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Elli Theel

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Editors in ConversationEditors in ConversationUpdated FDA Recognition of CLSI Breakpoints (JCM ed.)Oversight and guidance for performing antibiotic susceptibility testing can be bewildering. There is an alphabet soup of agencies and bodies involved: FDA, CLSI, and USCAST, to name a few here in the US. How does the Food and Drug Administration, which has regulatory authority over AST, work with a nimble group like the Clinical Laboratory Standards Institute?   Guests: Romney Humphries, Ph.D., D(ABMM), M(ASCP) Patricia Simner, Ph.D., D(ABMM) Links: Major updates to FDA-recognized Clinical and Laboratory Standards Institute breakpoints are a win for the fight against antimicrobial resistance J...2025-05-3052 minEditors in ConversationEditors in ConversationShow Me the Light! Uv Light for CyclosporaPicture this, you wake up one morning with nausea, body aches, abdominal pain, and despite sleeping all night, you are exhausted. You then find yourself running to the restroom with watery and somewhat explosive diarrhea. You think to yourself – what could this be? Well, if the year was 2023, in the summer and you happen to live in Texas, chances were somewhat high that you had probably had cyclosporiasis.  And today, we are going to talk about this particular parasite and focus in on what our options are for detecting it given that it is not routinely picked up on O&P...2025-04-0434 minEditors in ConversationEditors in ConversationBest Papers in the Journal of Clinical Microbiology, 2024The past year in Clinical Microbiology, as seen through the lens of the Journal of Clinical Microbiology. Four JCM editors have each selected a paper they consider to be among the “best” we published in 2024. Of course there are no objective criteria for what makes a paper the “best.” So, by “best,” we mean “a paper that I find exciting.” View this episode: https://www.youtube.com/watch?v=fK9ZqZUrDiY Guests: Patricia Simner, Ph.D., D(ABMM), Johns Hopkins University School of Medicine Romney Humphries, Ph.D., D(ABMM), M(ASCP), Vanderbilt University Medical Center 2025-02-141h 01Editors in ConversationEditors in ConversationGetting a Job in a Clinical Microbiology LabLooking for a dynamic and rewarding career? Learn what it means to be a Clinical Microbiology Laboratory Director and the necessary steps to get there. It’s a diverse job encompassing infectious diseases diagnostic testing, patient care, teaching, and research. This episode is geared for those who are interested in pursuing (or already have) a Ph.D. or M.D. Guests: Alexandra Bryson, Ph.D. Andrea Prinzi, Ph.D Links: Join ASM for up to 50% off the publication fees when you publish in JCM or any of the ASM journals. This episode of Ed...2025-01-1017 minEditors in ConversationEditors in ConversationThe Launch of ASM Case Reports JournalThe American Society for Microbiology is launching a new journal, ASM Case Reports. The journal is already accepting submissions and will begin publishing in January of 2025. We discuss ASM Case Reports and what you can expect from this new journal. Watch this episode: https://youtu.be/zHdZL0PYTuE Some of the questions we will discuss include: What is the scope of ASM Case Reports? What makes a case report or case series interesting and important? Why should people publish in ASM Case Reports? Guests: Dr. Carey-Ann Burnham (twitter/𝕏) Learn more about ASM...2024-10-1130 minEditors in ConversationEditors in ConversationMicrobiology in the Headlines: H5N1 in Dairy Cattle, The Plague, Measles, Neosporin and more!Join Dr. Ben Pinsky and Dr. Greg Berry as they dissect recent news stories, including the USDA's testing for H5N1 in ground beef and a surprising bubonic plague case in Oregon. They also tackle the resurgence of measles in the U.S., the local reappearance of malaria, and a curious study on Neosporin's potential to prevent viral infections. Overview: H5N1 Influenza Virus: Dr. Ben Pinsky provides an update on recent cases of H5N1 in humans and animals, including concerns about dairy cattle infections and the potential for human transmission. Bubonic Plague: Dr. Greg...2024-08-1628 minEditors in ConversationEditors in ConversationTurning the Output of the Microbiology Laboratory Into GoldThe European alchemists of the 12th century sought to find the philosopher’s stone, a substance that would transmute base metals, such as lead, into precious metals, such as silver and gold. Today, we discuss whether data analysis, including machine learning, can transmute base laboratory data into precious clinical tools. We will use antimicrobial susceptibility testing as a case-study for new applications of data analysis. Some of the questions we will address include: How can relatively simple data analyses be used to build upon current methods of verification of antimicrobial susceptibility testing? How do commercial systems analyze individual su...2024-06-2942 minEditors in ConversationEditors in Conversation10 Years of Rhodococcus: Clinical Trends and Susceptibility ProfilesRhodococcus infections are uncommon, however they can cause serious disease in certain patients. There are a number of challenges though when dealing with Rhodococcus infections, including the fact that much of what we know around their susceptibility profiles and the clinical management of infected individuals actually comes from a number case series and in some situations, from the veterinary literature.  So today, our two guests are going to tell us about their experiences with Rhodococcus over a 10-year period and bring us up-to-speed on things like:   Which species of Rhodococcus are most commonly isolated and associated wi...2024-04-2037 minEditors in ConversationEditors in ConversationIs Lophomonas a Pathogen?The protozoan Lophomonas has been reported to be a pathogen of humans in a large number of case reports and case series. Most of these case reports describe infections of the respiratory tract. Editors in Conversation is joined by two experts to discuss this possible parasite. Some of the questions addressed include: What are the characteristics of the species in the genus Lophomonas? What are the laboratory and morphological data that suggest that Lophomonas species cause human infections? What are the purported clinical manifestations of Lophomonas? Finally, is Lophomonas truly a pathogen of humans? Guests:2024-02-2334 minEditors in ConversationEditors in ConversationFavorite Clinical Microbiology Papers of 2023 (JCM ed.)We managed to make it through 2023 without a major epidemic or pandemic, and as we get into the holiday spirit and look forward to the new year, some of us took a look back and picked out one of our favorite JCM paper published in 2023, which I will tell you, was no easy task as there were many of good ones to choose from! And personally, after looking through all the issues over the last year, it never ceases to amaze me the variety of topics that we publish on in JCM – including unique things like the evaluation of a...2023-12-231h 05Editors in ConversationEditors in ConversationAntimicrobial Resistance in Neisseria Gonorrhoeae (JCM ed.)Gonorrhea remains one of the more common sexually transmitted infections. In North America, the number of reported cases has generally risen for over ten years, with interruptions in the early days of the COVID-19 pandemic, followed by returns to rising rates of infection. Under the selective pressure of antimicrobial treatment, antimicrobial resistance has risen, which has led to limited options for treatment Today, we will be discussing antimicrobial resistance in N. gonorrhoeae, including these questions:     •    How accurate is gradient diffusion susceptibility testing when compared to agar-dilution results?     •    Should we use analysis of whole genome sequencing results or agar...2023-12-0528 minEditors in ConversationEditors in ConversationA Novel Coccidioides Antibody LFA (JCM ed.)Despite the many advances in diagnostic testing for infectious diseases, detection of Coccidoides infections continues to rely on serologic assessment for anti-fungal antibodies, and what is perhaps more astonishing is that the serologic methods we use today, such as complement fixation and immunodiffusion, were first developed about a century ago. These assays are technically challenging to maintain and perform, and as a result few labs offer this testing, and even if performed on-site, testing can take up to 3 days complete, so there is definitely room for improvement. So today, we are talking about a study that aimed...2023-10-2144 minEditors in ConversationEditors in ConversationEmerging Antifungal-Resistant Dermatophytes (JCM ed.)Fungi that are resistant to antifungal drugs have been very much in the news and even the subject of the hugely popular television program, The Last of Us. We talk with two experts in mycology and fungal susceptibility testing about the recent descriptions of terbinafine-resistant dermatophytes in the United States. Some of the questions we will address include:  • What are the manifestations of infections caused by terbinafine-resistant dermatophytes?  • What species, including novel species, of dermatophytes are more commonly resistant to terbinafine?  • How common is terbinafine resistance in dermatophytes in the U.S.? Guests:2023-09-2329 minEditors in ConversationEditors in ConversationViral Outbreaks in the Headlines (JCM ed.)Dr. Elli Theel and Dr. Alex McAdam discuss recent viral outbreaks with expert virologists. Recorded before a live audience at ASM Microbe 2023. Topics: What are the recent epidemiologic and diagnostic findings with Mpox?  What are the reservoirs for influenza A H5N1 and how is it transmitted to humans? Why was there such a large number of cases of human metapneumovirus this past respiratory virus season? Guests: Dr. Ben Pinsky, Director of the Clinical Virology laboratory and Professor of Pathology and Medicine at Stanford Health Care and the Stanford University School of Medicine Dr. R...2023-08-1926 minEditors in ConversationEditors in ConversationSusceptibility Testing for Aztreonam with Ceftazidime-AvibactamThe combination of aztreonam with ceftazidime-avibactam is increasingly used for treatment of antimicrobial-resistant Gram-negative bacilli. Clinical laboratories are asked to perform susceptibility testing using this combination, but many laboratory directors have been unsure how to approach this. Today, we’ll discuss a recent paper in the Journal of Clinical Microbiology in which the investigators evaluated a promising method for testing this combination of two antimicrobials and a beta-lactamase inhibitor. We will also discuss the rational for combining these agents, as well as what lab directors should consider before validating and offering this susceptibility testing.   Guests:...2023-07-1338 minEditors in ConversationEditors in ConversationUpdates on Testing for Vaginitis/Vaginosis (JCM ed.)As many of you are likely aware, May is recognized as Women’s Health Care Month by the National Cervical Cancer Coalition, and this year, the CDC has identified the week of May 14th as National Women’s Health Week. So, what better way to recognize these national events on the podcast than to talk about diagnostics for a number of extremely common and uniquely female issues – of course, I’m talking about infectious causes of vaginitis and vaginosis. Classically, diagnosis of these infections has been done at the point-of-care using wet mount microscopy and assessment for various clinical criteria...2023-06-0340 minEditors in ConversationEditors in ConversationAvoiding HIV False Positives (JCM ed.)We can probably all agree that any false positive test result is bad, but I think it’s safe to say that some false positives, like a false positive HIV test for example, is much more anxiety provoking than others. And when it comes to HIV, there have been a number of key advances in the field over the past decade, include the development of improved diagnostics and optimized algorithmic approaches, all of which have allowed for earlier detection of infected patients, and particularly those with acute HIV. Among these advancements has been the development of 4th and 5th ge...2023-02-2429 minEditors in ConversationEditors in ConversationMolecular Testing for Periprosthetic Joint Infections (JCM ed.)The applications of large multiplex panels for detection of pathogens have greatly expanded in the past several years. Initial tests were for detection of respiratory viruses, and the first such test was labor intensive and vulnerable to frequent contamination. Since then, additional sample types have been added, such as cerebrospinal fluid and positive blood culture broths, and tests are easier to perform and reasonably reliable. We discuss a research use only multiplex PCR assay for detection of pathogens in joint infections, and learning how it compares to targeted metagenomic sequencing and culture for detection of pathogens in periprosthetic joint...2023-01-1438 minEditors in ConversationEditors in ConversationHow Can Clinical Microbiology Labs Contribute to Antimicrobial Stewardship? (JCM ed.)Deciding how extensively to work up and report respiratory cultures is the worst. There are useful guidelines on how to approach this. But, in my experience, very few laboratories strictly follow these guidelines. That can be because of concerns about under-reporting pathogens or about over-reporting microbiota, or it can be the result of pressure from clinical staff to report more organisms than the guidelines suggest. Today, we’ll be talking with two guests about their study on how over-reporting of organisms from respiratory tract cultures can lead to over treatment with antimicrobials. Guests: Dr. Sarah Parker, pe...2022-11-1942 minEditors in ConversationEditors in ConversationMachine Learning and Artificial Intelligence in the Clinical Microbiology Laboratory (JCM ed.)The idea of applying machine learning and digital pathology platforms to everyday workflows in the clinical microbiology laboratory has become increasing intriguing and appealing, especially as labs continue to optimize efficiency in the midst of workforce shortages. The promise of this new digital frontier is multifold, including decreasing turnaround time and potentially cost, and freeing up technologist time to focus on higher yield activities in the lab. Many labs have now taken the initial leap into automated culture and imaging systems, but what’s next? Are the digital pathology AI algorithms ready for prime-time in clinical microbiology labs? Is th...2022-10-0829 minEditors in ConversationEditors in ConversationHow Proposed Change to US Regulation Could Impact Clinical Microbiology LabsThere are a number of regulatory proposals under consideration which could have important effects on clinical microbiology labs, and clinical labs more generally. First, the VALID act would change how clinical tests are regulated with particularly important implications for laboratory-developed tests. Second, the Centers for Medicare and Medicaid Services has proposed changes to the educational requirements for lab directors under CLIA and additional changes that would increase the fees that clinical labs pay to CMS. If you have been waiting for someone to explain these changes and how they could affect your lab, you’ve come to the right po...2022-09-1651 minEditors in ConversationEditors in ConversationDiagnosis and Treatment of MonkeypoxAs July 26, the world has documented 19,188 cases of monkeypox, with 3,591 cases in the US alone, making the US the country with the most known infections amid the global outbreak. The WHO has declared monkeypox a public health emergency. Although this disease has been known for years, certain features suggest that we are facing a unique outbreak of monkeypox with the potential for worldwide spreading. In this special podcast edition of Editors in Conversation we will discuss the diagnosis and treatment of monkeypox with experts in the field who have dealt with significant number of cases in the...2022-08-0539 minEditors in ConversationEditors in ConversationDynamite Parasites, with Dr. Bobbi Pritt (JCM ed.)Dr. Bobbi Pritt aka @parasitegal, creator of the blog Creepy Dreadful Wonderful Parasites, is a pathologist and clinical microbiologist with specialty interests in parasitic and vector-borne infections, and the pathology of infectious diseases. Dr. Pritt discusses her career and how she became an expert in clinical parasitology, her work internationally and how others can participate in global health work and how technology (digital pathology, AI, automation, etc.) will affect the lab and technicians in the future. This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by J...2022-07-0223 minEditors in ConversationEditors in ConversationWhat’s New in Molecular Virology? (JCM ed.)We are just back from the Molecular Virology Workshop in West Palm Beach. This is a terrific meeting that is organized by the Pan-American Society for Clinical Virology or PASCV. The workshop immediately precedes the Clinical Virology Symposium that ASM organizes and many of us like to attend both. Today we’ll be talking about some of the high points of the Molecular Virology Workshop, with two members of the organizing committee from PASCV. Guests: Dr. Erin Graf, Director, Clinical Microbiology at Mayo Clinic in Phoenix Arizona. Dr. Stephanie Mitchell, Director of Medical Affairs at Cepheid. ...2022-05-2841 minEditors in ConversationEditors in ConversationPrevalence and Mortality Associated with Bloodstream Infections (JCM ed.)It is estimated that anywhere from 575,000 to 677,000 bloodstream infections occur annually in North America, with approximately 40,000 of those directly linked to patient mortality in the United States, making bloodstream infections the 11th most common cause of death in the US according to the Centers for Disease Control and Prevention. The detection of bloodstream infections and subsequent identification of the etiologic agent or agents is an essential role played by all clinical microbiology laboratories, day-in and day-out for routine patient care. So, today, we are going to dive into a recently published study in JCM, looking at organism-specific bloodstream infection...2022-04-2929 minEditors in ConversationEditors in ConversationMultiplex PCR for Predicting Antibiotic Susceptibility (JCM ed.)Antibiotic susceptibility testing is too slow. Faster identification of microorganisms is now common, as many laboratories use MALDI-TOF or molecular technologies for quick and definitive identification of bacteria. Improvements in susceptibility testing have lagged, as we continue to use tests that take a day for results, and which have not significantly changed in decades. Rapid phenotypic testing has can only be done on limited sample types, using a dedicated platform, and it has not been widely adopted. Tests for rapid genotypic testing usually include only a few genes and require confirmation by phenotypic testing. What are the prospects for...2022-03-1940 minEditors in ConversationEditors in ConversationCOVID-19 Associated Pulmonary Aspergillosis - The Other CAPA (JCM ed.)When most of us hear the word ‘CAPA’, these days we more than likely immediately start thinking about SARS-CoV-2 variants, trying to remember how important this particular one was in the grand scheme of the COVID-19 pandemic. But, that is not the ‘kappa’ we will be talking about today. Instead, we’ll be discussing the other CAPA, or COVID-19 Associated Pulmonary Aspergillosis, and we will cover a few areas on this topic, including: - Defining what CAPA is and how prevalent it is among ICU patients with COVID-19 - Discuss why identification of invasive aspergillosis in patient...2022-02-1846 minEditors in ConversationEditors in ConversationTesting for COVID-19 During the Age of Omicron (JCM ed.)In less than two months since it was discovered, the omicron variant of SARS-CoV-2 has become the dominant variant of the virus, causing an unprecedented rise in the number of cases of COVID-19 in the U.S. and elsewhere. The emergence of this variant has quickly led to some surprising claims about diagnostic testing for omicron and a renewed appreciation of the importance of sequencing the viral genome for typing purposes. We will address several questions about testing for omicron, including: • Are rapid antigen tests sensitive for detection of omicron? And should people swab their throats to in...2022-01-2150 minEditors in ConversationEditors in ConversationCOVID-19 Testing - Schools, False Positives, and In-Person Meetings (JCM ed.)Today we’re talking about testing in schools for COVID-19, and about recalls of SARS-CoV-2 tests due to false positive results, and, about whether we are ready to go to in-person scientific and medical meetings. Joining me for this roundtable discussion are two frequent guests on the podcast, Dr. Melissa Miller, from UNC School of Medicine, and Dr. Elli Theel, from Mayo Clinic. Links: School Testing for COVID-19. https://www.cp24.com/news/toronto-school-parents-set-up-diy-covid-19-surveillance-testing-program-1.5590772 and https://www.nytimes.com/2021/09/19/health/coronavirus-school-quarantine-testing.html False positive COVID-19 tests. https://www.nbcnews.com/news/us...2021-10-2245 minAnswers from the LabAnswers from the LabSerology Testing for COVID-19: Dr. Elitza TheelA discussion with Dr. Elli Theel, the Laboratory Director of the Infectious Diseases Serology Laboratory at Mayo Clinic, who led the efforts to evaluate and implement the antibody test for COVID-19. Topics covered include an overview of antibody testing, why Mayo is testing for IgG only, ordering scenarios, sensitivity and specificity of the Mayo test, a comparison with other serology test offerings, and what will be included with the test result.2020-04-2114 min