Simran Gupta
@simrangmd.bsky.social
Transplant/Oncology ID fellow at BWH/DFCI. @harvardmed. former @MayoAZ_IMRES. @UConnHealth alum. Dog mom & dancer.
Reposted by Simran Gupta
Antagonistic interaction between posaconazole & olorofim in a murine model of invasive pulmonary aspergillosis
Posaconazole ⬇️ the effect of olorofim in vivo. Combination of olorofim+azole likely efficacious in wt infections, may be suboptimal in azole R infections
academic.oup.com/jac/article/...
Posaconazole ⬇️ the effect of olorofim in vivo. Combination of olorofim+azole likely efficacious in wt infections, may be suboptimal in azole R infections
academic.oup.com/jac/article/...
Antagonistic interaction between posaconazole and olorofim in a murine model of invasive pulmonary aspergillosis
AbstractBackground. Olorofim is a new antifungal agent with a novel mechanism of action with in vitro activity against Aspergillus fumigatus and other clin
academic.oup.com
September 24, 2025 at 6:35 PM
Antagonistic interaction between posaconazole & olorofim in a murine model of invasive pulmonary aspergillosis
Posaconazole ⬇️ the effect of olorofim in vivo. Combination of olorofim+azole likely efficacious in wt infections, may be suboptimal in azole R infections
academic.oup.com/jac/article/...
Posaconazole ⬇️ the effect of olorofim in vivo. Combination of olorofim+azole likely efficacious in wt infections, may be suboptimal in azole R infections
academic.oup.com/jac/article/...
Reposted by Simran Gupta
Ah yes, the famously medium-spectrum doxycycline.
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
August 23, 2025 at 11:02 PM
Ah yes, the famously medium-spectrum doxycycline.
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
TLDR; We propose an optimized ASE 2.0 definition:
- allow POA infection diagnosis codes to anchor infection
- include pts discharged alive on QAD 3
- include hypotension w/out pressors (>/= 2 readings in 6h)
- include NIV or HFNC (>/= 2 days)
- minor changes in Plt, Cr, and Tbili thresholds
- allow POA infection diagnosis codes to anchor infection
- include pts discharged alive on QAD 3
- include hypotension w/out pressors (>/= 2 readings in 6h)
- include NIV or HFNC (>/= 2 days)
- minor changes in Plt, Cr, and Tbili thresholds
🆕 New in ICHE: How should the CDC’s Adult Sepsis Event (ASE) definition evolve?
This study modeled potential modifications and found tradeoffs between incidence, mortality, and clinical validity offering insight into how changes could shape surveillance
#IDSky
📄: doi.org/10.1017/ice....
This study modeled potential modifications and found tradeoffs between incidence, mortality, and clinical validity offering insight into how changes could shape surveillance
#IDSky
📄: doi.org/10.1017/ice....
August 7, 2025 at 12:11 AM
TLDR; We propose an optimized ASE 2.0 definition:
- allow POA infection diagnosis codes to anchor infection
- include pts discharged alive on QAD 3
- include hypotension w/out pressors (>/= 2 readings in 6h)
- include NIV or HFNC (>/= 2 days)
- minor changes in Plt, Cr, and Tbili thresholds
- allow POA infection diagnosis codes to anchor infection
- include pts discharged alive on QAD 3
- include hypotension w/out pressors (>/= 2 readings in 6h)
- include NIV or HFNC (>/= 2 days)
- minor changes in Plt, Cr, and Tbili thresholds
Reposted by Simran Gupta
Good perspective from @simrangmd.bsky.social et al re use of PCT in ICU.
Particularly pertinent that as data and practice keep pointing towards shorter antibiotic course therapy, the window for diagnostic stewardship will narrow, limiting PCT benefit.
#IDSky #ClinMicro #AMR
Particularly pertinent that as data and practice keep pointing towards shorter antibiotic course therapy, the window for diagnostic stewardship will narrow, limiting PCT benefit.
#IDSky #ClinMicro #AMR
Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial
✅ Just Accepted
⭐ Editor's Choice
#IDSky
✅ Just Accepted
⭐ Editor's Choice
#IDSky
Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial
Randomized trials of procalcitonin-guided algorithms to discontinue antibiotics in critically ill patients with sepsis report reduced antibiotic duration and possible mortality benefit.
academic.oup.com
June 29, 2025 at 5:43 AM
Good perspective from @simrangmd.bsky.social et al re use of PCT in ICU.
Particularly pertinent that as data and practice keep pointing towards shorter antibiotic course therapy, the window for diagnostic stewardship will narrow, limiting PCT benefit.
#IDSky #ClinMicro #AMR
Particularly pertinent that as data and practice keep pointing towards shorter antibiotic course therapy, the window for diagnostic stewardship will narrow, limiting PCT benefit.
#IDSky #ClinMicro #AMR
Check out our viewpoint!
Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial
✅ Just Accepted
⭐ Editor's Choice
#IDSky
✅ Just Accepted
⭐ Editor's Choice
#IDSky
Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial
Randomized trials of procalcitonin-guided algorithms to discontinue antibiotics in critically ill patients with sepsis report reduced antibiotic duration and possible mortality benefit.
academic.oup.com
June 29, 2025 at 2:45 AM
Check out our viewpoint!
Reposted by Simran Gupta
This is by far the most common vaccine I strongly recommend in ID adult clinical practice. As ID doctors, we see some truly severe cases of zoster, with post-zoster sequelae that may last months or even rarely be permanent. #IDSky doi.org/10.1093/cid/...
June 26, 2025 at 6:53 PM
This is by far the most common vaccine I strongly recommend in ID adult clinical practice. As ID doctors, we see some truly severe cases of zoster, with post-zoster sequelae that may last months or even rarely be permanent. #IDSky doi.org/10.1093/cid/...
Reposted by Simran Gupta
Procalcitonin-guided care cut antibiotic use by 1 day in sepsis patients but had no mortality impact. CRP showed no benefit. Adherence was low; future focus on early biomarker use is needed. 📉💊##idsky
Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial
AbstractRandomized trials of procalcitonin-guided algorithms to discontinue antibiotics in critically ill patients with sepsis report reduced antibiotic duration and possible mortality benefit. However, open-label trial designs, inconsistent algorithm adherence, and unclear stewardship practices have limited confidence in procalcitonin’s benefit. The ADAPT-Sepsis trial addressed several of these gaps through a concealed intervention, robust stewardship, and head-to-head comparison with CRP. Procalcitonin-guided care reduced antibiotic use without significantly impacting mortality, while CRP-guided care showed no benefit. However, algorithm adherence was suboptimal and the absolute reduction in antibiotic duration with procalcitonin was only one day. As shorter fixed-duration therapy becomes standard, procalcitonin’s utility in the ICU may decline. Embedding procalcitonin and other biomarkers into multifaceted stewardship strategies, and addressing barriers to clinician trust and implementation, is essential. Future research should also evaluate whether biomarker use earlier in the sepsis care pathway, particularly in Emergency Departments, can improve early diagnostic accuracy and enhance patient outcomes.
academic.oup.com
June 21, 2025 at 12:30 AM
Procalcitonin-guided care cut antibiotic use by 1 day in sepsis patients but had no mortality impact. CRP showed no benefit. Adherence was low; future focus on early biomarker use is needed. 📉💊##idsky
Reposted by Simran Gupta
Herpes zoster vaccination eligibility reduced the probability of new dementia diagnoses, suggesting its potential preventive effect.
https://ja.ma/4lagSB6
https://ja.ma/4lagSB6
June 22, 2025 at 1:00 PM
Herpes zoster vaccination eligibility reduced the probability of new dementia diagnoses, suggesting its potential preventive effect.
https://ja.ma/4lagSB6
https://ja.ma/4lagSB6
Reposted by Simran Gupta
🍾Last evening, the MGH & BWH ID faculty celebrated graduates of the MGB ID & MGH Transplant ID Fellowships, along with their families. It was a heartwarming celebration of stories, accolades, laughter, and tears. Special thanks go to our featured speakers Dr. Eric Rubin & Dr. Gabriel Motoa Cardona.🤩
June 18, 2025 at 2:28 PM
🍾Last evening, the MGH & BWH ID faculty celebrated graduates of the MGB ID & MGH Transplant ID Fellowships, along with their families. It was a heartwarming celebration of stories, accolades, laughter, and tears. Special thanks go to our featured speakers Dr. Eric Rubin & Dr. Gabriel Motoa Cardona.🤩
Last few weeks with this BWH crew! @mgb-id-fellows.bsky.social
June 9, 2025 at 2:27 PM
Last few weeks with this BWH crew! @mgb-id-fellows.bsky.social
Reposted by Simran Gupta
‼️Our new paper on social media in #TxID is officially out in @thetxidjournal.bsky.social
We summarize findings from our #TxIDChat @txidfellows.bsky.social
We discuss recs for trainees, career advancement, & future directions in this changing landscape. Check it out!
dx.doi.org/10.1111/tid....
We summarize findings from our #TxIDChat @txidfellows.bsky.social
We discuss recs for trainees, career advancement, & future directions in this changing landscape. Check it out!
dx.doi.org/10.1111/tid....
Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients
dx.doi.org
February 14, 2025 at 5:41 PM
‼️Our new paper on social media in #TxID is officially out in @thetxidjournal.bsky.social
We summarize findings from our #TxIDChat @txidfellows.bsky.social
We discuss recs for trainees, career advancement, & future directions in this changing landscape. Check it out!
dx.doi.org/10.1111/tid....
We summarize findings from our #TxIDChat @txidfellows.bsky.social
We discuss recs for trainees, career advancement, & future directions in this changing landscape. Check it out!
dx.doi.org/10.1111/tid....
Reposted by Simran Gupta
This will kill so many people living with HIV who depend on PEPFAR programs to stay on their HIV treatment driving further HIV drug resistance.
www.nytimes.com/2025/01/24/u...
www.nytimes.com/2025/01/24/u...
Trump Pauses Disbursements to Program Supplying H.I.V. Treatment Worldwide
Pepfar, which is estimated to have delivered lifesaving treatment as many as 25 million people in 54 countries, faces a funding delay of as long as 180 days.
www.nytimes.com
January 24, 2025 at 9:28 PM
This will kill so many people living with HIV who depend on PEPFAR programs to stay on their HIV treatment driving further HIV drug resistance.
www.nytimes.com/2025/01/24/u...
www.nytimes.com/2025/01/24/u...
Reposted by Simran Gupta
ICE was in my hospital today…
i am so beyond angry—this is unacceptable
stay away from our patients and let us do our jobs
i am so beyond angry—this is unacceptable
stay away from our patients and let us do our jobs
January 24, 2025 at 11:11 PM
ICE was in my hospital today…
i am so beyond angry—this is unacceptable
stay away from our patients and let us do our jobs
i am so beyond angry—this is unacceptable
stay away from our patients and let us do our jobs
Reposted by Simran Gupta
CDC's Morbidity and Mortality Weekly Report (MMWR) has provided real-time data and analysis about disease outbreaks and emerging health threats without a break every week since 1960.
Until today.
Until today.
January 23, 2025 at 6:38 PM
CDC's Morbidity and Mortality Weekly Report (MMWR) has provided real-time data and analysis about disease outbreaks and emerging health threats without a break every week since 1960.
Until today.
Until today.
Reposted by Simran Gupta
Trump's Gag Order Halts CDC Publication www.medpagetoday.com/infectiousdi... For the first time in its more than 60-year history, the CDC's Morbidity and Mortality Weekly Report (MMWR) did not go out as scheduled.
Trump's Gag Order Halts CDC Publication
MMWR did not publish as usual at 1 p.m. today
www.medpagetoday.com
January 23, 2025 at 7:48 PM
Trump's Gag Order Halts CDC Publication www.medpagetoday.com/infectiousdi... For the first time in its more than 60-year history, the CDC's Morbidity and Mortality Weekly Report (MMWR) did not go out as scheduled.
Reposted by Simran Gupta
Scientific advancements aside, this is economically irresponsible
Every $1 spent by NIH generates $2.46
For example, in 2023, $47B in NIH spending generated ~$93B
Halting NIH spending will LOSE the US a lot of money (and talent)
Every $1 spent by NIH generates $2.46
For example, in 2023, $47B in NIH spending generated ~$93B
Halting NIH spending will LOSE the US a lot of money (and talent)
January 22, 2025 at 11:04 PM
Scientific advancements aside, this is economically irresponsible
Every $1 spent by NIH generates $2.46
For example, in 2023, $47B in NIH spending generated ~$93B
Halting NIH spending will LOSE the US a lot of money (and talent)
Every $1 spent by NIH generates $2.46
For example, in 2023, $47B in NIH spending generated ~$93B
Halting NIH spending will LOSE the US a lot of money (and talent)
Reposted by Simran Gupta
For those asking how unusual it is for NIH review panels to be cancelled: I do not recall study sections ever being cancelled during my 30-year career except for during the “sequestration” period around 2012-2013 when there was, I think, a government shutdown.
January 23, 2025 at 12:39 AM
For those asking how unusual it is for NIH review panels to be cancelled: I do not recall study sections ever being cancelled during my 30-year career except for during the “sequestration” period around 2012-2013 when there was, I think, a government shutdown.
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...
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...
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 ...
journals.lww.com
January 17, 2025 at 4:21 PM
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...
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...
Reposted by Simran Gupta
🆕💫Retrospective Cohort Study
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of IE
Short TTP was associated wit IE
NPV >95% suggests that TTP>13h can be used to risk stratify pts with SAB #idsky #EMIMCC
academic.oup.com/cid/article/...
academic.oup.com/cid/advance-...
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of IE
Short TTP was associated wit IE
NPV >95% suggests that TTP>13h can be used to risk stratify pts with SAB #idsky #EMIMCC
academic.oup.com/cid/article/...
academic.oup.com/cid/advance-...
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of Infective Endocarditis: A Retrospective Cohort Study
Short time to blood culture positivity (TTP) was an independent risk factor of infective endocarditis in this large (N=1703) Staphylococcus aureus bacterem
academic.oup.com
December 21, 2024 at 2:14 PM
🆕💫Retrospective Cohort Study
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of IE
Short TTP was associated wit IE
NPV >95% suggests that TTP>13h can be used to risk stratify pts with SAB #idsky #EMIMCC
academic.oup.com/cid/article/...
academic.oup.com/cid/advance-...
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of IE
Short TTP was associated wit IE
NPV >95% suggests that TTP>13h can be used to risk stratify pts with SAB #idsky #EMIMCC
academic.oup.com/cid/article/...
academic.oup.com/cid/advance-...
Reposted by Simran Gupta
Did you know that Yersinia can cause pneumonia? It sure can. Check out this interesting report by @carlosportales.bsky.social @agstewart.bsky.social onlinelibrary.wiley.com/doi/10.1111/...
Yersinia enterocolitica Pneumonia in a Heart Transplant Recipient
Click on the article title to read more.
onlinelibrary.wiley.com
December 18, 2024 at 8:24 PM
Did you know that Yersinia can cause pneumonia? It sure can. Check out this interesting report by @carlosportales.bsky.social @agstewart.bsky.social onlinelibrary.wiley.com/doi/10.1111/...
Reposted by Simran Gupta
🔥Out now! Our latest from @txidfellows.bsky.social on the use of social media in #TxID. doi.org/10.1111/tid.... @courtharrismd.bsky.social @rebeccakumar.bsky.social @germhuntermd.bsky.social @paulsaxmd.bsky.social @transplantid.bsky.social
Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients
doi.org
December 18, 2024 at 7:53 PM
🔥Out now! Our latest from @txidfellows.bsky.social on the use of social media in #TxID. doi.org/10.1111/tid.... @courtharrismd.bsky.social @rebeccakumar.bsky.social @germhuntermd.bsky.social @paulsaxmd.bsky.social @transplantid.bsky.social
Reposted by Simran Gupta
On this day in 1981, a landmark paper in NEJM described four patients with evidence of immunodeficiency associated with PJP pneumonia, disseminated CMV, and Kaposi sarcoma. The disease would come to be known as HIV/AIDS. Revisit the paper: nej.md/41iekKD
#MedSky #IDSky
#MedSky #IDSky
December 10, 2024 at 2:28 PM
On this day in 1981, a landmark paper in NEJM described four patients with evidence of immunodeficiency associated with PJP pneumonia, disseminated CMV, and Kaposi sarcoma. The disease would come to be known as HIV/AIDS. Revisit the paper: nej.md/41iekKD
#MedSky #IDSky
#MedSky #IDSky
Reposted by Simran Gupta
🤩 WE ARE SUPER EXCITED to announce our 2025-2027 class of ID Fellows! 🥂
We are thrilled to have matched with such a talented group!
We are thrilled to have matched with such a talented group!
December 4, 2024 at 7:03 PM
🤩 WE ARE SUPER EXCITED to announce our 2025-2027 class of ID Fellows! 🥂
We are thrilled to have matched with such a talented group!
We are thrilled to have matched with such a talented group!
Reposted by Simran Gupta
7-year performance of a clinical mNGS test for diagnosis of CNS infections
Sensitivity 63.1%
Specificity 99.6%
Accuracy 92.9%
4 potential use cases:
➡️unculturable, difficult-to-diagnose organisms
➡️broadly dx viral infections
➡️rare, unexpected infections
➡️outbreaks
doi.org/10.1038/s415...
#IDSky
Sensitivity 63.1%
Specificity 99.6%
Accuracy 92.9%
4 potential use cases:
➡️unculturable, difficult-to-diagnose organisms
➡️broadly dx viral infections
➡️rare, unexpected infections
➡️outbreaks
doi.org/10.1038/s415...
#IDSky
November 23, 2024 at 4:22 PM
7-year performance of a clinical mNGS test for diagnosis of CNS infections
Sensitivity 63.1%
Specificity 99.6%
Accuracy 92.9%
4 potential use cases:
➡️unculturable, difficult-to-diagnose organisms
➡️broadly dx viral infections
➡️rare, unexpected infections
➡️outbreaks
doi.org/10.1038/s415...
#IDSky
Sensitivity 63.1%
Specificity 99.6%
Accuracy 92.9%
4 potential use cases:
➡️unculturable, difficult-to-diagnose organisms
➡️broadly dx viral infections
➡️rare, unexpected infections
➡️outbreaks
doi.org/10.1038/s415...
#IDSky