Joseph Marcus
josephmarcusid.medsky.social
Joseph Marcus
@josephmarcusid.medsky.social
Infectious Diseases MD, parent, lifelong learner, opinions are my own

Interests: Getting trainees excited about ID/Research, ECMO infections, STIs, and Transfusion-Transmitted Infections

https://scholar.usuhs.edu/en/persons/joseph-marcus
Reposted by Joseph Marcus
Antimicrobial in critically Ill adult patients receiving #ECMO: challenges, evidence, and future directions
💉 PK/PD concepts & considerations
🧫 antibacterials
🍄 antifungals
🦠 antivirals
🩺 management recommendations: dose optimization, challenges/recommendations, ABT stewardship
🔓 bit.ly/45vjrbt
December 28, 2025 at 6:32 PM
Working with 🩸 donors, it is good to have guidance on asymptomatic pts with ➕babesia screens.

Blood banks use PCR which can be positive for months to years after infection.

Guidance is to 🚫not treat unless positive smear

doi.org/10.1093/cid/...
Guidance on the management of asymptomatic blood donors who test positive for Babesia
AbstractDescription. Babesiosis is a tick-borne disease that is endemic in the United States (US). The major species, Babesia microti, is readily transmiss
doi.org
December 27, 2025 at 2:46 PM
2025 was an exciting year in the world of ECMO infections research

Some highlights below:

A 🧵

#IDSky
2024 was an exciting year in the world of ECMO infections research

Some highlights below:

A 🧵

#IDSky
December 26, 2025 at 3:25 AM
Reposted by Joseph Marcus
🧵 Essential ID Papers for 2025: A Clinician’s Guide

Each year brings a flood of amazing ID literature.

Here are candidates for some of the most important ID papers of 2025, spanning guidelines, trials, antimicrobials, and vaccines.
👇
December 22, 2025 at 3:22 PM
A phase 2 open label RCT of weekly Islatravir + Lenacapravir in patients living with HIV combared B/F/TAF:

-Similar rate of viral suppression (VL<50)
-Similar effect on CD4 count

Likely one step closer to a weekly oral HIV med.

#IDSky

www.acpjournals.org/doi/10.7326/...
Once-Weekly Oral Islatravir Plus Lenacapavir Versus Daily Oral Bictegravir, Emtricitabine, and Tenofovir Alafenamide in Persons With HIV-1: A Phase 2 Randomized Study: Annals of Internal Medicine: Vol...
Background: Once-weekly oral islatravir plus lenacapavir (ISL+LEN) has the potential to address adherence challenges with daily HIV-1 treatment. Objective: To evaluate efficacy and safety of once-week...
www.acpjournals.org
December 22, 2025 at 11:50 PM
WHO-certified Tropical Diseases Eliminated in 2025

African Trypanosomiasis: 🇬🇳 🇰🇪
Malaria: 🇬🇪 🇸🇷 🇹🇱
MTCT HBV: 🇲🇻
Onchocerciasis: 🇳🇪
Trachoma: 🇧🇮🇪🇬🇲🇷 🇵🇬

#IDSky
WHO-certified Neglected Tropical Diseases Eliminated in 2024

🇨🇻 🇪🇬-Malaria
🇧🇷 🇹🇱 - Lymphatic filariasis
🇯🇴-Leprosy
🇹🇩-African Trypanosomiasis
🇵🇰 🇮🇳 🇻🇳- Trachoma

www.npr.org/sections/goa...

#IDSky
9 countries said goodbye to a devastating disease in 2024
Nine countries eliminated a disease in 2024. Here's how Pakistan pulled it off — fulfilling a young boy's dream of eliminating blindness caused by bacterial infections.
www.npr.org
December 20, 2025 at 2:03 PM
Brazil 🇧🇷 meets elimination targets for mother-to-child transmission of HIV

#IDSky

www.who.int/news/item/18...
December 19, 2025 at 1:47 AM
🇳🇱 RCT of DFI w/ suspected osteo and w/o debridement/amputation and got bone+ulcer biopsy

Comparison: abx targeting unblinded 🦴 cx or ulcer cx

Outcome: Remission at 12 months

Outcome: No difference RR 1.13; (95% CI 0.80-1.60).

Why? Both cxs concordant 85% of time

#IDSky

doi.org/10.1093/cid/...
“Bone biopsy not superior to ulcer bed biopsy guided antibacterial therapy on remission of diabetic foot osteomyelitis: A randomized controlled trial”
AbstractBackground. Percutaneous bone biopsy is the reference standard for guiding antibiotic therapy in diabetic foot osteomyelitis (DFO). However, ulcer
doi.org
December 17, 2025 at 2:51 AM
Reposted by Joseph Marcus
New Let’s Talk ID episode out now! 🎙️ @paulsaxmd.bsky.social sits down with infectious disease and critical care physician @mbrigmon.bsky.social of @uthealthsa.bsky.social to discuss forging a career in ID Critical Care.

Available on all podcast apps. Transcript: www.idsociety.org/multimedia/p...
Charting a Path in ID Critical Care
Paul Sax, MD, FIDSA, sits down with infectious disease and critical care physician, Matthew Brigmon, MD, discuss forging a career in ID Critical Care.
www.idsociety.org
December 15, 2025 at 4:35 PM
Happy Hanukkah to #IDSky!
December 15, 2025 at 12:06 AM
Possible nosocomial transmission of malaria 🦟 in 🇺🇸?!?

A 65M in NY developed severe P. falciparum malaria (16% parasitemia) after hospitalization for SDH.

Extensive tracing determined transmission at hospital with likely 🩸 borne transmission from returning traveler

#IDSky

doi.org/10.1093/ofid...
Validate User
doi.org
December 13, 2025 at 1:12 AM
Reposted by Joseph Marcus
Excited to share our latest publication about SEP-1 metrics during the BCx shortage in the setting of enhanced BCx stewardship efforts

@kcawcutt.bsky.social @ichejournal.bsky.social #IDSky

www.cambridge.org/core/journal...
Are SEP-1 and blood culture stewardship at odds? Retrospective review of SEP-1 failures pre- and during a blood culture bottle shortage | Infection Control &amp; Hospital Epidemiology | Cambridge Core
Are SEP-1 and blood culture stewardship at odds? Retrospective review of SEP-1 failures pre- and during a blood culture bottle shortage
www.cambridge.org
December 12, 2025 at 3:33 PM
Reposted by Joseph Marcus
This single-center quality improvement study found that 45% of C. difficile infections were preventable due to inappropriate antibiotic use or treatment of non-guideline conditions. These findings support continued antimicrobial stewardship efforts to reduce CDI rates. doi.org/10.1017/ash....
Low adherence to institutional clinical practice guideline in patients diagnosed with Clostridioides difficile infection | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core
Low adherence to institutional clinical practice guideline in patients diagnosed with Clostridioides difficile infection - Volume 5 Issue 1
doi.org
December 11, 2025 at 7:00 PM
Travel medicine clinic does not have many travelers to Switzerland 🇨🇭

-70yo 🇺🇸 traveler to 🇨🇭 died from Tick-Borne Encephalitis after 🥾 in Alps
-12th case in 🇺🇸 traveler since 2000
-TBE vaccine 💉 recommended for travelers to Europe/Asia with⬆️ tick exposures

#IDSky

wwwnc.cdc.gov/eid/article/...
Fatal Tick-Borne Encephalitis in Unvaccinated Traveler from the United States to Switzerland, 2022
Fatal Tick-Borne Encephalitis in Traveler
wwwnc.cdc.gov
December 12, 2025 at 2:12 AM
New paper out today where we tried to apply the framework of preventability to our C diff cases.

Unpreventable (53%)
-1/3 received no abx
-1/5 receive CPG abx only

Preventable (47%)
-1/4 conditions not on CPG
-1/4 non-CPG treatment given

Goal: ⬇️ preventable CDI

doi.org/10.1017/ash....

#IDSky
doi.org
December 11, 2025 at 1:57 AM
Historical #IDSky quotes that still are true today:

“It is a regrettable fact that discussion of syphilis of the nervous system and its treatment is still necessary”

H. Houston Merritt
@nejm.org
1939

#IDSky

www.nejm.org/doi/full/10....
Neurosyphilis and Its Treatment | NEJM
Original Article from The New England Journal of Medicine — Neurosyphilis and Its Treatment
www.nejm.org
December 10, 2025 at 2:20 AM
Reposted by Joseph Marcus
A paper in Nature reports the details of a 60-year-old male individual from Germany who achieved sustained HIV remission after a stem cell transplant, the seventh-known case reported to date. go.nature.com/4rNjedx #medsky 🧪
December 9, 2025 at 2:16 AM
A @idsainfo.bsky.social position statement in @cidjournal.bsky.social describing why the society backed out of ATS CAP guidelines.

[In viral pneumonia] “briefly withholding antibiotics for patients with nonsevere illness to clarify the diagnosis is safe”

#IDSky

academic.oup.com/cid/advance-...
Infectious Diseases Society of America (IDSA) Position Statement: Why IDSA Did Not Endorse the Community-Acquired Pneumonia Guidelines 2025 Update
The Infectious Diseases Society of America (IDSA) did not endorse updated community-acquired pneumonia guidelines because they recommend antibiotics for pa
academic.oup.com
December 8, 2025 at 11:58 PM
The fourth case of transplant-transmitted rabies reported in this week’s MMWR.

-🦇 Strain
-Symptoms 5 week transplant in kidney recipient
-Donor with neurological symptoms, but died at home from presumed cardiac arrest

#IDSky

www.cdc.gov/mmwr/volumes...
Human-to-Human Rabies Transmission via Solid Organ...
This report describes the public health response to a patient who died after transplantation with an organ from a donor with undiagnosed rabies.
www.cdc.gov
December 4, 2025 at 6:44 PM
Are there any stewards on #IDSky that have experience working to improving local antimicrobial prescribing in non-CF bronchiectasis exacerbations?

Are there hospitals were ID is very involved in antibiotic selection and duration?
November 24, 2025 at 12:12 AM
Two Transplant ECMO #IDSky papers this week:

1) 🇺🇸 Pre-🫁 transplant ECMO associated with ⬆️ BSI post-transplant

link.springer.com/article/10.1...

2) 🇨🇭Post ❤️ transplant ECMO associated with ⬆️ 1 yr infections including bacterial and fungal

journals.lww.com/transplantat...
Impact of pre-transplant veno-venous extracorporeal membrane oxygenation on post-lung transplant infections - Journal of Artificial Organs
Bridging critically ill patients to lung transplantation with veno-venous extracorporeal membrane oxygenation (VV-ECMO) may increase infection risk, yet its impact on post-transplant outcomes remains ...
link.springer.com
November 22, 2025 at 11:02 PM
A great @cidjournal.bsky.social case series that led to lots of discussion with the fellows today- 4 🇬🇧 pts with HBV reactivation after change off of a TAF-based HIV regimen

Pt1/4: +HBcAB, -HBVsAg, -HBVsAB
Pt2/3: +HBcAB, -HBVsAg,+HBVsAB

#IDSky

academic.oup.com/cid/advance-...
Hepatitis B reactivation following switch away from tenofovir-containing anti-retroviral therapy in people living with HIV: A case series and lessons for practice
Abstract. The potential for hepatitis B reactivation must be considered when switching people with HIV and prior hepatitis B exposure away from tenofovir-c
academic.oup.com
November 22, 2025 at 12:44 AM
New #IDSky paper describing antimicrobial dosing in ECMO by @haifalyster.bsky.social:

🔑 Critical illness contributes to more PK variability than ECMO
🔑 Lipopophilic, protein-bound
drugs sequestered by circuit
🔑 Use extended infusions for beta-lactams

www.sciencedirect.com/science/arti...
Antimicrobial Pharmacokinetics and Stewardship in Critically Ill Adult Patients Receiving ECMO: Challenges, Evidence, and Future Directions
Infection is a common indication and complication for extracorporeal membrane oxygenation (ECMO), and adult ECMO recipients face increased nosocomial …
www.sciencedirect.com
November 19, 2025 at 2:16 AM
I just had my first day as the Associate Director of my hospital’s Infectious Disease Fellowship!

I’m excited to spend more time with the fellows!

#IDSky
November 18, 2025 at 1:06 AM
Fascinating article on the history of syphilis:

“English people called it the
“Spanish disease”… the Spanish called it mal inglés.
The Dutch called it “Spanish smallpox”
The Russians blamed the Poles, and the Turks referred to it as the “Christian disease””

#IDSky

academic.oup.com/jid/advance-...
Syphilis Transmission: Contagion of Bodies and Words
Syphilis, infection caused by Treponema pallidum, occurred in Naples and in Europe in the late 15th century impacting on people’s lives. Here, we explored
academic.oup.com
November 16, 2025 at 3:56 AM