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Cody Cunningham

@cunninghamresus.bsky.social
970 followers 121 following 32 posts

MD, PhD. Current ID fellow. Former scientist. #IDSky.

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Reposted by Cody Cunningham
Julio C. Zuniga-Moya @julioczuniga1.bsky.social · 18/09/2026
www.ovid.com/jnls/co-infe... Check out our latest review discussing how climate change, human mobility, and socioeconomic factors are expanding endemic mycoses beyond classic regions. Clinicians everywhere must stay alert and test patients. @fungaldoc.bsky.social @washumedicine.bsky.social
ovid.com
Endemic Mycoses in 2026: can we keep the pace of... : Current Opinion in Infectious Diseases
Purpose of reviewThe dimorphic fungal infections were classically grouped as endemic mycoses due to their restricted geographic distribution....
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Reposted by Cody Cunningham
Darcy Wooten (she/her) @darcy-id-doc.bsky.social · 03/12/2025
Congratulations to our incoming WashU ID fellows!!!! The future is bright!!!!!
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Reposted by Cody Cunningham
Darcy Wooten (she/her) @darcy-id-doc.bsky.social · 02/07/2025
Welcome to our new fellows!!! SO excited for the start of a new year!!!
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Cody Cunningham @cunninghamresus.bsky.social · 01/06/2025
7 years of training down, 3(?) to go
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Cody Cunningham @cunninghamresus.bsky.social · 13/05/2025
Medicine resident wins award
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Cody Cunningham @cunninghamresus.bsky.social · 11/02/2025
Also there are now only 3 strains in the vaccine 2/2: www.thelancet.com/journals/lan...
thelancet.com
Probable extinction of influenza B/Yamagata and its public health implications: a systematic literature review and assessment of global surveillance databases
Early after the start of the COVID-19 pandemic, the detection of influenza B/Yamagata cases decreased globally. Given the potential public health implications of this decline, in this Review, we syste...
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Cody Cunningham @cunninghamresus.bsky.social · 11/02/2025
We (Arizona) peaked at 131% above 5 year average a few weeks ago, thankfully we have continued to downtrend
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Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025
Great paper overall, look forward to seeing how the authors move this work forward #IDSky www.science.org/doi/10.1126/...
science.org
Barcoded SARS-CoV-2 viruses define the impact of duration and route of exposure on the transmission bottleneck in a hamster model
Barcoded SARS-CoV-2 enables precise, quantitative studies of transmission.
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Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025
During aerosol transmission, virus appeared to be sourced from the upper airway (nasal turbinates) but not the trachea or lungs
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Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025
The number of unique barcodes transferred depended on route of infection with direct contact > aerosol > fomite
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Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025
During productive aerosol transmission, between 13 - 42 unique viruses were transferred. Upper and lower airways had unique signatures suggesting independent seeding by different virus particles.
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Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025
The authors generated >200 unique (barcoded) viruses that were fitness neutral in vitro and in vivo
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Cody Cunningham @cunninghamresus.bsky.social · 30/01/2025
Really elegant paper using barcoded SARS-CoV-2 to explore virus transmission in a small animal model. Some highlights: #IDSkyhttps://www.science.org/doi/10.1126/sciadv.ads2927
science.org
Barcoded SARS-CoV-2 viruses define the impact of duration and route of exposure on the transmission bottleneck in a hamster model
Barcoded SARS-CoV-2 enables precise, quantitative studies of transmission.
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Cody Cunningham @cunninghamresus.bsky.social · 21/01/2025
New paper describing different routes of H5N1 infection in a non-human primate model #IDsky www.nature.com/articles/s41...
nature.com
Pathogenesis of bovine H5N1 clade 2.3.4.4b infection in Macaques - Nature
Nature - Pathogenesis of bovine H5N1 clade 2.3.4.4b infection in Macaques
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Reposted by Cody Cunningham
Simran Gupta @simrangmd.bsky.social · 17/01/2025
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...
journals.lww.com
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 ...
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Cody Cunningham @cunninghamresus.bsky.social · 17/01/2025
New correspondence in CID from myself and Dan Ilges discussing important recent work on antibiotic deescalation in patients with sepsis #IDsky academic.oup.com/cid/advance-...
academic.oup.com
Epidemiology and Outcomes of Antibiotic De-escalation in Patients with Suspected Sepsis in US Hospitals
Cody A Cunningham, Dan Ilges; Epidemiology and Outcomes of Antibiotic De-escalation in Patients with Suspected Sepsis in US Hospitals, Clinical Infectious
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Cody Cunningham @cunninghamresus.bsky.social · 17/01/2025
Interesting data on suraxavir-marboxil for uncomplicated influenza. Hopefully the there is less treatment emergent resistance than the other PA endonuclease inhibitor on the market #IDsky www.nature.com/articles/s41...
nature.com
Single-dose suraxavir marboxil for acute uncomplicated influenza in adults and adolescents: a multicenter, randomized, double-blind, placebo-controlled phase 3 trial - Nature Medicine
Suraxavir marboxil, an antiviral drug designed to inhibit the polymerase acidic protein of influenza, alleviates symptoms in individuals with influenza faster than placebo in a phase 3 trial conducted...
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Cody Cunningham @cunninghamresus.bsky.social · 10/01/2025
www.nature.com/articles/s41...
nature.com
An early precursor CD8 T cell that adapts to acute or chronic viral infection - Nature
Nature - An early precursor CD8 T cell that adapts to acute or chronic viral infection
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Cody Cunningham @cunninghamresus.bsky.social · 10/01/2025
Very interesting pair of papers out this week redefining T cell responses to acute vs chronic viral infections #IDSky www.nature.com/articles/s41...
nature.com
Precursors of exhausted T cells are preemptively formed in acute infection - Nature
Nature - Precursors of exhausted T cells are preemptively formed in acute infection
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
3. The test only detects Legionella pneumophilia serogroup 1, and serogroup composition varies geographically 4 . Peak positivity occurs 5 – 10 days into illnes
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
Bottom line (1/2): 1. Currently, the ATS/IDSA recommend obtaining Legionella testing only in patients with severe CAP or epidemiologic risk factors (such as association w/ an outbreak or recent travel) 2. The urine test only has modest sensitivity but good specificity
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
Legionella by both PCR and culture! The patient recovers well after a course of effective therapy.
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
Back to the case, given the patient’s immunocompromised state he ultimately undergoes a bronchoscopy with BAL which shows…
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
When 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/
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
A 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/
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
What'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)
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
Several SRMAs have addressed this question, the most recent found that the Legionella urine antigen test had a pooled sensitivity of 0.79 (95% CI, 0.71-0.85). pubmed.ncbi.nlm.nih.gov/34972680/
pubmed.ncbi.nlm.nih.gov
Diagnostic accuracy of urinary antigen tests for legionellosis: A systematic review and meta-analysis - PubMed
The review protocol was prospectively registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000041080).
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
Negative. Does this test sufficiently rule out Legionella?
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
Given concomitant PNA and gastrointestinal symptoms (and occupational exposure to cooling systems), Legionella thought to be high on the differential and empiric antimicrobials are chosen to cover for Legionella. However, the urine antigen test is…
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Cody Cunningham @cunninghamresus.bsky.social · 05/01/2025
How 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
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Cody Cunningham @cunninghamresus.bsky.social · 02/01/2025
Im 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
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Reposted by Cody Cunningham
Darcy Wooten (she/her) @darcy-id-doc.bsky.social · 05/12/2024
Incredibly THRILLED to introduce the incoming WashU Infectious Diseases Fellowship Class of 2025. The future is SO bright!
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Reposted by Cody Cunningham
Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 05/12/2024
🆕🔥Across 236 US hospitals, de-escalation of antiMRSA & antipseudomonal Abx in suspected sepsis was infrequent & variable across hospitals De-escalation more common in more stable pts and associated with lower adjusted risks for AKI, ICU admission& death #idsky academic.oup.com/cid/advance-...
academic.oup.com
Epidemiology and Outcomes of Antibiotic De-escalation in Patients with Suspected Sepsis in US Hospitals
Across 236 US hospitals, de-escalation of anti-MRSA and anti-pseudomonal antibiotics in suspected sepsis was infrequent and variable across hospitals. De-e
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Cody Cunningham @cunninghamresus.bsky.social · 04/12/2024
I’m headed to WashU for fellowship! #IDsky
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Cody Cunningham @cunninghamresus.bsky.social · 01/12/2024
www.nature.com/articles/s41...
nature.com
Pathogenesis, epidemiology and control of Group A Streptococcus infection - Nature Reviews Microbiology
In this Review, Brouwer et al. summarize recent developments in our understanding of Group A Streptococcus (GAS), focusing on the epidemiologic and clinical features of GAS infection and the molecular...
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Cody Cunningham @cunninghamresus.bsky.social · 28/11/2024
Look forward to reading the paper when it’s published!
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Reposted by Cody Cunningham
Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 27/11/2024
Conventional intermittent dosing remains the current standard of care for beta-lactam antibiotics 🆕🔥 Editorial with ✨Prof.Jason Roberts Is it time to implement prolonged infusions of beta-lactam antibiotics in and beyond critical care settings? #idsky #medsky onlinelibrary.wiley.com/doi/10.1111/...
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Reposted by Cody Cunningham
Cody Cunningham @cunninghamresus.bsky.social · 17/11/2024
Quick synthesis of the recent trials on ppx antibiotics to prevent VAP
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Cody Cunningham @cunninghamresus.bsky.social · 17/11/2024
Quick synthesis of the recent trials on ppx antibiotics to prevent VAP
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Reposted by Cody Cunningham
almoskow.bsky.social @almoskow.bsky.social · 16/11/2024
Late-breaking science session #ReSs24! First up the PROTECT trial examining ceftriaxone PPx after cardiac arrest @nickjohnsonmd.bsky.social @pulmtoilet.bsky.social @imcrit.bsky.social @pulmcrit.bsky.social
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Cody Cunningham @cunninghamresus.bsky.social · 11/11/2024
Howdy #IDsky, I’m a PGY3 medicine resident and incoming ID fellow at (check back in 22 days). My interests include sepsis, OI in the ICU, and infection induced immune dysregulation. Look forward to keeping the conversation alive on BlueSky.
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