Assessing clinicians' and trainees' knowledge and practice of the IDSA guidelines for asymptomatic bacteriuria in older adults.

A survey of advanced practice clinicians (APCs), physicians, residents, and medical students at an academic medical center and community practices in southeastern Texas revealed a gap in knowledge and practice related to testing and treatment for asymptomatic bacteriuria (ASB) in older adults.

Diagnosis of Mycobacterium marinum Infection Based on Seroconversion of QuantiFERON-TB Gold Test.

Mycobacterium marinum is a slow-growing photochromatic acid fast bacilli (AFB). Following exposure of injured skin to fish tanks and other aquatic bodies, it usually causes indolent skin and soft tissue infections. Incubation period differs but it is generally long; hence, diagnosis is often missed leading to delay in treatment. Obtaining proper history along with histopathology and cultures leads to diagnosis. There is evidence of cross-reactivity of M. marinum with QuantiFERON-TB gold test. In patients without risk factors for tuberculosis, recent seroconversion may provide a clue to diagnosis and eliminate differentials. We present a case of M. marinum skin and soft tissue infection diagnosed based on seroconversion of QuantiFERON-TB gold test in an immunocompromised patient. This was confirmed by AFB culture after six weeks.

Treatment Experience With Inhaled Corticosteroids in Combination with Remdesivir and Dexamethasone Among COVID-19 Patients Admitted to a Rural Community Hospital: A Case Series.

Background Pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause severe inflammation of the lungs resulting in acute respiratory distress syndrome (ARDS). Current treatment guidelines support use of remdesivir as well as dexamethasone in hypoxic patients. There is very little information known about use of inhaled corticosteroids (ICS) in combination with the other two medications.  Methods and outcomes We report our experience among six coronavirus disease 2019 (COVID-19) patients who received ICS, remdesivir and dexamethasone for treatment as well as their outcomes. Data were obtained from retrospective chart review during a two-week period from July 8, 2020 to July 22, 2020. Five patients were treated successfully and discharged home. One patient expired. Conclusions This case series highlights the possible benefits of inhaled steroids in treatment of COVID-19 patients with hypoxia. Further randomized controlled studies are needed to assess inhaled corticosteroids as possible treatment either alone or in combination with systemic steroids for treating COVID-19 patients. Dose and optimal duration need to be studied and evaluated.