Publications by authors named "Vera Luther"

The field of infectious diseases (ID) offers a rewarding career path and is widely viewed as an essential subspecialty in medicine. However, in recent years, these positive aspects have been overshadowed by concerns surrounding low fellowship match rates, undercompensation, and burnout. The Infectious Diseases Society of America Fellowship Training Program Directors Committee met in 2023, discussed the future of ID as a specialty, and sought to develop strategies to highlight the value and opportunities of ID for future generations, as well as underscore the importance of and provide tools for positive messaging to trainees about the subspecialty.

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Article Synopsis
  • The Infectious Diseases Society of America made a new training program to help doctors learn about managing infections better.
  • They asked different hospitals and training programs how they used this new curriculum.
  • Many faced challenges like not having enough teachers, but they also found helpful ways to share the information, which led to creating guides for better teaching.
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  • The Infectious Diseases Society of America Training Program Directors Committee convened in October 2022 to address challenges in fellow education due to increased clinical demand and complexity in ID services.
  • The committee focused on setting goals and strategies to enhance training program culture while ensuring quality education both in inpatient settings and outpatient clinics.
  • This document summarizes the ideas discussed during the meeting and aims to provide a reference for training program directors in infectious diseases looking for guidance on these issues.
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  • The 2023 U.S. infectious diseases fellowship match saw many programs left with unfilled positions, prompting a survey of program directors to explore the reasons behind it.
  • Program directors identified factors like geographic location, a limited number of applicants, and low pay as key contributors to these unfilled spots.
  • To improve future match outcomes, suggestions include creating specialized training tracks, boosting funding for ID training programs, advocating for better salaries, and discussing potential changes to fellowship program sizes.
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  • * In 2018, the IDSA established the IDA&E Task Force to implement these priorities, while a 2021 meeting focused on best practices for training infectious disease fellows.
  • * The document highlights specific goals and strategies related to recruitment, clinical training, and faculty development, serving as a resource for ID training program directors.
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Background: Antimicrobial stewardship (AS) is an important topic in infectious diseases (ID) training, yet many ID fellowships lack formal training, and little is known about fellows' learning preferences.

Methods: We conducted 24 in-depth interviews with ID fellows across the United States during 2018 and 2019 to explore their experiences with and preferences for AS education during fellowship. Interviews were transcribed, deidentified, and analyzed to identify themes.

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Objectives: Students and residents rotating through infectious diseases (ID) electives are instructed primarily by participation in rounds and clinics, with teaching focused on diseases encountered. This "you get what you get" approach allows learners to apply knowledge directly to patient care, however, may miss topics encountered in standardized testing. This multisite study investigates the use of asynchronous web-based learning modules and its impact on student and resident knowledge.

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Objective: Among patients with a history of ESBL infection, uncertainty remains regarding whether all of these patients require ESBL-targeted therapy when presenting with a subsequent infection. We sought to determine the risks associated with a subsequent ESBL infection to help inform empiric antibiotic decisions.

Methods: A retrospective cohort study of adult patients with positive index culture for or (EC/KP) receiving medical care during 2017 was conducted.

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Objective: To evaluate the clinical impact of the BioFire FilmArray Pneumonia Panel (PNA panel) in critically ill patients.

Design: Single-center, preintervention and postintervention retrospective cohort study.

Setting: Tertiary-care academic medical center.

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Acetone is one of the three main types of ketone bodies that can be found in ketoacidosis, along with acetoacetate, and beta-hydroxybutyrate. Any of these three ketone bodies can be found in the blood after the natural breakdown of fatty acids in diabetes, starvation, or alcoholic ketoacidosis. However, a patient can also develop acetone poisoning from ingestion of common household products such as nail polish removers, paint removers, isopropyl alcohol, or other detergents and cleaners.

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is a rarely isolated yeast that is now considered a species within the complex. Anti-fungal susceptibilities and treatments of are often assessed on a case-by-case basis. In this case, a 70-year-old male with a complex medical history presented to a large academic medical center in the United States for vascular surgery.

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Objective: To compare 2 methods of communicating polymerase chain reaction (PCR) blood-culture results: active approach utilizing on-call personnel versus passive approach utilizing notifications in the electronic health record (EHR).

Design: Retrospective observational study.

Setting: A tertiary-care academic medical center.

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Objective: To determine whether a multifaceted initiative resulted in maintained reduction in inappropriate treatment of asymptomatic pyuria (ASP) or bacteriuria (ASB) in the emergency department (ED).

Design: Single-center, retrospective study.

Methods: Beginning in December 2015, a series of interventions were implemented to decrease the inappropriate treatment of ASP or ASB in the ED.

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The expanding knowledge of the breast microbiome and its constituents necessitates understanding of how it plays into human disease. Consideration of how to identify novel organisms in breast tissue is a topic of hot debate. We report a case of a 26-year-old woman with repeat incisional break-down and sanguinopurulent drainage who required repeat incision and drainage procedures after bilateral breast reduction.

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The common practice of changing patients to daptomycin for outpatient parenteral antibiotic therapy (OPAT) can increase inpatient daptomycin use and impact inpatient pharmacy expenses. The purpose of this study was to quantify the additional inpatient antibiotic expenditures associated with changing patients from vancomycin to daptomycin for OPAT. This study examined patients who were discharged from January 1, 2018 to June 30, 2019.

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(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin is being used for off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this off-label usage are limited. The purpose of this study was to evaluate the real-world efficacy, safety, and financial impact of off-label dalbavancin use.

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Background Rapid diagnostic tools have emerged as valuable assets assisting clinicians in decision-making regarding patient management in the hospital setting. Our study sought to identify the potential impact of the BioFire® FilmArray® Pneumonia Panel (FP Panel) (BioFire Diagnostics, Salt Lake City, UT, USA) in patients with hospital-acquired pneumonia (HAP). Methods Respiratory samples obtained by bronchoalveolar lavage (BAL) or tracheal aspiration (TA) from ICU patients with a diagnosis of HAP were tested by the FP panel in addition to routine bacterial cultures.

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Background: Graduate Medical Education training programs transitioned to all-virtual recruitment in 2020. Limited data have been published regarding the consequences of this transition. We aimed to understand (1) infectious diseases (ID) fellowship programs' recruitment efforts and the effect of virtual recruitment on application and interview numbers and (2) the number of programs to which matched applicants applied and interviewed and applicants' perspectives on virtual recruitment.

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Background: Antimicrobial stewardship (AS) programs are required by Centers for Medicare and Medicaid Services and should ideally have infectious diseases (ID) physician involvement; however, only 50% of ID fellowship programs have formal AS curricula. The Infectious Diseases Society of America (IDSA) formed a workgroup to develop a core AS curriculum for ID fellows. Here we study its impact.

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To address the growing need for dedicated stewardship training in undergraduate medical education, we developed an antimicrobial stewardship curriculum for medical students with the objectives of increasing expertise in antimicrobial prescribing, introducing antimicrobial stewardship fundamentals, and enhancing comfort with engagement in interprofessional antimicrobial stewardship activities.

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Standardized letters of recommendation (SLOR) have become common features of the medical school to residency transition. Research has shown many advantages over the narrative letter of recommendation including improved letter-writing efficiency, ease of interpretation, and improved reliability as performance predictors. Currently, at least four specialties require fellowship SLORs.

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