Simran Gupta
@simrangmd.bsky.social
430 followers 200 following 5 posts
Transplant/Oncology ID fellow at BWH/DFCI. @harvardmed. former @MayoAZ_IMRES. @UConnHealth alum. Dog mom & dancer.
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Reposted by Simran Gupta
germhuntermd.bsky.social
Antagonistic interaction between posaconazole & olorofim in a murine model of invasive pulmonary aspergillosis

Posaconazole ⬇️ the effect of olorofim in vivo. Combination of olorofim+azole likely efficacious in wt infections, may be suboptimal in azole R infections

academic.oup.com/jac/article/...
Antagonistic interaction between posaconazole and olorofim in a murine model of invasive pulmonary aspergillosis
AbstractBackground. Olorofim is a new antifungal agent with a novel mechanism of action with in vitro activity against Aspergillus fumigatus and other clin
academic.oup.com
Reposted by Simran Gupta
idiots-pod.bsky.social
Ah yes, the famously medium-spectrum doxycycline.

It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori

1/2
simrangmd.bsky.social
TLDR; We propose an optimized ASE 2.0 definition:
- allow POA infection diagnosis codes to anchor infection
- include pts discharged alive on QAD 3
- include hypotension w/out pressors (>/= 2 readings in 6h)
- include NIV or HFNC (>/= 2 days)
- minor changes in Plt, Cr, and Tbili thresholds
ichejournal.bsky.social
🆕 New in ICHE: How should the CDC’s Adult Sepsis Event (ASE) definition evolve?

This study modeled potential modifications and found tradeoffs between incidence, mortality, and clinical validity offering insight into how changes could shape surveillance

#IDSky

📄: doi.org/10.1017/ice....
Reposted by Simran Gupta
gpollara.bsky.social
Good perspective from @simrangmd.bsky.social et al re use of PCT in ICU.

Particularly pertinent that as data and practice keep pointing towards shorter antibiotic course therapy, the window for diagnostic stewardship will narrow, limiting PCT benefit.
#IDSky #ClinMicro #AMR
Reposted by Simran Gupta
paulsaxmd.bsky.social
This is by far the most common vaccine I strongly recommend in ID adult clinical practice. As ID doctors, we see some truly severe cases of zoster, with post-zoster sequelae that may last months or even rarely be permanent. #IDSky doi.org/10.1093/cid/...
Reposted by Simran Gupta
id-journal.bsky.social
Procalcitonin-guided care cut antibiotic use by 1 day in sepsis patients but had no mortality impact. CRP showed no benefit. Adherence was low; future focus on early biomarker use is needed. 📉💊##idsky
Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial
AbstractRandomized trials of procalcitonin-guided algorithms to discontinue antibiotics in critically ill patients with sepsis report reduced antibiotic duration and possible mortality benefit. However, open-label trial designs, inconsistent algorithm adherence, and unclear stewardship practices have limited confidence in procalcitonin’s benefit. The ADAPT-Sepsis trial addressed several of these gaps through a concealed intervention, robust stewardship, and head-to-head comparison with CRP. Procalcitonin-guided care reduced antibiotic use without significantly impacting mortality, while CRP-guided care showed no benefit. However, algorithm adherence was suboptimal and the absolute reduction in antibiotic duration with procalcitonin was only one day. As shorter fixed-duration therapy becomes standard, procalcitonin’s utility in the ICU may decline. Embedding procalcitonin and other biomarkers into multifaceted stewardship strategies, and addressing barriers to clinician trust and implementation, is essential. Future research should also evaluate whether biomarker use earlier in the sepsis care pathway, particularly in Emergency Departments, can improve early diagnostic accuracy and enhance patient outcomes.
academic.oup.com
Reposted by Simran Gupta
jama.com
JAMA @jama.com · Jun 22
Herpes zoster vaccination eligibility reduced the probability of new dementia diagnoses, suggesting its potential preventive effect.

https://ja.ma/4lagSB6
Herpes Zoster Vaccination and Dementia Occurrence
Reposted by Simran Gupta
mgb-id-fellows.bsky.social
🍾Last evening, the MGH & BWH ID faculty celebrated graduates of the MGB ID & MGH Transplant ID Fellowships, along with their families. It was a heartwarming celebration of stories, accolades, laughter, and tears. Special thanks go to our featured speakers Dr. Eric Rubin & Dr. Gabriel Motoa Cardona.🤩
Reposted by Simran Gupta
courtharrismd.bsky.social
‼️Our new paper on social media in #TxID is officially out in @thetxidjournal.bsky.social

We summarize findings from our #TxIDChat @txidfellows.bsky.social

We discuss recs for trainees, career advancement, & future directions in this changing landscape. Check it out!

dx.doi.org/10.1111/tid....
Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients
dx.doi.org
Reposted by Simran Gupta
tbrnaughttb.bsky.social
ICE was in my hospital today…

i am so beyond angry—this is unacceptable

stay away from our patients and let us do our jobs
Reposted by Simran Gupta
drtomfrieden.bsky.social
CDC's Morbidity and Mortality Weekly Report (MMWR) has provided real-time data and analysis about disease outbreaks and emerging health threats without a break every week since 1960.

Until today.
Reposted by Simran Gupta
docdelrio.bsky.social
Trump's Gag Order Halts CDC Publication www.medpagetoday.com/infectiousdi... For the first time in its more than 60-year history, the CDC's Morbidity and Mortality Weekly Report (MMWR) did not go out as scheduled.
Trump's Gag Order Halts CDC Publication
MMWR did not publish as usual at 1 p.m. today
www.medpagetoday.com
Reposted by Simran Gupta
germhuntermd.bsky.social
Scientific advancements aside, this is economically irresponsible

Every $1 spent by NIH generates $2.46

For example, in 2023, $47B in NIH spending generated ~$93B

Halting NIH spending will LOSE the US a lot of money (and talent)
An image of NIH campus. Text says : With annual budget of more than $47 billion, NIH is the largest single public funder of biomedical and behavioural research in the world. In fiscal year 2023, NIH funding generated an estimated $92.89 billion in economic activity Every state and almost every congressional district received a share of NIH investment
Each year, NIH awards over 60,000 grants that directly support more than 300,000 researchers at more than 2,500 different institutions
In fiscal year 2023, every $1 of NIH funding generated approximately $2.46 of economic activity
Reposted by Simran Gupta
elizabethjacobs.bsky.social
For those asking how unusual it is for NIH review panels to be cancelled: I do not recall study sections ever being cancelled during my 30-year career except for during the “sequestration” period around 2012-2013 when there was, I think, a government shutdown.
simrangmd.bsky.social
Excited to share our research on duration of antifungal ppx for Cocci in SOT!

TLDR; For patients repeatedly pos for EIA-IgM-only w no seroconversion, compatible clinical illness, or rads findings, discontinuing antifungal ppx may be reasonable after 1st posttxp yr

journals.lww.com/transplantjo...
Outcomes of Coccidioides Seropositive Solid Organ... : Transplantation
by enzyme immunoassay (EIA-IgM-only), although this result may be falsely positive. Methods. We conducted a retrospective study at a large-volume transplant center in an endemic coccidioidomycosis ...
journals.lww.com
Reposted by Simran Gupta
nejm.org
NEJM.org @nejm.org · Dec 10
On this day in 1981, a landmark paper in NEJM described four patients with evidence of immunodeficiency associated with PJP pneumonia, disseminated CMV, and Kaposi sarcoma. The disease would come to be known as HIV/AIDS. Revisit the paper: nej.md/41iekKD

#MedSky #IDSky
Published on This Day in 1981.  
Pneumocystis carinii Pneumonia and Mucosal Candidiasis in Previously Healthy Homosexual Men — Evidence of a New Acquired Cellular Immunodeficiency  

An illustration showing the reproductive cycle of human immunodeficiency virus type 1 (HIV-1) and sites of action of the major classes of antiretroviral medications.  

The NEJM identity sits at the bottom.
Reposted by Simran Gupta
mgb-id-fellows.bsky.social
🤩 WE ARE SUPER EXCITED to announce our 2025-2027 class of ID Fellows! 🥂

We are thrilled to have matched with such a talented group!
Reposted by Simran Gupta
drtimothyli.bsky.social
7-year performance of a clinical mNGS test for diagnosis of CNS infections

Sensitivity 63.1%
Specificity 99.6%
Accuracy 92.9%

4 potential use cases:
➡️unculturable, difficult-to-diagnose organisms
➡️broadly dx viral infections
➡️rare, unexpected infections
➡️outbreaks

doi.org/10.1038/s415...

#IDSky