Nico Barros
@nicobarrosid.bsky.social
960 followers 76 following 37 posts
Transplant Infectious Diseases Indiana University
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nicobarrosid.bsky.social
Histoplasma working group ISHAM. Let's do it! 90-90-90 for 2030!
ISHAM targets 90-90-90
nicobarrosid.bsky.social
Saving the best for last, Histoplasma working group
ISHAM2025 Foz do Iguaçu, Brazil
ISHAM Histoplasma working group
nicobarrosid.bsky.social
Michael Mansour presenting about "Augmenting neutrophil function as a therapeutic strategy for high risk-patients"
Next level stuff! @mansourlab.bsky.social @mgh-id.bsky.social
Michael Mansour presenting
Reposted by Nico Barros
germhuntermd.bsky.social
Are contemporary antifungal doses sufficient for critically ill patients? Outcomes from an international, multicenter PK study for Screening Antifungal Exposure in Intensive Care Units (SAFE-ICU)

J Roberts etc

TLDR: ++variable, need tailored approach w TDM

link.springer.com/article/10.1...
AUC0-24/MIC for two different durations of antifungal treatment in ICU: 1-3 days vs 4-7 days, shown for various antifungals (and for caspofungin and anidulafungin shown separately for C albicans and C glabrata)

PK/PD target-related exposures per occasion of the study antifungals prescribed for treatment. The shaded area represents the PK/PD target used in this study. For fluconazole, 15 data points are outside the y-axis limits (max AUC0-24/MIC value was 3250.3); ICU intensive care unit; AUC0-24 area under the plasma concentration-time curve from zero to 24 h; fAUC0-24 free AUC0-24; MIC minimum inhibitory concentration; Cmin minimum observed plasma concentration; Cmax maximum observed plasma concentration
nicobarrosid.bsky.social
That's great news. Looking forward to it.
nicobarrosid.bsky.social
You are absolutely right, "screening" is not the appropriate word. I agree with more testing in patients with suspected histoplasmosis. However, prior studies do show a significant prevalence (~5%) in asymptomatic advanced HIV. Certainly, this is region specific and should not be generalized.
nicobarrosid.bsky.social
Histoplasmosis screening was positive in 9.1% of PLWHIV with clinical manifestations suggestive of histoplasmosis (including fever, night sweats and weight loss) in a Brazilian center. More screening is required for early diagnosis and improved outcomes.

academic.oup.com/mmy/advance-...
Histoplasmosis screening using urinary antigen detection in people living with HIV in Southern Brazil
Abstract. Histoplasmosis is a life-threatening opportunistic infection in individuals with advanced HIV disease (AHD), particularly in endemic regions such
academic.oup.com