SOS AMS Podcast

Applied Cases: Bacteremia 2

This episode of the SOS AMS podcast is a continuation of the Bacteremia part 1 podcast. In this episode, our hosts apply the systematic approach to bacteremia discussed in the previous podcast to 3 patient cases. Relevant references [https://sites.google.com/view/sos-ams-podcast-home/references/episodes-10-12?authuser=3] can always be accessed at the provided hyperlink.   The learning objectives for the podcast are: 1. Case 1: Viridans group Strep “bacteremia” 1 of 2 sets in a patient admitted with AECOPD 2. Case 2: E. coli bacteremia secondary to pyelonephritis 3. Case 3: Staph aureus bacteremia, unclear source Stock Media provided by raspberrysounds / Pond5

Bacteremia

In this episode of the SOS AMS podcast, Julia and Nicki take a closer look at the management of bacteremia. They discuss interpretation of blood culture results, including distinguishing between contaminant and true pathogen, the clinical utility of time to positivity, and the identification of high risk bacteremias. They discuss a systematic approach to managing patients with bacteremia, and evaluation for sources of infection. They then make specific mention of Staphylococcus aureus bacteremia and the four-pronged bundle of care for Staphylococcus aureus bacteremia as well as discussing the rationale for that bundle. Relevant references [https://sites.google.com/view/sos-ams-podcast-home/references/episodes-10-12?authuser=3] can be accessed at the provided hyperlink   The learning objectives for this podcast are: 1. Review interpretation of blood culture results with respect to community vs hospital onset, time to positivity, discerning true pathogen from contaminant, and identifying highest risk pathogens.  2. Explain why identifying the source of bacteremia is critical to the management plan. 3. Review appropriate bundle of care for Staphylococcus aureus bacteremia.  4. Apply this knowledge to 3 patient cases (in Part 2 of this podcast: Applied Cases in Bacteremia) Stock Media provided by raspberrysounds / Pond5

Sepsis NYD

This episode of the SOS AMS podcast focuses on the ID/AMS side of sepsis and septic shock. Our hosts distinguish sepsis and septic shock from infection with systemic features, and bacteremia, both of which are commonly incorrectly referred to as sepsis in practice. They discuss an approach to identifying the source of sepsis in a patient with sepsis NYD, with emphasis on localizing symptoms, investigations, and what to do in the absence of localizing symptoms. They discuss the challenge in finding a balance between good stewardship and the use of aggressive antimicrobial therapy given the high mortality associated with sepsis. They then end the podcast by applying principles discussed to a case of nosocomial sepsis NYD. Relevant references [https://sites.google.com/view/sos-ams-podcast-home/references/episodes-10-12?authuser=3] can be accessed at the provided hyperlink.    The learning objectives for the podcast are:  1. Distinguish between sepsis, septic shock, infection with systemic features, and bacteremia. 2. Describe the work-up of a patient with sepsis unclear source.  3. Discuss considerations for appropriate empiric therapy for a patient with sepsis NYD.  4. Apply this  knowledge to a patient case Stock Media provided by raspberrysounds / Pond5

Intraabdominal Infections (IAI)

This episode of the SOS AMS podcast focuses on the pathophysiology, diagnosis, and management of various community-onset intraabdominal infections. Infections discussed include cholecystitis, cholangitis, diverticulitis, acute appendicitis, pancreatitis, and liver abscess. Our hosts end the podcast by applying principles discussed to a patient case, going from differential diagnosis to management. Check out the clinical decision-making matrix [https://sites.google.com/view/sos-ams-podcast-home/cdm-matrices/cdm-matrix-iai?authuser=3] for a summary of our top 3 differential diagnoses, as well as the relevant references [https://sites.google.com/view/sos-ams-podcast-home/references/episode-9?authuser=3] at the provided hyperlinks. The learning objectives for this podcast are as follows: 1. Contrast the pathophysiology of cholecystitis, cholangitis, diverticulitis, acute appendicitis, pancreatitis, and liver abscess.  2. List the usual pathogens implicated in community-onset intraabdominal infection. 3. Discuss selection of empiric therapy for community-onset intraabdominal infections. 4. Recognize the importance of source control in management of intraabdominal infections. 5. Apply knowledge of the above to a patient presenting with suspected intraabdominal infection.  Stock Media provided by raspberrysounds / Pond5

Urinary Tract Infections (UTI)

This episode of the SOS AMS podcast focuses on the diagnosis, microbiology, and management of urinary tract infections, including cystitis, pyelonephritis, and catheter-associated UTIs. Our hosts also discuss the pressures in practice that lead to over-diagnosis of UTIs, a significant contributor to antibiotic resistance. They then end the podcast by applying the principles discussed to two patient cases, addressing common practice issues that arise when dealing with patients with suspected urinary tract infection.  Relevant references [https://sites.google.com/view/sos-ams-podcast-home/references/episode-8?authuser=3] can be accessed at the provided hyperlink, and we would encourage taking a read through the excellent 3 page article written by Dr. Tom Finucane of Johns Hopkins.   The learning objectives for this podcast are as follows: 1. Distinguish between asymptomatic bacteriuria (ASB), cystitis, pyelonephritis, and catheter associated UTI.  2. Discuss important considerations for optimal timing and interpretation of urine cultures. 3. Rationalize which pathogens are usually implicated in UTIs. 4. Discuss usual treatment and treatment duration for UTIs Stock Media provided by raspberrysounds / Pond5