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Reposted by Andrew Skinner

id-journal.bsky.social @id-journal.bsky.social · Mar 22

📉 C. difficile tests/1,000 PD dropped from 20.53 to 6.92; HO-CDI cases/10,000 PD fell from 9.80 to 0.20. Interventions led to 28%-95% reductions in testing rates.##idsky

Three stages of laboratory stewardship in improving appropriate Clostridioides difficile testing in a community-based setting

View abstract Objective:Assess the efficacy of staged interventions aimed to reduce inappropriate Clostridioides difficile testing and hospital-onset C. difficile infection (HO-CDI) rates.Design:Interrupted time series.Setting:Community-based.Methods/Interventions:National Healthcare Safety Network (NHSN) C. difficile metrics from January 2019 to November 2022 were analyzed after three interventions at a community-based healthcare system. Interventions included: (1) an electronic medical record (EMR) based hard stop requiring confirming ≥3 loose or liquid stools over 24 h, (2) an infectious diseases (ID) review and approval of testing >3 days of hospital admission, and (3) an infection control practitioner (ICP) reviews combined with switching to a reverse two-tiered clinical testing algorithm.Results:After all interventions, the number of C. difficile tests per 1,000 patient-days (PD) and HO-CDI cases per 10,000 PD decreased from 20.53 to 6.92 and 9.80 to 0.20, respectively. The EMR hard stop resulted in a (28%) reduction in the CDI testing rate (adjusted incidence rate ratio ((aIRR): 0.72; 95% confidence interval [CI], 0.53 to 0.96)) and ID review resulted in a (42%) reduction in the CDI testing rate (aIRR: 0.58; 95% CI, 0.42–0.79). Changing to the reverse testing algorithm reduced reported HO-CDI rate by (95%) (cIRR: 0.05; 95% CI; 0.01–0.40).Conclusions:Staged interventions aimed at improving diagnostic stewardship were effective in overall reducing CDI testing in a community healthcare system.

www.cambridge.org

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Reposted by Andrew Skinner

Ilan Schwartz @germhuntermd.bsky.social · Nov 23

It’s cool that folks can reinvent themselves during the #IDSky migration

Some have been surprised to find plum handles unclaimed eg @iddoc.bsky.social

But the best transformation
🐛➡️🦋 is @MaggieMonogue to @tazoswift.bsky.social

a woman wearing a black tuxedo and red lipstick applauds

Alt: Taylor Swift doing a chef’s kiss sign

media.tenor.com

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Andrew Skinner @askinnermd.bsky.social · Nov 20

Let me introduce you to my brand of ADHD…

Andrew Skinner @askinnermd.bsky.social · Nov 20

Lets get to the important things - when writing, do you listen to music, podcasts, or nothing? #IDSky #MedSky #cdiff #microsky

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Reposted by Andrew Skinner

Ilan Schwartz @germhuntermd.bsky.social · Nov 20

And just like that, we have our first #idjclub article #idsky

Sébastien Poulin @sebpoule.bsky.social · Nov 20

🚨 Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections

BALANCE trial publication is here !

#IDsky #Medsky

@idjclub.bsky.social

www.nejm.org/doi/full/10....

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM

Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. In a multicenter, non...

www.nejm.org

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Andrew Skinner @askinnermd.bsky.social · Nov 16

I’ll join in the fun

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Andrew Skinner @askinnermd.bsky.social · Nov 14

Ah, so we are just going to the journal model of grants

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Andrew Skinner @askinnermd.bsky.social · Nov 14

An honest question for my fellow US researchers. Funding has been drying up for years, but how much worse do we think it will be in the next 2-3 years? Asking for a friend… #IDSky #MedSky

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Reposted by Andrew Skinner

Aneesh K Mehta, MD, FIDSA, FAST @aneeshkmehta.bsky.social · Nov 14

Hello BlueSky and #IDSky community! I am making the jump here and excited to see how we can build better here. I am Professor of Medicine in Infectious Diseases at Emory Univ, a Transplant ID clinician, a viral immunology and antiviral researcher, and a dad of two girls. Cheers!

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Andrew Skinner @askinnermd.bsky.social · Nov 12

Oh I wasn’t refuting your point. Just like providing context for people on ggplot.

Also I have spent more time reformatting ggplot figures in illustrator than I care to admit…

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Andrew Skinner @askinnermd.bsky.social · Nov 12

I you want something fun on this: www.christophenicault.com/post/underst...

But also, people just like to complain that is why

Understanding text size and resolution in ggplot2 | Christophe Nicault

What’s complicated about size and resolution ? Have you ever tried to reproduce a plot like the first one and make minor changes on the size or resolution and end up with something like the second plo...

www.christophenicault.com

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Andrew Skinner @askinnermd.bsky.social · Nov 11

One of the big things for hospital follow up is early recognition of symptoms. Anecdotally, people ended up being re-hospitalized because diarrhea has gone on for days in a patient population that cannot tolerate large volume shifts. More study is needed to figure out when the follow up is needed

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Andrew Skinner @askinnermd.bsky.social · Nov 10

While we are all in a good(ish) mood about the move, check out Emily Drwiega’s work from last month. Need to get her on here so I can tag her… #IDSky

www.cambridge.org/core/journal...

Risk of rehospitalization due to Clostridioides difficile infection among hospitalized patients with Clostridioides difficile: a cohort study | Infection Control & Hospital Epidemiology | Cambridg...

Risk of rehospitalization due to Clostridioides difficile infection among hospitalized patients with Clostridioides difficile: a cohort study

www.cambridge.org

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Reposted by Andrew Skinner

Sébastien Poulin @sebpoule.bsky.social · Nov 10

As we try to ↗️ I.D. community activity on #IDsky, please don’t forget to add details in your profile/bio.

Nothing is less « attractive » than a blank profil/bio. And personally, I don’t follow blindly

a woman wearing blindfolds and a red jacket is walking through a forest .

ALT: a woman wearing blindfolds and a red jacket is walking through a forest .

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Andrew Skinner @askinnermd.bsky.social · Nov 10

Nothing to extreme. Just remember they are not trying to purposely trick you and bad questions will likely get thrown out

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Andrew Skinner @askinnermd.bsky.social · Nov 10

Hello #IDSky and #MedSky. Seems like I may stick around this time. For an introduction to those following. I am an ID physician with an unhealthy obsession with C. difficile.

I’m always game to talk about the clinical, epidemiological, and wet lab aspects of C diff. I talk about HIV after a drink.

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Andrew Skinner @askinnermd.bsky.social · Nov 10

I think the more interesting question is would a company move forward with clindamycin if it came to market today? If not, why are we still using it

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Reposted by Andrew Skinner

Ilan Schwartz @germhuntermd.bsky.social · Nov 8

Good news:

Our community is growing!

The IDSky Starter Pack has exceeded the max 150 accounts, so I’ve started on another (pls share here and the other place, and LMK if I missed you)

IDSky starter pack 1 go.bsky.app/LnAQjdq

IDSky starter pack 2 go.bsky.app/JNfSvQT

a man in a white shirt is standing in a corn field at sunset .

Alt: Kevin Costner from field of dreams is standing in a corn field at sunset . Text says “if you build it, they will come”

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Andrew Skinner @askinnermd.bsky.social · Nov 10

#IDSky
#MedSky

a man with a beard and a hat is saying `` i have no memory of this place . ''

ALT: a man with a beard and a hat is saying `` i have no memory of this place . ''

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