Cody Cunningham @cunninghamresus.bsky.social · 11/02/2025We (Arizona) peaked at 131% above 5 year average a few weeks ago, thankfully we have continued to downtrend 120
Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025During aerosol transmission, virus appeared to be sourced from the upper airway (nasal turbinates) but not the trachea or lungs 100
Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025The number of unique barcodes transferred depended on route of infection with direct contact > aerosol > fomite 100
Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025During productive aerosol transmission, between 13 - 42 unique viruses were transferred. Upper and lower airways had unique signatures suggesting independent seeding by different virus particles. 100
Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025The authors generated >200 unique (barcoded) viruses that were fitness neutral in vitro and in vivo 100
Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025Legionella by both PCR and culture! The patient recovers well after a course of effective therapy. 110
Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025When using the Legionella urine antigen test, it is also critical to know the relative abundance of L. pneumophila serogroups. For my local area, serogroup 1 (detected by the urine test) makes up less than half of all confirmed Legionella cases. pubmed.ncbi.nlm.nih.gov/30814318/ 110
Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025A second consideration is the duration of symptoms. One study found that the peak of urine antigen positivity (black bars) occurred 5 – 10 days into illness. pubmed.ncbi.nlm.nih.gov/14970242/ 110
Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025What's important to remember when interpreting these tests is that they detect only Legionella pneumophilia serogroup 1. When restricting to this serogroup only, the pooled sensitivity was somewhat improved at 0.86 (95% CI 0.78-0.91) 110
Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025Negative. Does this test sufficiently rule out Legionella? 110
Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025How good (or bad) is the Legionella urine antigen test? A middle-aged SOT patient presents to the ED with fever, cough, and diarrhea of 2 days duration. T = 39.4 C, rest of vitals stable. Labs show neutrophilic leukocytosis and mild hyponatremia. CT of the chest shows a LLL consolidation. #IDSky 2192
Cody Cunningham @cunninghamresus.bsky.social · 02/01/2025Im not sure how much baloxavir marboxil added to this case (if we can extrapolate from endemic IAV), but it certainly has the coolest MOA in ID 000
Cody Cunningham @cunninghamresus.bsky.social · 04/12/2024I’m headed to WashU for fellowship! #IDsky 6351
Cody Cunningham @cunninghamresus.bsky.social · 17/11/2024Quick synthesis of the recent trials on ppx antibiotics to prevent VAP 073
