the INFECTIOUS DISEASES channel

The latest international AIDS meeting took place in Rio de Janeiro highlights https://voices.nejm.org/doi/full/10.1056/VOICESpost2600043?query=voices_ps&cid=DM2461488_&bid=-649123859

Ask the Expert, focusing on the diagnosis and management of pyelonephritis in kidney transplant recipients. https://www.tts.org/tid-education/tid-ask-the-expert

The curious case of thick-walled buds and a pink lung! https://www.idimages.org/m/cases/viewfeatured/?caseid=625&fbclid=IwT01FWATj7GdwZG9mBWV4dG4DYWVtAjEwAHNydGMGYXBwX2lkDDM1MDY4NTUzMTcyOAABHqv45QzJRcxA3rL6FvwR46G1-rK6NKF1hLisW4WrGjj4KvhRhm5eAmnX5YN1_aem_uAsZ91Ag6pAML-7aQvFRJQ

Infections in Hematologic Malignancies and Stem Cell Transplantation https://youtu.be/v0Vl7ui1mVQ?si=9L4jZRj9tY0_bW45

Burn Infections Dana M. Blyth; Clinton K. Murray Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 318, 3774-3781.e3

Source: Nix C, Bisht A. Infection Prevention in Oncology. In: APIC Text Online. Association for Professionals in Infection Control and Epidemiology (APIC); 2026.

🦠 IDSA 2026 AMR Gram-Negative Guidance What's New? | July 2026 🔵 ESBL-Producing Enterobacterales (ESBL-E) 🧪 New ESBL definition Ceftriaxone MIC ≥4 µg/mL 💊 New agents added ✅ Gepotidacin ✅ Pivmecillinam ✅ Oral sulopenem ✅ IV fosfomycin ✅ Cefepime-enmetazobactam (emerging role) 📌 Practice update Piperacillin-tazobactam may be considered for complicated UTI (not first choice for invasive disease). --- 🟢 AmpC-Producing Enterobacterales 🦠 New organism Hafnia alvei added as moderate-risk AmpC producer. 📌 Key updates Continue ceftriaxone if: Non-severe infection Clinical improvement Adequate source control ⚠️ Piperacillin-tazobactam appears suboptimal for invasive AmpC infections. --- 🔴 Carbapenem-Resistant Enterobacterales (CRE) ⭐ Major advance Aztreonam-avibactam introduced for NDM-producing CRE and is slightly preferred over ceftazidime-avibactam + aztreonam. 🆕 Added: IV fosfomycin Gepotidacin Pivmecillinam 🔬 Updated comparisons: Ceftazidime-avibactam vs Meropenem-vaborbactam Aztreonam-avibactam vs Cefiderocol --- 🟣 Difficult-to-Treat (DTR) Pseudomonas aeruginosa 🏆 Preferred for uncomplicated UTI Single-dose amikacin or tobramycin 🫁 Pneumonia Ceftolozane-tazobactam preferred over ceftazidime-avibactam. 💨 Nebulised antibiotics: Still not routinely recommended, but evidence is becoming more favourable. --- 🟠 Carbapenem-Resistant Acinetobacter baumannii (CRAB) 🥇 First-line therapy Sulbactam-durlobactam + carbapenem ⏳ Alternative regimens: Only as bridge therapy until sulbactam-durlobactam becomes available. If resistant: Two active non-sulbactam agents or Sulbactam-durlobactam + cefiderocol --- 🟡 Stenotrophomonas maltophilia ⭐ Preferred therapy Cefiderocol monotherapy ➕ Aztreonam-avibactam added as part of combination therapy for selected invasive infections. --- 🚨 Top 6 Take-Home Messages ✅ New FDA-approved antibiotics incorporated into guidance. ✅ Aztreonam-avibactam is now preferred for NDM-producing CRE. ✅ Sulbactam-durlobactam becomes the cornerstone of invasive CRAB treatment. ✅ Ceftolozane-tazobactam is favoured for DTR Pseudomonas pneumonia. ✅ Piperacillin-tazobactam has a limited role (acceptable for some complicated ESBL UTIs but generally not for invasive AmpC infections). ✅ Updated microbiology definitions and resistance epidemiology should guide antimicrobial stewardship and empiric therapy. > Bottom line: The 2026 IDSA guidance expands therapeutic options, emphasises newer β-lactam/β-lactamase inhibitor combinations, refines laboratory interpretation, and strengthens precision treatment based on resistance mechanisms. https://www.idsociety.org/practice-guideline/amr-guidance/

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