the INFECTIOUS DISEASES channel

🦠 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/

Latent TB pearls ✨️

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Management of Staphylococcus aureus bacteremia https://www.idsociety.org/globalassets/idsa/practice-guidelines/sab/consensus-statement-7-manuscript.pdf

https://www.idsociety.org/practice-guideline/2026-idsa-clinical-practice-guidelines-on-prevention-of-invasive-aspergillosis-in-adult-solid-organ-transplant-recipients/ new ia guidelines are out check it out 🔥👍🏻

Photo from Mohammed Alabdullah ID

Photo from Mohammed Alabdullah ID http://www.isac-abxguide.world/

✈️🌍 Planning to Travel Soon? Stay Informed, Stay Safe : 🇸🇦Saudi Arabia Travel Health Resources: 🔹 PHA (هيئة الصحة العامة): https://www.pha.gov.sa/ar-sa/Healthportal/Pages/travel-danger.aspx 🔹 MOH Travel Clinics Guide: https://www.moh.gov.sa/awarenessplateform/SeasonalAndFestivalHealth/Documents/Travel-Clinics.pdf 🌐 International Travel Advisory Sites: 🔹 CDC Travel Notices (USA): https://wwwnc.cdc.gov/travel/notices 🔹 CDC Travel Health Portal: https://wwwnc.cdc.gov/travel 🔹 Government of Canada Travel Advisories: https://travel.gc.ca/travelling/advisories 🔹 UK Foreign Travel Advice: https://www.gov.uk/foreign-travel-advice 🔹 NHS Fit for Travel (UK): https://www.fitfortravel.nhs.uk/destinations