Mohanad Al-Obaidi

@mycosis.bsky.social

Medical mycology and transplant ID

📈Candidemia cases ↑ (P=.02) 2015-24; 30-day mortality rose from 24.7% to 31.8% (P=.02). C. auris cases ↑ (P=.008), linked to Black race, renal failure, high social vulnerability.

Changes in Epidemiology of Candidemia in the United States With a Focus on Candida auris

Candidemia is a common complication in hospitalized and critically ill patients. Nationwide US data on candidemia risk factors, species, antifungal resistance, and outcomes remain limited. Our objective was to describe candidemia trends from 2015 to 2024 and identify risk factors for Candida auris candidemia.MethodsRetrospective study using the Epic Cosmos database. We analyzed trends in candidemia risk factors and outcomes. Thirty-day mortality was evaluated using multivariable logistic regression adjusted for age, Elixhauser comorbidity index, COVID-19–related hospitalization, ICU-acquired candidemia, and calendar year. We compared characteristics of patients with C. auris vs. non-C. auris candidemia.ResultsA total of 29 454 candidemia cases were identified among 27 926 unique patients; candidemia incidence increased over time (P = .02). Overall 30-day mortality was 31.5% and increased significantly over the study period (from 24.7% to 31.8%; P = .02). There were similar trends in in-hospital mortality (P = .01) and intensive care unit–acquired candidemia (P = .03). The proportion of cases involving C. albicans decreased (P = .05) while C. auris cases increased (P = .008). Patients with C. auris candidemia were more likely to be Black, have renal failure, and have a higher social vulnerability index (P < .001 for all comparisons). Fluconazole resistance increased in C. parapsilosis (from 2.5% to 10.8%, P = .02) and C. tropicalis (from 6.2% to 18.1%, P = .03).ConclusionsCandidemia-associated 30-day mortality increased over the past decade, aligning with a trend toward older, more acutely ill patients developing candidemia. Candida auris candidemia was associated with Black race, higher social vulnerability, and renal failure. Overall, our findings highlight concerning nationwide US candidemia trends.

academic.oup.com

Four days ago, a scientist was surprised by the news that Anthropic discovered new virus genes for making DNA. He says he’s been studying them for years—and feeding his data to Anthropic’s AI as part of his own research. Coincidence? Here’s my story. nyti.ms/3VSWayc

Did Anthropic’s A.I. Really Make a Scientific Discovery on Its Own? (Gift Article)

An expert at the University of Copenhagen said his team had been sharing its research with the company’s A.I. model, Claude, and that its new finding matched their work.

nyti.ms

Leishmaniases comprise clinically distinct diseases caused by the protozoan parasite leishmania, transmitted through the bite of infected sand flies. A new review summarizes current approaches and recent advances in the diagnosis and treatment of leishmaniasis. Full review: https://nej.md/4nPCWn6

The image is a section from the New England Journal of Medicine titled "Key Points" about leishmaniasis. It explains that leishmaniasis is transmitted by infected sand flies, with increasing cases in the Eastern Mediterranean region. Asymptomatic cases are common but can become severe without treatment. HIV infection is a risk factor. Laboratory diagnosis involves sample culturing or species identification using genetics. Treatment is hampered by limited drug options. A recent advance is the use of combination
therapies for the treatment of visceral leishmaniasis. Two leishmaniasis vaccines are undergoing preclinical testing or are ready for testing in humans.

Studying hundreds of patients with severe coccidioidomycosis, we found two patterns of immune dysregulation. Th2 skewing affects about 25% of DCM (mostly males!), while T-cell exhaustion (like cancer) arises early during infection in those with DCM and causes reduced responses. Both are treatable!

JCI insight@insight.jci.org · 5mo ago

Two Research articles in this issue explore immune phenotypes from individuals with coccidioidomycosis including those with severe, life-threatening disease: doi.org/10.1172/jci.... & doi.org/10.1172/jci....

Plasma Cell-Free DNA PCR has ~50% sensitivity with lower sensitivities for localized pulmonary disease compared to higher sensitivities in disseminated disease and immunosuppressed hosts, reflecting previous observation with antigenic tests. #IDSky #medmyco academic.oup.com/cid/advance-...

Accuracy of Plasma Cell-Free DNA PCR for Diagnosis of Coccidioidomycosis

Diagnosis of coccidioidomycosis can be challenging with conventional diagnostics and may require collection of an invasive specimen. This study showed that

academic.oup.com

A single mushroom can release 3 BLLION spores a day at a rate of 30,000 PER SECOND. A single giant puffball can produce 7 TRILLION spores in its lifetime. Each year, fungi collectively produce 50 million TONS of them, enough to coat every square mm of Earth with 1,000 spores. Let's talk about it.

Weird case of a liver transplant recipient in Idaho dying of Japanese encephalitis virus, which does not circulate in the US. The donor was a trauma patient who had received blood transfusions prior to death, and been exposed to seaports in southern California, but had not traveled to Asia #IDSky

Probable Japanese Encephalitis Virus Transmission through Organ Transplantation | NEJM

Infection with Japanese encephalitis virus, a mosquito-borne flavivirus, was identified in a patient who received a liver transplant from a donor who resided in California.

nejm.org

I'm craving sushi: let's talk about who *invented it*. Our story starts in the Mekong River valley: Laos, Cambodia, Thailand. Locals realize they can preserve river fish in barrels with layers of salt & rice for YEARS, a precaution against drought, famine.

A whole fish sits next to salt and rice filled barrels, I think.  It's got stylized kanji in vertical lines along the side.  There are trays of cuts of fish, or vegetables next to the barrels.

A 🕵️ was in this case investigation: While performing investigation of water system in pt w/ Legionella, infection control found an unregistered water flosser. They ran sterile water through flosser and Legionella grew + matched infection strain wwwnc.cdc.gov/eid/article/... #IDSky

Case of <em>Legionella pneumophila</em> Serogroup 1 Infection Linked to Water Flosser, France

<em>L. pneumophila</em> Infection Linked to Water Flosser

wwwnc.cdc.gov

Every machine in a Hospital that diagnoses your body without cutting you open is based on a principle of Physics, discovered by a Physicist who had no interest in Medicine. If you think the world doesn’t need Basic Science, or that somehow Science has failed you, think again.

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