Category: Uncategorized
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Staphylococcus aureus bacteremia and acute kidney injury
Ever wondered what the risk is of Acute Kidney Injury (AKI) in patients with Staphylococcus Aureus Bacteremia (SAB)? I did not, and I didn’t know.
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The gastropulmonary route of infection: fact or fiction?
In the 1990s – when I started my PhD – this was a relevant and intensely debated question. Now, almost 35 years later, we finally have the answer.
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Control yourself: the self-controlled case series
Does influenza increase the risk of acute myocardial infarction (AMI)? Do bivalent mRNA COVID-19 vaccines cause acute ischemic stroke? Relevant questions, but difficult to answer. Incidences of both outcomes are low, precluding an answer from randomised trials (in case of vaccination) and analyses from observational studies will be flawed by…
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Solving the small crappy trial problem
Randomised controlled trials (RCTs) yield the strongest evidence to inform medical practice. Each year, more than 40,000 new RCTs are registered, and some have estimated that they cost more than 80 billion US dollars. Yet RCTs are remarkably inefficient.
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How to change RCT-based “definitive” practice
Randomised controlled trials (RCT) provide the highest level of evidence. But what to do if a disease changes? Only a new RCT can provide sufficient evidence to change the associated RCT-based practice.
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COVID-19: An outbreak of books
Twenty-nine years ago, Bob Weinstein told me that “every outbreak is in fact three outbreaks: spread of a pathogen, followed by an outbreak of meetings, followed by an outbreak of publications.” A pandemic adds a next level: an outbreak of books.
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How deadly is antibiotic resistance?
How can we quantify the attribution of antibiotic resistance to detrimental patient outcome? Some believe that in 2050, 10 million people will die every year because of antibiotic resistance! But is antibiotic resistance always the cause of death? And if so, how can we explain detrimental outcomes of infections treated…
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Nebulized amikacin and VAP prevention (part 2): the art of circular reasoning
Three months ago, a French investigator-initiated, multicenter, double-blind, randomized, placebo-controlled study reported that nebulized amikacin reduced the occurrence of VAP. Positive cultures of endotracheal aspirates were part of (the few) diagnostic criteria for VAP. My response was that “the possibility of artificial sterilization of microbiological cultures through nebulized amikacin is…
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Hypervirulent Klebsiella: the next pandemic?
Last week, ECDC issued a risk assessment on the emergence of hypervirulent Klebsiella pneumoniae ST23 carrying carbapenemase genes in Europe, concluding that “there is a possibility of potentially untreatable infections in previously healthy adults”.