Heteroresistance is a phenomenon that has been well characterized for many years. However, we are only now starting to understand its mechanistic basis. Indeed, the manner how bacteria respond to antibiotics is complex and phenomena such as persistance, tolerance may be overlapping with heteroresistance. Furthermore, heteroresistance seems to be common in real clinical scenarios and understanding its basis is likely to open new avenues on how we deploy antibacterials in clinical practice., Today, we have experts in the field to discuss this important topic.

Watch this episode at https://youtu.be/qcIcyn1bIHU.

• The differences between heteroresistance, persistence and tolerance
• The mechanistic basis both in Gram-positive and Gram-negative bacteria
• The clinical implication and diagnosis of heteroresistance

• David Weiss, Ph.D. Professor of Medicine and Director Center for Antimicrobial Resistance, Emory University School Of Medicine, Atlanta. GA.
• William Miller, MD. Assistant Professor of Medicine, Houston Methodist, Houston, TX and Weill Cornell Medical College, New York, NY.

• Cefiderocol heteroresistance associated with mutations in TonB-dependent receptor genes in Pseudomonas aeruginosa of clinical origin

This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal.

Visit asm.org/aac to browse issues and/or submit a manuscript. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/joinasm to sign up.

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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.

• 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 Berry discusses a recent case in Oregon, its transmission through cats, and the historical context of the plague.
• Measles: The resurgence of measles in the U.S. is addressed, with Dr. Pinsky noting an increase in cases compared to previous years and emphasizing the importance of vaccination.
• Malaria: The episode covers recent cases of locally acquired malaria in the U.S. and discusses the history of malaria in America.
• Neosporin and Viral Infections: The hosts examine a study suggesting Neosporin might prevent viral infections and discuss the implications and practicality of this claim.

• Dr. Ben Pinsky
• Dr. Greg Berry

• Join ASM for up to 50% off the publication fees when you publish in JCM or any of the ASM journals.

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro.

Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

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The pipeline of antibiotic discovery is a major necessity due to the continuous evolution of resistance to currently used antimicrobials. This pipeline faces important challenges due to the lack of investment on antimicrobial research in the private sector and an economic model that discourages investment. In the last few years, however, encouraging signs are occurring but major gaps still remain. The World Health Organization has regularly assessed the preclinical and clinical antibacterial development pipeline and the latest report is now available in the journal, lets discuss it!

Watch this episode: https://youtu.be/IgqWmHDIx-0

• The process for review of the antibacterial pipeline.
• The progress and gaps in antibiotic discovery
• The opportunities to overcome the numerous hurdles in the early stages of the antibacterial research and development space

• Valeria Gigante Ph.D., Team Lead at the World Health Organization's (WHO) in the AMR Division, Geneva, Switzerland.

• Multi-year analysis of the global preclinical antibacterial pipeline: trends and gaps.

This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up.

Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

The 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 susceptibility results and can we improve on this analysis using new methods?
• Finally, what is the long-term potential for leveraging laboratory data and other clinical data to improve and support clinical decision making? And what needs to happen to realize this goal?

• Dr. Sanjat Kanjilal (twitter/𝕏)

The modern alchemy of clinical pathology: turning the output of microbiology laboratory operations into gold

• Join ASM for up to 50% off the publication fees when you publish in JCM or any of the ASM journals.
• Watch this episode: youtu.be/rWuQ0nSWL1Y

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro.

Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

Antimicrobial resistance is a priority public health problem with complex roots and connotations. However, due to a lack of focus on this topic, research training programs, specifically those focused on AMR are limited. Additionally, scientific meetings that particularly highlight the science of antimicrobial resistance are scarce. We recently published a commentary that evaluates the state-of-the-art of the training programs in AMR in the US. We discuss this topic with the leading author and discussed the issue with leaders in the field.

• The challenges that training in AMR poses and how to approach them.
• The current status of training programs in the USA
• Specific strategies that could improve the access and dissemination of AMR research

• William M Shafer, PhD, Professor, Department of Microbiology and Immunology; Director
  Antimicrobial Resistance and Therapeutic Discovery Training Program.
• Lee H. Harrison, M.D. Professor of Medicine and Epidemiology, Associate chief of epidemiology and education Division of Infectious Diseases, University of Pittsburgh School of Medicine. Director University of Pittsburgh Antimicrobial Resistance T32 Program

• Ensuring a sustained workforce to combat antibiotic resistance in the 21st century: the critical need for training the next-gen of scientists at the pre-doctoral level

This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up.

Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

Rhodococcus 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 with clinical disease
• What is the recommended approach to susceptibility testing for Rhodococcus and what sorts of susceptibility trends do we see at both the genus and species levels
• And also, of course, we’re going to talk about the clinical manifestations and outcomes of clinically significant Rhodococcus infections

• Adi S. Shah, M.B.B.S., Mayo Clinic
• Nancy L. Wengenack, Ph.D., Mayo Clinic

Rhodococcus infection: a 10-year retrospective analysis of clinical experience and antimicrobial susceptibility profile | Journal of Clinical Microbiology

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro.

Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

Follow JCM on Twitter via @JClinMicro

Phage therapy has gained a lot of traction but the challenges created by this approach have not been properly assessed at a big scale. We often read about therapy successes on isolated cases but, rarely, we read or hear about failures. AAC recently published a case series of patients who failed phage therapy. Today, we will discuss this topic with the principal investigator on the research.

• Phage therapy as an approach for MDR bacteria.
• The challenges of phage therapies.
• Issues that can influence the success of phage therapy

• Saima Aslam, MBBS. Director, Solid Organ Transplant Infectious Diseases Service, Professor of Medicine, University of California, San Diego.

Pseudomonas aeruginosa ventricular assist device infections: findings from ineffective phage therapies in five cases https://journals.asm.org/doi/10.1128/aac.01728-23

• How are we doing with phage therapy at this point?
• What are the challenges to deploy phage therapy in clinical settings?
• The 5 cases of failure of phage therapy in patients with LVADs summarized
• What factors did Dr. Aslam identify that were related with the failure?
• How do you develop neutralization against phages and how can you prevent it?
• Bacterial isolates with varying phage susceptibility, how can this be detected?
• What did Dr. Aslam learn?
• Future research

This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up.

Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

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?

• Dr. Abhishek Mewara - Additional Professor in the Department of Medical Parasitology at the Postgraduate Institute of Medical Education and Research in Chandigarh, India.
• Dr. Bobbi Pritt - Chair of the Division of Clinical Microbiology and Professor of Laboratory Medicine and Pathology at Mayo Clinic.

“Lophomonas as a respiratory pathogen—jumping the gun,” by Abhishek Mewara, Gillian H. Gile, Blaine Mathison, Huan Zhao, Bobbi Pritt, and Richard S. Bradbury (https://journals.asm.org/doi/10.1128/jcm.00845-23).

This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro.

Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript.

Follow JCM on Twitter via @JClinMicro