USF Health’s IDPodcasts

Dr. Todd Wills, Professor of Medicine with the Morsani College of Medicine at the University of South Florida, reviews the unique complications and issues that can occur in the elderly HIV patient. Dr. Wills begins by reviewing the epidemiology of HIV by age group, including the fact that the HIV positive population is growing older with time. Dr. Wills also discusses issues regarding polypharmacy and medication tolerability in the older patient. Next, the speaker relates how the high prevalence of chronic diseases affect the HIV positive patient’s prognosis. HIV positive elderly patients can suffer not just from frailty, but from cardiovascular disease, diabetes, osteoporosis, and cancer. Dementia can also affect an elderly HIV paitent’s overall wellness and compliance with antiviral therapy. Dr. Wills also covers the assessment of bone density in elderly HIV positive patients. Lastly, Dr. Wills discusses HIV positive patient life expectancy in the modern age of antiretroviral therapy. The lecture is updated for 2024.

Dr. Sung Soo Kim, ID clinical pharmacist, presents a talk on the spectrum of HIV therapy and ART (Antiretroviral Therapy)-related adverse drug interactions. Dr. Kim begins by describing the mechanisms by which HIV therapy-related adverse drug interactions occur. Next, he discusses the various classes of antiretrovirals and their specific drug interactions, including integrate inhibitors, NNRTIs, NRTIS, and Protease Inhibitors. Dr. Kim closes by discussing the consequences of unmanaged drug-drug interactions in patients on ARTs as well as the available drug-drug interaction resources available to the clinician.

Dr. Olga Klinkova covers essential information regarding the management of infectious complications of hematologic malignancies. Topics covered include the initial evaluation of patients, neutropenic fever, neutropenic enterocolitis, and antimicrobial prophylaxis. Next, Dr. Baluch discusses ID management of stem cell transplants, CAR-T therapy, and when it is necessary to administer antimicrobial prophylaxis in these patients. The lecture is updated as of 2024.

Dr. Richard Oehler, Professor of Medicine at the Division of Infectious Diseases at the University of South Florida Morsani College of Medicine, presents a review of bacteremia. Dr. Oehler begins by reviewing the epidemiology, personal and institutional costs of bacteremia. He then discusses blood culture collection and how false positive blood cultures occur. With the recent blood culture bottle shortage of 2024, he emphasizes the new concept of “blood culture stewardship”–when it is most appropriate to order a blood culture versus when it may be unnecessary. Next, Dr. Oehler reviews automated blood culture systems and other related identification technology, with a focus on new methods of blood culture isolate identification such as multiplex PCR and Maldi-TOF. The speaker then contrasts gram positive and gram negative bacteremia in general and by organism. The management of a positive blood culture with regard to treatment and source control is discussed. Lastly, ways to reduce the incidence of bacteremia are shared.

Dr. Jackie Sherbuk, Assistant Professor of Medicine at the USF Morsani College of Medicine, presents this case-based review of the opportunistic infectious syndromes associated with HIV-AIDS. The speaker covers PJP prophylaxis and treatment, HIV pulmonary disease, and cryptococcal meningitis. Dr. Sherbuk also discusses IRIS (Immune Response Inflammatory Syndrome) and its effect on the AIDS patient when antiretrovirals are started. Lastly, Dr. Sherbuk covers HIV esophageal disorders, Histoplasmosis, Coccidioidomycosis, and Mycobacterium avian-complex-related syndromes.

Dr. Jackie Sherbuk, Assistant Professor of Medicine at the Morsani College of Medicine Division of Infectious Diseases, presents this case-based review of the use of antiretroviral therapy in HIV/AIDS patients. Dr. Sherbuk begins by reviewing and available antireturovial options, including those that are considered first line. She also covers the use of antiretrovirals in special groups, including expectant mothers, elite controllers, treatment experienced patients, HBV/HIV connected patients, and patients with chronic renal insufficiency. Lastly, Dr. Sherbuk discusses the nuances of using co-formulated combinations of antiretrovirals and mentions the newer long-acting injectable preparations.

Dr. Jamie Morano, Infectious Diseases and HIV Specialist with the University of South Florida College of medicine, presents an overview of the diagnosis and management of HIV infection. Part of USF ID’s Basics of HIV Management Review Series.

Pharmacotherapy specialist Kristin Zeitler, PharmD, from Tampa General Hospital in Tampa, FL, presents this talk on the basics of antimicrobial therapy management for hospital patients. Dr. Zeitler begins by emphasizing the important of the ID clinical pharmacist. She then compares and contrasts Pharmacokinetics (PK) , the way drugs move through the body, with Pharmacodynamics (PD), the relationship between serum drug concentration and the therapeutic/toxic effects of the drug. PK/PD effects of antimicrobials are then further explored. Dr. Zeitler goes on to discuss Vancomycin dosing strategies, the effects of serum albumin on serum antimicrobial drug levels, drug penetration into the site of interest, drug dosing strategies for patients with renal insufficiency, and the effects of obesity and critical illness on antimicrobial dosing strategies.

Dr. Shylah Moore-Pardo, Infectious Diseases clinician and Assistant Professor at the University of South Florida, reviews antiretroviral initiation in HIV positive patients. In a case-based format, Dr. Pardo begins by discussing the interpretation of HIV test results. Next, she highlights several unique positive test scenarios. Dr. Pardo then reviews the characteristic serological patterns of acute HIV infection. The impact of False Positive HIV testing is also explained. Also covered are patients known as elite-controllers and long-term non-progressers who are more tolerant of HIV infection. Dr. Pardo then goes on to describe essential components of the initial HIV positive patient encounter. She then relates recommended test and treat strategies compatible with current guidelines. Lastly, she covers the next steps in management for future patient visits.

Dr. Jose Montero, Medical Director of the Antibiotic Stewardship Program at Tampa General Hospital, presents a basic review of the use of antibiotics in infectious diseases for 2024. Dr. Montero reviews the different classes of antibiotics used in the hospital setting. He then covers each agent’s mechanisms of action, spectrum of activity and common indications. He also mentions the most common adverse reactions associated with antibiotic agents. Classes of agents covered include the penicillin agents, cephalosporins, carbapenems, fluoroquinolones, macrolides, aminoglycosides, glycopeptides, oxazolidinones, glycylcyclines, and beta-lactam-beta-lactamase inhibitor combinations. Lastly, Dr. Montero reviews emerging new agents on the horizon.

Melissa Albert, Infectious Diseases Pharmacist at the James A Haley Veterans Hospital, discusses the recent new literature regarding changes in the clinical breakpoints. Utilizing clinical cases, Dr. Albert demonstrates how to interpret antimicrobial susceptibility reports as well as how to design a patient-centered treatment regimen. Dr. Albert also discusses inducible AmpC-E resistance and how specific breakpoints have been changed for Aminoglycosides. From a lecture originally presented in March 2024.

Dr. Shylah Moore-Pardo, Assistant Professor with the Division of Infectious Diseases and International Medicine, reviews the basics regarding vaccinations in the HIV-positive population. Dr. Pardo first reviews routine immunizations, such as Influenza, Tetanus, and COVID-19. She then covers risk specific vaccines, such as shots for Hepatitis B and C, meningococcus, and Mpox. Next, Dr. Pardo discusses routine vaccines indicated based upon one’s age, including Shingles, HPV, and pneumococcus. She then reviews non-routine vaccines given as indicated (Rabies, Men-B, Travel vaccines, etc.). Lastly, in a question and answer format, Dr. Pardo goes over common vaccine-oriented board questions and provides explanations and context as to the answers to those questions. From a lecture originally presented in January 2024.

Dr. Lauren Rybolt, Infectious Diseases Fellow at the Division of Infectious Diseases, Morsani College of Medicine, discusses the ways that climate change is expected to alter the infectious diseases landscape. Dr. Rybolt begins her talk with the discussion of vector-borne diseases, and then goes on to discuss zoonotic infections, water-borne diseases, habitat changes, and natural disaster impacts. Lastly, Dr. Rybolt completes her talk by sharing information on climate change solutions and adaptations.

Dr. Guy Handley, Assistant Professor of Medicine with the Division of Infectious Diseases, USF Morsani College of Medicine, provides an overview of Human Herpesvirus 6 in Stem Cell Transplant Patients. Dr. Handley uses clinical cases to describe several scenarios related to HHV6 infection. Topics discussed include background, HHV6 latency, reactivation, clinical presentation, encephalitis, treatment strategies, and outcomes. Guidelines for HHV care are also discussed. Dr. Handley closes by discussing controversies and future directions in HHV6 management.

In a lively case-based format, Dr. Jackie Sherbuk, Assistant Professor of Medicine at the Division of Infectious Diseases, Moroni College of Medicine at USF, reviews important opportunistic infections (OI’s) in HIV/AIDS patients. Included in the talk, Dr. Sherbuk discusses effective timing of antiretrovirals in the setting of an opportunistic infection. She addresses HIV associated pulmonary disease, cerebral Toxoplasmosis, Cryptococcosis, esophageal candidiasis, cryptosporidiosis, Mycobacterium Avian Complex, and Histoplasmosis. Immune Reconstitution Inflammatory Syndrome (IRIS) is also discussed as a phenomenon when antiretroviral therapy is started in the setting of an OI.

Dr. Jamie Morano, Professor of Medicine at the Division of Infectious Diseases, USF Morsani College of Medicine, reviews the epidemiology of Tuberculosis and its relationship to Human Immunodeficiency Virus infection. Topics discussed include TB trends in the US, factors contributing to an increase in TB morbidity, tuberculosis transmission, TB screening, and progression to active disease. Next, Dr. Morano outlines the relationship between tuberculosis and HIV infection. She also presents pearls on the use of antiretrovirals in active TB treatment and how to utilize TB meds in patients who are on antiretrovirals.

Dr Guy Handley, Assistant Professor of Medicine at the Division of Infectious Diseases, Morsani College of Medicine, discusses the Clinical manifestations of Pneumocystis Jirovecii infections in a question and answer format. Dr. Handley begins the talk by giving an overview of Pneumocystis, including its history and taxonomy. He then discusses the typical presentation when it causes pneumonia (PCP), the most likely clinical manifestation. Dr. Handley then covers PCP treatment, including the most commonly used therapy (trimethoprim-sulfamethoxasole) and other alternatives. Next, diagnostic testing is discussed, including the use of the 1,3 Beta-Gucan test. Lastly, the use of Echinocandins for the treatment of PCP pneumonia is covered.

Jessica Kennedy, MD, Infectious Diseases Fellow at the University of South Florida Division of Infectious Diseases, discusses the scientific basics around many of the primary Infectious Diseases tests ordered by providers. Dr. Kennedy discusses the scientific basis for EIA/ELIZA, Quantiferon, chemiluminant immunoassays, lateral flow assays, RT-PCR, Fungitell, and LC/MS-MS. In explaining these diagnostic assays, Dr. Kennedy helps the provider understand the limitations and advantages of each test and when they are best used in a clinical scenario.

Dr. Arun Sunny, Infectious Diseases Senior Fellow at the University of South Florida Division of Infectious Diseases, presents a second overview of the current infectious diseases literature focusing on studies that may influence your medical practice. Dr. Sunny focuses on the areas of climate change, prophylaxis, antimicrobial stewardship, and the use of AI (Artificial Intelligence) in medicine. From a talk originally presented in February, 2024.

Dr. John Sia, Infectious Diseases Fellow at the University of South Florida Morsani College of Medicine, looks at the field of Infectious Diseases Medicine, and its prospects for continued success in recruitment and the economics of practice. Dr. Sia looks at some of the challenges for the infectious Diseases clinician, what ID needs to do to continue to attract some of the brightest and most talented medical professionals to the field, and how ID continues to be one of the most satisfying and rewarding of all the medical subspecialties. Dr. Sia also shares some of the reasons he chose Infectious Diseases as part of his own personal journey.