New ESCMID blog - Leveling the Field

The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) formed a Parity Commission in 2010 to address barriers and facilitators for women and minorities in the fields of clinical microbiology and infectious disease. To further their mission, the Commission has started an important new blog called "Leveling the Field." The first post titled "Between Privilege and Merit" was written by Dr. Angela Huttner, the current advocate for gender. The plan is for her colleagues on the Commission to contribute future posts. Their aim is to "convey the voices of all" involved and they invite us to contact them with our thoughts and experiences. If future posts are half as good as Dr. Huttner's, this blog will be one to check in on often.

Barriers exist outside of infectious diseases and microbiology and Nisha Mehta's recent post on KevinMD titled, "Why are female physicians scared to be women?" provides a description of many issues. And these are not confined to medical fields  - I would point you to this excellent post by Sarah Bond, an assistant professor in the UI Classics Department titled "The Decline and Fall of the All-Male Panel."

I would just close with a question - is it time for a similar platform in the U.S.?

2013 Studies in Memoriam - A Tribute to Studies Almost Lost

Each year the Academy Awards honors those actors and directors who've died in the prior year. It's one of my favorite tributes. Recently, I found myself with a stack of unread journals about four feet high and one of my routines is to clean my office before the start of each year. Thus, I am catching up on what studies I missed or failed to mention when they were first published. This post is a tribute to those studies that have "almost" died in my journal pile...happy holiday reading...

1) I'm particularly embarrassed that we haven't yet mentioned this review written by Dan. He and Michael Pfaller published a review in the June 1 CID on the promise of rapid microbiological detection of MDRO for infection prevention. Sections cover MRSA, VRE and MDR-GNR. What I really like about this review is that it covers the barriers to successful implementation of rapid detection including the "post-analytic" turn-around time and the current dearth of data supporting the clinical utility for many of these approaches. A must read. (NOTE: Currently the CID website is down, I will update with a direct link to the paper once they are back online)

2) Bevin Cohen from Elaine Larson's group at Columbia published a retrospective cohort study in JGIM investigating gender differences in BSI and SSI risk.  The study included three years (2006-2008) of data from a single center. Odds of these HAI were between 15 to 22% lower in women.

3) John Hollingsworth. Sanjay Saint and colleagues from the University of Michigan published a systematic review and meta-analysis of non-infectious complications of indwelling urethral catheters in Annals this past fall. After identifying and reviewing 37 studies they found that minor complications were quite common. For example, urinary leakage ranged from 10.6% in short-term catheterized patients to 52% in those with long-term catheterization. Serious complications were also quite common. If CAUTI isn't reason enough to remove a urinary catheter, these non-infectious complications should be!

4) And to follow up on the urinary catheter removal theme, there was a meta-analysis published in BMJ that quantified the benefits of antibiotic prophylaxis after urinary catheter removal. When analyzing seven controlled studies (5 from surgical patients), they found antibiotic prophylaxis was associated with an absolute risk reduction of 5.8% for UTI and a risk ratio of 0.45. I suspect there are trade-offs in increased antimicrobial resistance that should be assessed before this is more widely adopted.

Credit: James Taylor at the 2010 Academy Awards - one of my favorite tunes