lancet
    2. Lemiale V et al, Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC). Lancet Respir Med
    3. Luetkemeyer AF et al, Doxycycline to prevent bacterial sexually transmitted infections in the USA. Lancet Inf Dis
    4. Eyting M, et al. A natural experiment on the effect of herpes zoster vaccination on dementia. Nature
    5. Xie M, et al. The effect of shingles vaccination at different stages of the dementia disease course. Cell
    6. Pomirchy M, et al. Herpes Zoster Vaccination and Dementia Occurrence. JAMA
    7. Durbin AP et al, Daily Mosnodenvir as Dengue Prophylaxis in a Controlled Human Infection Model. NEJM
    8. Hook EW et al, One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis. NEJM
    9. Opdam MAA et al, Continuation versus temporary interruption of immunomodulatory agents during infections in patients with inflammatory rheumatic diseases. Clin Infect Dis
    10. Arundel C et al, Negative pressure wound therapy versus usual care in patients with surgical wound healing by secondary intention in the UK (SWHSI-2). Lancet

    Honourable mentions

    • Chaccour C, et al. Ivermectin to Control Malaria. NEJM
    • Lucinde RK, et al. A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia. NEJM
    • Morel J, et al. Effect of a 1-month methotrexate delay on pneumococcal vaccine immunogenicity and disease control in patients with early rheumatoid arthritis (VACIMRA). Lancet Rheumatol
    • Haukoos J, et al. Hepatitis C Screening in Emergency Departments. JAMA
    • Major Extremity Trauma Research Consortium (METRC). Oral vs Intravenous Antibiotics for Fracture-Related Infections: The POvIV Randomized Clinical Trial, JAMA Surg
    • Anderson CS, et al. Influenza vaccination to improve outcomes for patients with acute heart failure (PANDA II). Lancet
    • St Peter SD, et al. Appendicectomy versus antibiotics for acute uncomplicated appendicitis in children. Lancet
    • Pan CQ, et al. Tenofovir and Hepatitis B Virus Transmission During Pregnancy. JAMA
    • Gohil SK, et al. Improving Empiric Antibiotic Selection for Patients Hospitalized With Abdominal Infection. JAMA Surg

    Related podcast episodes

  24. Communicable E44: Top clinical microbiology papers in 2025

    1 h 11 minSeason 2 · Episode 44

    In the first Communicable episode of 2026, Annie Joseph and Josh Nosanchuk invite Robin Patel (Rochester, USA) and Fidelma Fitzpatrick (Dublin, Ireland) to discuss some of their favourite clinical microbiology …

    Show notes

    In the first Communicable episode of 2026, Annie Joseph and Josh Nosanchuk invite Robin Patel (Rochester, USA) and Fidelma Fitzpatrick (Dublin, Ireland) to discuss some of their favourite clinical microbiology papers published in 2025. These six papers highlight everything from technological advances of genomics and molecular diagnostic testing to the importance of patient and public involvement in research as well as effective communication [1-6]. The panel also discusses whether or not any of these papers have changed their practice.

    This episode was edited by Kathryn Hostettler and peer reviewed by Sinéad Kilgarriff of the National Virus Reference Laboratory University College, Dublin in Ireland.


    Robin’s papers

    Fidelma’s papers

    Related podcast episodes

    References

    1. Oyeniran SJ, et al. J Clin Microbiol 2025. DOI: https://doi.org/10.1128/jcm.00986-25
    2. Xie O, et al. Lancet Microbe 2025. DOI: 10.1016/j.lanmic.2025.101182
    3. Turner NA, et al. JAMA 2025. DOI: 10.1001/jama.2025.12543
    4. Paterson DL, et al. Lancet Infectious Diseases 2025. DOI: 10.1016/S1473-3099(25)00469-4
    5. Lopopolo M et al., Science 2025. DOI: 10.1126/science.adu7144
    6. Langford BJ, et al. Antimicrobial Stewardship & Healthcare Epidemiology 2025. DOI: 10.1017/ash.2025.10210

    Further reading

  25. Communicable E43: Katie's picks

    47 minSeason 2 · Episode 43

    In this final episode of 2025, hosts Annie Joseph (Nottingham, UK) and Angela Huttner (Geneva, Switzerland), interview Communicable's producer, Katie Hostettler-Oi (Zurich, Switzerland), to learn which episodes …

    Show notes

    In this final episode of 2025, hosts Annie Joseph (Nottingham, UK) and Angela Huttner (Geneva, Switzerland), interview Communicable's producer, Katie Hostettler-Oi (Zurich, Switzerland), to learn which episodes she liked best this year. Their discussion provides a behind-the-scenes look at some of the episodes--including the strange surprises that sometimes came with them. Finally, the CMI Comms editors and editorial fellows send in their perspectives on 2025 and their wishes for 2026.

  26. Communicable E42: Should doctors stay at X (Twitter) or leave it?

    1 h 5 minSeason 2 · Episode 42

    During the COVID-19 pandemic with lockdown mandates and social distancing, doctors, researchers, and the public were able to find refuge and community online; for the infectious disease community, it was on the …

    Show notes

    During the COVID-19 pandemic with lockdown mandates and social distancing, doctors, researchers, and the public were able to find refuge and community online; for the infectious disease community, it was on the social media platform Twitter, and more specifically under the widely used hashtag, #IDTwitter. Under new ownership from 2022, however, Twitter’s name and brand changed to what we now know as X, and “the heyday of #IDTwitter is long since gone”. In this special episode of Communicable, Angela Huttner and Marc Bonten invite doctors and science communicators, Neil Stone (London, UK), Ilan Schwartz (Durham, USA), and Tara Smith (Kent, USA) to debate whether we should stay on X or leave it for alternatives.

    This episode is a follow-up from Stone and Schwartz’s commentary [1] and Smith’s response letter [2] addressing the same topic published in CMI Communications. The views expressed by the panelists are their own and do not represent the positions of their affiliated institutions or ESCMID. This episode was not peer reviewed.

    Resources

    You can follow all participants of this episode on Bluesky: @drneilstone.bsky.social, @germhuntermd.bsky.social, @aetiology.bsky.social, @marcbonten.bsky.social, @angelahuttner.bsky.social, and Stone on X: @DrNeilStone.


    References

    1. Stone NRH and Schwartz IS. Joining the X-odus: Contrasting perspectives on whether infection specialists should leave X (formerly Twitter). CMI Comms 2025. DOI: 10.1016/j.cmicom.2025.105140
    2. Smith TC. Twitter remains a haven of harassment. CMI Comms 2025. DOI: 10.1016/j.cmicom.2025.105144

    Further reading

  27. Communicable E41: Diagnostic stewardship

    1 h 2 minSeason 2 · Episode 41

    In the last ten years, 'diagnostic stewardship' has emerged as a core principle of good clinical practice whose implementation impacts both the individual patient and public health at large. In this episode of …

    Show notes

    In the last ten years, 'diagnostic stewardship' has emerged as a core principle of good clinical practice whose implementation impacts both the individual patient and public health at large. In this episode of Communicable, hosts Angela Huttner and Annie Joseph invite two experts in the field, Daniel Morgan (Maryland, USA) and Valerie Vaughn (Utah, USA), to discuss diagnostic stewardship in the context of infectious diseases, hospital medicine, and healthcare in general. Other topics covered include practical interventions for better testing practices and the role of artificial intelligence in the future of diagnostics. The episode highlights how thoughtful, intentional diagnostic practices can enhance clinician workflows and improve patient outcomes.

    This episode is a follow-up from Morgan’s recently published commentary in CMI Communications on diagnostic testing, and the need for evaluating its clinical impact [1]. The episode was peer reviewed by Özlem Türkmen Recen of Çınarcık State Hospital, Yalova, Türkiye.


    References

    1. Baghdadi JD & Morgan DJ. Diagnostic tests should be assessed for clinical impact. CMI Comms 2024. DOI: 10.1016/j.cmicom.2024.105010

    Further reading

    • Advani S and Vaughn VM. Quality Improvement Interventions and Implementation Strategies for Urine Culture Stewardship in the Acute Care Setting: Advances and Challenges. Curr Infect Dis Rep 2021. DOI: 10.1007/s11908-021-00760-3
    • Core Elements of Hospital Antibiotic Stewardship Programs, https://www.cdc.gov/antibiotic-use/hcp/core-elements/hospital.html
    • Core Elements of Hospital Diagnostic Excellence (DxEx), https://www.cdc.gov/patient-safety/hcp/hospital-dx-excellence/index.html
    • Cosgrove SE & Srinivasan A. Antibiotic Stewardship: A Decade of Progress. Infect Dis Clin North Am 2023. DOI: 10.1016/j.idc.2023.06.003
    • Dik JH, et al. Integrated Stewardship Model Comprising Antimicrobial, Infection Prevention, and Diagnostic Stewardship (AID Stewardship). J Clin Microbiol 2017. DOI: 10.1128/jcm.01283-17
    • Fabre V, et al. Principles of diagnostic stewardship: A practical guide from the Society for Healthcare Epidemiology of America Diagnostic Stewardship Task Force. Infect Control Hosp Epidemiol 2023. DOI: 10.1017/ice.2023.5
    • Huttner A, et al. Re: ‘ESR and CRP: it's time to stop the zombie tests’ by Spellberg et al. CMI 2025. DOI: 10.1016/j.cmi.2024.09.016
    • Morgan DJ, et al. Diagnostic Stewardship—Leveraging the Laboratory to Improve Antimicrobial Use. JAMA 2017. DOI: 10.1001/jama.2017.8531
    • Messacar K, et al. Implementation of rapid molecular infectious disease diagnostics: the role of diagnostic and antimicrobial stewardship. J Clin Microbiol 2017. DOI: 10.1128/jcm.02264-16
    • Messacar K, et al. Clinical and Financial Impact of a Diagnostic Stewardship Program for Children with Suspected Central Nervous System Infection. J Pediatr. 2022. DOI: 10.1016/j.jpeds.2022.02.002
    • Qian ET, et al. Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection: The ACORN Randomized Clinical Trial. JAMA 2023. DOI: 10.1001/jama.2023.20583
    • Siontis KC et al. Diagnostic tests often fail to lead to changes in patient outcomes. J Clin Epidemiol 2014. DOI: 10.1016/j.jclinepi.2013.12.008
    • Vaughn VM, et al. Antibiotic Stewardship Strategies and Their Association With Antibiotic Overuse After Hospital Discharge. Clin Infect Dis 2022. DOI: 10.1093/cid/ciac104
    • Vaughn VM, et al. A Statewide Quality Initiative to Reduce Unnecessary Antibiotic Treatment of Asymptomatic Bacteriuria. JAMA Intern Med 2023. DOI: 10.1001/jamainternmed.2023.2749

  28. Communicable E40: AMR in conflict and crisis zones

    57 minSeason 2 · Episode 40

    It’s World AMR Awareness Week (WAAW) and we have prepared a special episode in light of that. In this week's Communicable, Navaneeth Narayanan and Thomas Tängdén host Aula Abbara (London, UK), Guido Granata …

    Show notes

    It’s World AMR Awareness Week (WAAW) and we have prepared a special episode in light of that. In this week's Communicable, Navaneeth Narayanan and Thomas Tängdén host Aula Abbara (London, UK), Guido Granata (Rome, Italy) and Tuomas Aro (Helsinki, Finland) to discuss the phenomenon of AMR in conflict and crisis zones. They elaborate on how difficult conditions and austere environments amplify the spread of AMR, drawing on findings from the ongoing conflicts in Ukraine, Gaza, Syria and other regions. Other topics covered include adapting antimicrobial stewardship and infection prevention and control (IPC) practices as well as the need for genuine political will and international collaboration to end conflicts and their exacerbation on AMR.

    This episode follows the webinar “Beyond the frontlines” organised by ESCMID’s AMR Action Subcommittee for WAAW 2025, featuring the same guests, and is available on ESCMID Media. This Communicable episode was peer reviewed by Arjana Zerja of Mother Theresa University Hospital Centre, Tirana, Albania.

    Related ESCMID and Communicable media

    Resources

    Further Reading

    • Abbara A, et al. Unravelling the linkages between conflict and antimicrobial resistance. NPJ Antimicrob Resist. 2025. DOI: 10.1038/s44259-025-00099-y
    • Abbara A, et al. A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict. Int J Infect Dis. 2018. DOI: 10.1016/j.ijid.2018.06.010
    • Abu-Shomar R, et al. Multidrug-resistant Pseudomonas isolated from water at primary health care centers in Gaza, Palestine: a cross-sectional study. IJID Reg. 2025. DOI: 10.1016/j.ijregi.2025.100671
    • Aldbis A, et al. The lived experience of patients with conflict associated injuries whose wounds are affected by antimicrobial resistant organisms: a qualitative study from northwest Syria. Confl Health. 2023. DOI: 10.1186/s13031-023-00501-4
    • Aro T, et al. War on antimicrobial resistance: high carriage rates of multidrug-resistant bacteria among war-injured Ukrainian refugees. Clin Microbiol Infect. 2025. DOI: 10.1016/j.cmi.2025.07.010
    • Bazzi W, et al. Heavy Metal Toxicity in Armed Conflicts Potentiates AMR in A. baumannii by Selecting for Antibiotic and Heavy Metal Co-resistance Mechanisms. Front Microbiol. 2020. DOI: 10.3389/fmicb.2020.00068
    • Dewachi O. War Biology and Antimicrobial Resistance: The Case of Gaza, AMR Insights, 2024.
    • Granata G, et al. The impact of armed conflict on the development and global spread of antibiotic resistance: a systematic review. Clin Microbiol Infect. 2024. DOI: 10.1016/j.cmi.2024.03.029
    • Huang XZ, et al. Molecular analysis of imipenem-resistant Acinetobacter baumannii isolated from US service members wounded in Iraq, 2003-2008. Epidemiol Infect. 2012. DOI: 10.1017/S0950268811002871
    • Hujer KM, et al. Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. Antimicrob Agents Chemother. 2006. DOI: 10.1128/AAC.00778-06
    • Karah N, et al. Teleclinical Microbiology: An Innovative Approach to Providing Web-Enabled Diagnostic Laboratory Services in Syria. Am J Clin Pathol. 2022. DOI: 10.1093/ajcp/aqab160
    • Keen EF 3rd, et al. Evaluation of potential environmental contamination sources for the presence of multidrug-resistant bacteria linked to wound infections in combat casualties. Infect Control Hosp Epidemiol. 2012. DOI: 10.1086/667382
    • Murray CK, et al. Recovery of multidrug-resistant bacteria from combat personnel evacuated from Iraq and Afghanistan at a single military treatment facility. Mil Med. 2009. DOI: 10.7205/milmed-d-03-8008
    • Petersen K, et al. Diversity and clinical impact of Acinetobacter baumannii colonization and infection at a military medical center. J Clin Microbiol. 2011. DOI: 10.1128/JCM.00766-10
    • Scott P, et al. An outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus complex infection in the US military health care system associated with military operations in Iraq. Clin Infect Dis. 2007. DOI: 10.1086/518170
    • Sensenig RA, et al. Longitudinal characterization of Acinetobacter baumannii-calcoaceticus complex, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus colonizing and infecting combat casualties. Am J Infect Control. 2012. DOI: 10.1016/j.ajic.2011.03.025
    • World Health Organization. Fourth WHO Global Evidence Review on Health and Migration stresses that equitable access to and appropriate use of antibiotics for refugees and migrants is essential to tackling Antimicrobial Resistance, News, 2022.

  29. Communicable E39: Dengue on the rise

    57 minSeason 2 · Episode 39

    Once confined to the tropics, dengue is spreading via its vector, the Aedes mosquito, to more temperate regions, causing increases in global morbidity, mortality and cost. In 2019, the WHO recognised dengue as …

    Show notes

    Once confined to the tropics, dengue is spreading via its vector, the Aedes mosquito, to more temperate regions, causing increases in global morbidity, mortality and cost. In 2019, the WHO recognised dengue as one of the top ten global health threats alongside climate change and antimicrobial resistance [1]. In this episode of Communicable, Annie Joseph and Nav Narayanan welcome two dengue experts, André Siqueira of the non-profit Drugs for Neglected Diseases Initiative based in Geneva, Switzerland (Rio de Janeiro, Brazil), and Steven Lim of the Raja Permaisuri Bainun Hospital (Ipoh, Malaysia). Together, they discuss the epidemiology, clinical presentation and management of dengue including comparisons to other arboviral infections like zika and chikungunya, and the heightened risk of disease for vulnerable populations such as pregnant women and those with comorbidities. The conversation also highlights innovative vector-control strategies and candidate therapeutics currently under investigation.

    This episode was edited by Kathryn Hostettler and peer reviewed by Loora Grünvald of the University of Tartu, Estonia.

    Resources:

    References:

    1. World Health Organization, Ten threats to global health in 2019.

    Further reading:

  30. Communicable E38: Why do you have to be so complicated? The 2025 IDSA Complicated UTI Guidelines

    48 minSeason 2 · Episode 38

    In this episode of Communicable, Erin McCreary and Angela Huttner are joined by Barbara Trautner (St. Louis, USA) and Valéry Lavergne (Vancouver, Canada), the co-chairs and leading authors of the first IDSA …

    Show notes

    In this episode of Communicable, Erin McCreary and Angela Huttner are joined by Barbara Trautner (St. Louis, USA) and Valéry Lavergne (Vancouver, Canada), the co-chairs and leading authors of the first IDSA guideline on complicated urinary tract infection (cUTI), which was published a few months ago [1]. Together, they discuss the process of developing the guideline from its conception in 2018, the new definition of cUTI, their stepwise approach to clinical decision-making, and some case-by-case scenarios for common antibiotics. They also elaborate on how this guideline compares (and contrasts) to other existing UTI guidelines—including the previous IDSA guideline for UTI [2] —and the clinical need to supply frontline clinicians to identify and distinguish complicated cases from the uncomplicated ones. The episode closes with what essential clinical questions the guests hope to tackle next.

    This episode was edited by Kathryn Hostettler and peer reviewed by Maria Ana Flores of Santa Maria Local Health Unit, Lisbon, Portugal.

    Other resources:


    References

    1. Trautner BW, et al. Clinical Practice Guideline by Infectious Diseases Society of America (IDSA): 2025 Guideline on Management and Treatment of Complicated Urinary Tract Infections
    2. Gupta, K, et al. Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: 2010 Update by IDSA

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