Joseph Marcus
josephmarcusid.medsky.social
Joseph Marcus
@josephmarcusid.medsky.social
Infectious Diseases MD, parent, lifelong learner, opinions are my own

Interests: Getting trainees excited about ID/Research, ECMO infections, STIs, and Transfusion-Transmitted Infections

https://scholar.usuhs.edu/en/persons/joseph-marcus
The Biofire which is most effective at identifying bacteria in pleural fluid?

The joint infection panel which normally runs synovial fluid. 🤯

#IDSky

academic.oup.com/cid/advance-...
Microbial Detection in Community Acquired Pleural Space Infection Using the BioFire Joint Infection Panel and Individual PCR Assays
PCR-based diagnostics, combining the BIOFIRE FILMARRAY Joint Infection Panel with targeted assays for Fusobacterium nucleatum group, Streptococcus intermed
academic.oup.com
February 3, 2026 at 2:54 AM
I highly recommend @patrickching.bsky.social latest commentary in @ashejournal.bsky.social describing:

-the history of contact precautions
-the need for balance ⚖️ between the benefits of gowns/gloves with their cost/environmental impact

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

#IDSky
The rise and fall of contact precautions: how does personal protective equipment fit into sustainable healthcare? | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core
The rise and fall of contact precautions: how does personal protective equipment fit into sustainable healthcare? - Volume 5 Issue 1
www.cambridge.org
February 1, 2026 at 10:14 PM
A wonderful matching #IDSky meet-up with @jonathanrydermd.bsky.social in San Antonio!
January 31, 2026 at 1:56 AM
Male USAF trainees are rarely tested for STIs, what happens to the 0.03% of males who test positive during basic training?

❌Only 56% had follow-up testing within 1 year (compared to 78% of women)

❌16% with STI in 3 years (24% of women)

✅0 cases of HIV

www.health.mil/News/Article...

#IDSky
www.health.mil
January 27, 2026 at 2:38 AM
In Active Duty Service members women are tested much more frequently for GC/CT than men, but sexual networks are unknown.

In this paper led by a USUHS Med student, we anonymized contact tracing forms for those with CT with several important findings:

www.health.mil/News/Article...

#IDSky
www.health.mil
January 26, 2026 at 12:09 PM
Applying AMBITION
(single dose Ampho +14 days of 1200 fluconazole + 100mg/kg flucytosine) cryptococcal meningitis treatment at LA county 🏥:

-Higher completion w/o adverse effect (76% vs 35% in conventional dosing)

-Significantly less pts leaving AMA

#IDSky

jamanetwork.com/journals/jam...
Liposomal Amphotericin Plus Fluconazole and Flucytosine for Cryptococcal Meningitis
This cohort study explores survival and recurrence outcomes of the AMBITION protocol (single-dose liposomal amphotericin with 2 weeks of fluconazole and flucytosine) vs standard protocol for cryptococ...
jamanetwork.com
January 25, 2026 at 2:02 AM
Reposted by Joseph Marcus
Bozzi et al. identified a 5500-year-old Treponema genome during sequencing of human remains from Colombia without skeletal signs of treponematosis, genome falls outside of known T. pallidum lineages today…

www.science.org/doi/10.1126/... #IDSky
A 5500-year-old Treponema pallidum genome from Sabana de Bogotá, Colombia
Treponematosis, a bacterial infection caused by Treponema pallidum subspecies and T. carateum (yaws, bejel, syphilis, pinta), has afflicted humans for millennia. Despite paleopathological evidence and...
www.science.org
January 23, 2026 at 3:39 PM
The controversial CAP guidelines with two perspectives in CID:

IDSA Team on why they pulled out of guidelines: academic.oup.com/cid/advance-...

ATS Team response: academic.oup.com/cid/advance-...

This is certainly a peek behind the curtain of how guidelines get made

#IDSky
Methodology Misrepresented: Correcting the Record on the ATS Community-acquired Pneumonia Guideline Process
Kevin C Wilson, MD, Eyal Oren, PhD, MSc; Methodology Misrepresented: Correcting the Record on the ATS Community-acquired Pneumonia Guideline Process, Clini
academic.oup.com
January 24, 2026 at 2:43 AM
There is minimal data on PK/PD of ART on ECMO.

This 🇳🇱 case study denonstrated “9.6-fold lower dolutegravir, 1.5-fold lower tenofovir and 1.7-fold higher lamivudine exposure as compared to reference populations.”

#IDSky

bpspubs.onlinelibrary.wiley.com/doi/abs/10.1...
BPS Publications
While providing potentially life-saving cardiorespiratory support for critically ill patients, extracorporeal membrane oxygenation (ECMO) may detrimentally affect pharmacokinetic (PK) performance and...
bpspubs.onlinelibrary.wiley.com
January 23, 2026 at 2:59 AM
New @cidjournal.bsky.social article on febrile neutropenia from @uwidfellowship.bsky.social:

“Of 503 patients with ≥1 blood culture collected after FN day 3, 19 (4%) had a new BSI after FN day 3”

Authors suggest low utility of repeat BCx after day 3

#IDSky

academic.oup.com/cid/advance-...
Diagnostic Yield of Repeat Blood Cultures and Risk Factors for Bloodstream Infection in Persistent Febrile Neutropenia
New bloodstream infections after day 3 of febrile neutropenia (FN) were uncommon in patients with cancer and hematopoietic cell transplant (HCT) recipients
academic.oup.com
January 21, 2026 at 2:38 AM
Reposted by Joseph Marcus
SAVECMO study, consensus of international experts on key aspects of cannula-site infections complicating peripheral #ECMO
#FOAMcc #FOAMecmo
🔗 rdcu.be/eZd0g
SAVECMO study, consensus on key aspects of cannula-site infections in peripheral #ECMO:
🔍 Delphi study involving 39 international #ECLS experts
definition
🩺 suspicion & methodology for diagnosis
🧫 bacteriology
💉 treatment & treatment failure
⚠️ preventive measures
#FOAMcc #FOAMecmo
🔗 rdcu.be/eZd0g
January 15, 2026 at 4:00 PM
A controversial topic in ECMO is cannula site infections. This📝 has 39 ECMO experts (2 of which are ID) define CSI:

Requires symptoms (➕ skin swabs culture🙅‍♂️🟰 infection)
✅ send cultures if signs of infection
❌ antimicrobial ppx or digestive decontamination

#IDSky

link.springer.com/article/10.1...
January 9, 2026 at 3:13 AM
Amazing EID paper describing potential mammal exposure in 🇺🇸 organ donors based on data from 7️⃣ OPOs:

4,555 referred
244 (5.4%) w/ bite/scratch
4 (0.09%) wild mammals (2 🐀, 1 🦝, 1 porcupine)

Extrapolating 🇺🇸 donors:
~ 881 bite/scratch
~12 wild exposure

#IDSky

wwwnc.cdc.gov/eid/article/...

#IDSky
Wild and Domestic Animal Exposure among Deceased Persons Referred for Organ Procurement, United States
Wild and Domestic Animal Exposure among Deceased Persons Referred for Organ Procurement
wwwnc.cdc.gov
January 7, 2026 at 3:53 AM
New article out today describing the use of ECMO for tropical infections with authors from 🇨🇴 🇸🇬🇿🇦🇺🇸

Sadly limited descriptions of tropical infections, but in this review we summarize the literature.

link.springer.com/article/10.1...

#IDSky
Extracorporeal membrane oxygenation support for tropical infections: a scoping review - Journal of Intensive Care
Background Extracorporeal membrane oxygenation (ECMO) for infectious causes of refractory cardiopulmonary failure is established as appropriate therapy in high-income countries. Its use in low- and mi...
link.springer.com
January 3, 2026 at 4:29 PM
Reposted by Joseph Marcus
Early-career ID researchers: OFID is piloting a new, mentored peer review pathway to support developing authors. Get structured feedback from editors and reviewers and strengthen your submission.

Learn more and secure your spot today: https://bit.ly/48YuVoP
January 2, 2026 at 11:52 PM
Good news to end 2025 in MMWR

Human Guinea worm cases by year:
1983 - 3.5 million
2024 - 15 cases
Jan-Jun 2025- 1 case

Many non-medical challenges until complete eradication

#IDSky

www.cdc.gov/mmwr/volumes...

#IDSky
Progress Toward Eradication of Dracunculiasis...
This report describes progress in the eradication of Guinea worm disease during 2024 and from January-June 2025.
www.cdc.gov
December 31, 2025 at 4:01 PM
Reposted by Joseph Marcus
Antimicrobial in critically Ill adult patients receiving #ECMO: challenges, evidence, and future directions
💉 PK/PD concepts & considerations
🧫 antibacterials
🍄 antifungals
🦠 antivirals
🩺 management recommendations: dose optimization, challenges/recommendations, ABT stewardship
🔓 bit.ly/45vjrbt
December 28, 2025 at 6:32 PM
Working with 🩸 donors, it is good to have guidance on asymptomatic pts with ➕babesia screens.

Blood banks use PCR which can be positive for months to years after infection.

Guidance is to 🚫not treat unless positive smear

doi.org/10.1093/cid/...
Guidance on the management of asymptomatic blood donors who test positive for Babesia
AbstractDescription. Babesiosis is a tick-borne disease that is endemic in the United States (US). The major species, Babesia microti, is readily transmiss
doi.org
December 27, 2025 at 2:46 PM
2025 was an exciting year in the world of ECMO infections research

Some highlights below:

A 🧵

#IDSky
2024 was an exciting year in the world of ECMO infections research

Some highlights below:

A 🧵

#IDSky
December 26, 2025 at 3:25 AM
Reposted by Joseph Marcus
🧵 Essential ID Papers for 2025: A Clinician’s Guide

Each year brings a flood of amazing ID literature.

Here are candidates for some of the most important ID papers of 2025, spanning guidelines, trials, antimicrobials, and vaccines.
👇
December 22, 2025 at 3:22 PM
A phase 2 open label RCT of weekly Islatravir + Lenacapravir in patients living with HIV combared B/F/TAF:

-Similar rate of viral suppression (VL<50)
-Similar effect on CD4 count

Likely one step closer to a weekly oral HIV med.

#IDSky

www.acpjournals.org/doi/10.7326/...
Once-Weekly Oral Islatravir Plus Lenacapavir Versus Daily Oral Bictegravir, Emtricitabine, and Tenofovir Alafenamide in Persons With HIV-1: A Phase 2 Randomized Study: Annals of Internal Medicine: Vol...
Background: Once-weekly oral islatravir plus lenacapavir (ISL+LEN) has the potential to address adherence challenges with daily HIV-1 treatment. Objective: To evaluate efficacy and safety of once-week...
www.acpjournals.org
December 22, 2025 at 11:50 PM
WHO-certified Tropical Diseases Eliminated in 2025

African Trypanosomiasis: 🇬🇳 🇰🇪
Malaria: 🇬🇪 🇸🇷 🇹🇱
MTCT HBV: 🇲🇻
Onchocerciasis: 🇳🇪
Trachoma: 🇧🇮🇪🇬🇲🇷 🇵🇬

#IDSky
WHO-certified Neglected Tropical Diseases Eliminated in 2024

🇨🇻 🇪🇬-Malaria
🇧🇷 🇹🇱 - Lymphatic filariasis
🇯🇴-Leprosy
🇹🇩-African Trypanosomiasis
🇵🇰 🇮🇳 🇻🇳- Trachoma

www.npr.org/sections/goa...

#IDSky
9 countries said goodbye to a devastating disease in 2024
Nine countries eliminated a disease in 2024. Here's how Pakistan pulled it off — fulfilling a young boy's dream of eliminating blindness caused by bacterial infections.
www.npr.org
December 20, 2025 at 2:03 PM
Brazil 🇧🇷 meets elimination targets for mother-to-child transmission of HIV

#IDSky

www.who.int/news/item/18...
December 19, 2025 at 1:47 AM
🇳🇱 RCT of DFI w/ suspected osteo and w/o debridement/amputation and got bone+ulcer biopsy

Comparison: abx targeting unblinded 🦴 cx or ulcer cx

Outcome: Remission at 12 months

Outcome: No difference RR 1.13; (95% CI 0.80-1.60).

Why? Both cxs concordant 85% of time

#IDSky

doi.org/10.1093/cid/...
“Bone biopsy not superior to ulcer bed biopsy guided antibacterial therapy on remission of diabetic foot osteomyelitis: A randomized controlled trial”
AbstractBackground. Percutaneous bone biopsy is the reference standard for guiding antibiotic therapy in diabetic foot osteomyelitis (DFO). However, ulcer
doi.org
December 17, 2025 at 2:51 AM