Let's Talk Micro
148: Bonus: Live from ASM Microbe 2024
[Music] Welcome to Lestock Micro! Hello everyone, welcome to a bonus episode of Lestock Micro. I hope you are doing well. As you know, we normally publish on Thursdays, but this is an extra episode regarding Microb 2024. And those of you in the Microbiology community and those of you that follow the podcast, you know, that last week Microb took place in Atlanta, and as I did in 2023, I recorded a live episode. So in this episode, I talk about my experiences, you know, I was involved in two events, one of them was Battle of the Brains, and the second one was I'm in-depth in posting about Subbactam, Doodlebactam, so I talk about my experiences with both of those. And I also talk about what I did, of course, you know, I attended a podcast and I went over to some posters and I talked to people, so I talk about the posters that I liked, and one of the things that I saw this year was AI, of course, so with the use of gram stains and reading cultures and things like that. So, of course, I had a great time in Microb, and I hope to attend next year, so I hope you enjoyed this episode, and of course, you know, if you have anything to share any posters that you like, any talks that you like, please, you know, send that feedback via social media via emails. So I hope you enjoyed this episode, and as I said, had a great time at Microb, I met some great people, it's always great to meet listeners, so thank you so much for the support. So let's go ahead and listen to this episode, and of course, on Thursday, we have a regular episode of Lestock Micro. Hi, everyone, this is Louis Plaza from the Lestock Microb podcast, recording live from ASM Microb 2024. I am recording this on Sunday, June 16th. We're live from the Georgia Convention Center. At this point in time, pretty much the podcast, the podcast, at this time, pretty much the event is kind of over with some conferences, the exception of some late conferences, and there's going to be some events on Monday morning, but all the exhibitions and all the posters have been completed by this time. As always, I am happy to be here with you, and just like I did last year, I just wanted to take a few, you know, take some time and go ahead and talk about my experiences at ASM. So as you, those of you that are tuning in, so ASM Microb, it has an animal event, and this is just the largest meeting of microb allergies, and it takes place on different locations. Last year, it was in Houston, Texas, this year in Atlanta, Georgia. As always, you know, Thursday was great, great reception, and then on Friday, one big difference from last year, as I kept mentioning on previous episodes of the podcast, this year I actually participated in two events. Last year, I was attending for the first time, and I didn't participate in anything, but I just listened to some great talks, met some great people, saw some great posters, and this year was no exception. One thing that those of you that have attended microb before, you know, that there's a lot of events, a lot of things to do, so you really have to stay organized, and there's an app for that, so you can pick events, but the reality is that you're going to miss a lot of events, because there's no time to do them all. But having said that, there's always a little bit of something for everyone, so you can kind of pick and choose what you want to do, maybe you want to talk to vendors, maybe you want to see posters, maybe you want, maybe there's that one conference that you really want to attend or a couple, and then you pick those and attend, and the rest of the time, it's always great to network and connect with people. So my event on Friday was the Battle of the Brains, and this is an event that's been around for a while, from what I understand, and then just basically you get some teams of about four team members, and they can be composed from different areas of the microbiology realm, let's say, for example, my team was the microbiology influencers, composed by some, what I call A-listers, right, this is like for me, someone that has worked in the bench, let's say, for a long time, getting to be on a team with these individuals, it was a pleasure, it felt like a Hollywood moment, let's say, being surrounded by so many A-listers, so we have Dr. Diana Hernandez from the industry, we had Dr. Bobby Priton, our team, very known parasitologists from the Mayo Clinic, also she has that blog, that a creepy wonderful parasites, and maybe some of you that do parasitology, maybe follow her, but she's definitely very known and respected in the microbiology community, and then there was also Rich Davis, the director at a hospital in Washington State, so that was my team, and then we competed against other teams, which was two other teams, the reference lab, and then there was also the public health lab, and you get to choose the theme, and you can wear shirts of any sort of costume that you want, to kind of, you know, just create like that team atmosphere, in our case, we had shirts, and we walked to music, I really love that I have to say that the questions are high level, but if I'm, if I have the opportunity of getting invited again, some point in time, you know, A, I will happily accept, and B, I would, now I know what kind of questions they can ask, so maybe, you know, sit down and maybe do a little review, and maybe pay a little more attention to things that are going on, let's say media, like social media, and any publications that are taking place, so, but at least, you know, like I said, now I know what questions to look for, but overall, it was great, you know, we played second place, I really enjoyed it, it can be anything from questions like from parasitology, from mycology and bacteriology, those of you that follow the podcast from the American study from microbiology, there's one called the editors in conversation with Ellie Theo, and Alex McAdams, definitely a very known podcast, so they got to ask some questions, but it's just basically, you sit down when I go over about 22 questions, you answer them, so with three teams, the winner from each round got to participate in the final round, and that's why we place second place, overall, definitely grateful for the opportunity, oh, and of course, you know, my team, the wonderful microbiologist and co-host of the AMR series, Dr. Andrea Princey, but she was the alternate, so she didn't get to participate, but definitely still part of the team, you know, and just lovely and I always get a chance to see her at this event, and you know, see her in person and connect, so that's always good, so overall, very happy with this event, so of course, right, you cannot, I cannot be, I'm a podcaster, I cannot be at ASM micro without listening to some podcasts, they always do some live recordings, which they will post in a lot of time, but I definitely invite you to check out the ASM website, they have a definitely a wide variety of podcasts if you haven't listened to them, but I'm sure you have, since they're very popular, they've been around for a long time and they do well, so you know, you have that whole series this week in microbiology, this week in biology, this week in barostism, editors in conversation, meet the microbiologist, micro talk, so overall, a lot of podcasts, when I attend micro, I definitely listen, last year I listened to one taping of it, and then this year I actually got to listen to two of them, that was definitely very neat, so one of them was, that I attended was meet the microbiologist where they invited Dr. Nicole Dublier, and she is the director of symbiosis department of the Max Planck Institute for marine microbiologists, so she's a marine microbiologist, right, definitely, it seems like a whole different world, that clinical microbiology, I have a chance if you want to learn a little bit more about marine microbiology, check out the episode that I did with Dr. Ocean, so she talked about her expeditions and research, it was definitely a very interesting episode, and then I also attended an episode of this week in microbiology, and the topic was could fungal pathogens outsmart us, and it was basically talking about how something like, right, like the last of us in core decepts, you know, this was something that was actually, you know, realistic, so they discussed that, it was just very interesting, of course, as you know, I did an episode about core decept with under respect, so I definitely invite you to check that one out if you haven't already, and the guess in this week of microbiology was another that Dr. Arturo Cassadevall, which is a distinguished professor, a molecular microbiology in immunology, and he's also a published author, he definitely was discussing that, it's always very interesting, right, and it just makes us think, we see this episode, it's about a fungus to say taking over, and maybe those of you that are microbiologists, you see, like typically we don't get a lot of infections with a fungal pathogens, unless we're maybe immunocompromised, and the temperature factor, right, that there's a different temperature where they thrive, so, but if those gaps were closed, let's say, could that happen? So it was very interesting listening to that, so I definitely invite you to check out that episode when it comes out, so you can get more information and detail, you know, that will be good. So I got my fix of podcast that day, and that's always great, so it's always some great posters that I saw, and I just wanted to just, you know, mention a few of them that I looked at, very interesting, and one of them was titled analysis of drug-resistant bacteria detected in students of the Department of Clinical Laboratory Science, this is from Tokyo University, authors, and I don't want to butcher the names, but Mitsuru, Matsumura, S. Kurosu, M. Azahara, and Jay Sasaki, from the Tokyo University of Tokyo, Japan, so it was very interesting, you know, they tested some rectal swabs from third-year students at the Department of Clinical Laboratory Science at take university in 2022, and then of all the bacteria strains isolated from the swab samples, they targeted two suspected of producing ESBL for bacterial identification, and they discussed their results, and, you know, they did ESBL testing, and, you know, they do some further testing, and they determined the ESBL genotype, so it revealed that have the resistant genes of the CTXM9 group. Another one very interesting was the isolation and identification of antibiotic-producing bacteria in New Jersey soil samples, and the author for this was Diana Malinkova from Seton Hall University. One topic that I saw in this meeting was that, you know, AI, right, we're definitely hearing more and more about AI and its potential applications in the laboratory, and one of them was from Dr. Kendall Bryant, who's from Vanderbilt University in Tennessee, and his talk was titled Picture Perfect Plate Reading Grant, nowadays, you know, right, we have automated instrumentation that does plating, plating, right, you know, you think like the BD Kistra, where pictures are taken, and, you know, there's an incubator, you know, the setup is done by the instrument, and then you kind of, the positives are flagged, and pictures are taken, and you look at those, and then from there, you know, do proper testing, but he was mentioning using those those instruments, and then building some algorithms where you can, they can kind of like start, you know, identifying the colonies and doing the testing, doing identification, and doing a ST, you know, like maximizing the amount of work that AI can do, and then maybe leaving some cultures that maybe the algorithm doesn't fit, and those will have to fully work up manually, right, so that definitely is something that's, it makes us think, I mean, they can always be the worry, right, if eventually AI will replace us, but definitely we still need people to operate instruments, and, but that's, at the same time, I mean, it brings us the question in mind that, that maybe, we need to do something to alleviate some of the work, right, I think a centralized microbiology laboratories increase more and more, it is definitely the volume increases, right, so, so, and then you have things like people burning out fatigue over work, and this is something that I discussed in the podcast before, that you get, you know, the training is not the same in the lab for, for as it is in, it is not the same in the microbiology lab, as it is in all the areas, for example, like in hematology, chemistry, maybe blood bag, and I mentioned this before, right, so if you're in hematology, you work your hours and say you work first shift, and then someone from second shift has the same training as you take them in, they take over, right, there's like a, maybe like a typical scenario, there's a 30 minute overlap, and then you do your pending log to say, or whatever you have to troubleshoot and fix, and then you're gone, but as, as maybe some of you that work in the the microbiology lab, you might be able to identify with this, but in the lab, you know, micro lab, you come in first shift, you work in the wound bench, and there's no one, maybe even in first shift, there's not that many people trained, they can read that particular bench, I mean, they can, they can help out with bite tick, or doing moldy-tough, or things like that, you know, they can help out with setting identification on sub-tabilities, I mean, I mentioned the bite tick, because I work with it, and it's not an endorsement, but any other instrumentation, but you're basically stuck with that number of cultures, right, so that's something that, that you have to finish it, so let's say we have 60 cultures, or 80 cultures, that day you have to finish them all, and that can leave some very long days, right, I think it's very common knowledge that microbiologists in the lab, this is never an eight-hour day, right, it's always 10, so that's one big difference from other areas, so maybe at the very least something have to be done, I don't know how AI is gonna factor into this, and I'm gonna talk about AI with gram stains, which is very cool, but with this, like, you know, picking the colonies, and doing sub-tability, and anyway, at some point in time, and I would like to definitely talk more about this, maybe something can be done to alleviate some of that, I mean, that will be helpful in my opinion, but like a fully automated thing like that, that's probably far away, but who knows, but definitely one thing when it comes to that, you know, AI, and reading plays is that one point that Dr. Bryant brought up was that when it comes to working things up in the lab, let's say a lot of labs do things differently, right, there's always some variation, you typically follow the ASM guidelines, but there might be a little variation here and there, and you go to one place and there's do something different, right, now everyone, some procedures that might be older, some other places might be using it, so coming up in an algorithm, algorithm might be something challenging, I will say, and have to be custom-made for that particular facility, so that's something to think about, so in the, continuing the line about from Dr. Bryant's talk, there was a very interesting topic about what they used at GPT, and just basically there were some pictures of gram stains, and then they were trying to jab chat DPT and then eventually seeing how the responses were, and that was definitely very interesting, I mean, I think overall there's definitely a room for improvement, but definitely it shows how, how AI's been starting to being applied in the lab, I mean, I know that I did an episode previously where an AI algorithm was used for reading parasitology slides, right, so that was something that definitely helped because it reduces the amount of time that those texts are looking at negative, that's a big thing at least here in the United States, where parasite infections are not as prevalent as other parts of the world, so a lot of the samples tend to be negative, so that can lead to text sifting over stuff over and over again, and that can be, you know, that can be challenging because you get tired, Lisa burned out, and it's not fun sitting and looking at a microscope for eight hours, right, might get a headache or get cross-eyed, and definitely challenging, so that was something interesting, but that was a recurrent team, I also saw another poster where they kind of implemented AI to read some, some gram stains, you know, and the poster with chat GPT was just circling back real quick, it was called evaluation of open source artificial intelligence platform for reading of microbiology smears, and this is from George Washington University, author of CM WhatsApp, so that was definitely very interesting, and then I also saw some other posters about that doing some, right, you already have kind of like systems like this when it comes to hematology, where it takes pictures of the slides, and so implementing AI, perhaps one of the things that they can, and some of the results that I was looking at was that you could see maybe that they detected more organisms, and especially those that are in their rare area, and that sometimes, you know, they might get missed by a person, and those of you that read, read gram stains, you know, that in read cultures, you know, a lot of times they don't match with the culture, so you're going in and you see three plus GPC, and okay, you have staff warriors, two plus GNR, and then or, or you see NOS, and then you have a full growth of the plate, so that's definitely something that we have to work on, and perhaps different training, I mean, it is challenging when you're in a large facility and you're reading 40 grams stains, so that's something to think about, but a lot of times, you know, they don't match, so maybe with that system, and that's something that I will definitely learn more about, and I will bring more information to you in the podcast about AI and gram stains and see how what other places are doing, because this is something that definitely, when it comes to that, you know, gram stains can be definitely labor intensive, and if they can have something to alleviate that, maybe you can have that tech, you know, you have someone monitoring the pictures and seeing things, and it might make things a little bit easier. Maybe you can maximize the use of that, of them microbiology is to do other, other types of testing, rather than having someone sitting there, reading gram stains all day. Other, you know, I saw a poster of note, and I'm not gonna mention it because it hasn't been published yet, but it was very interesting, it was very interesting about novel, a novel species that was discovered, and, and, and that's always, you know, very cool. As you know, I did an episode about that, which was episode 126, talking very vorax, dura verdonensis. So it's always fascinating when we see novel species being discovered, and that, that was a poster that I saw, I mean, especially now, when both start doing whole genome sequencing, and if you get a lot of volume, and maybe you can discover a novel organism, so that's very fascinating, fascinating. So stay tuned with that. I will definitely be working on an episode about that in the future, because that's definitely something very interesting. Another poster that I saw was about doing automated, automated, this diffusion reading, and then comparing it to manual reading. As you know, that's something that some it's a little labor intensive, it can be. If you're doing if your step to testing, I mean, the setup is not bad, but if you have a lot, the reading of them can be, you know, time consuming, because you can fit many disks in one plate, and then you have to read one by one. So maybe if, and I know that there are some places that that's their method of susceptibility. But hopefully for that, you kind of have to have the staffing and the work setup. So to read that, that was for something very interesting. And today, I saw some interesting posters about evaluating some different break points. And I'm just gonna go over some general terms here, but as you know, the CLSI M45, which is the one for fastest organisms, that you can find information on Carnivacterium, lactosellas, bacillus, pastrella, and organisms like that, it hasn't been updated in quite a while. So last update was in 2016. I saw some posters regarding trying to update some break points. So that was definitely very cool. And of course, I am not going to go into much detail because some of these items they haven't been published yet. So I'm just gonna leave it on general terms. But I saw some of that. And those of you that know, when it comes to a lot of these organisms, sometimes you don't have enough data, let's say for example, the non-fermenting, or when you go to the CLSI, the non-enterobacteralis, they don't have, there's no data on this diffusion. There's only MICs because there's some more information. So when you do testing on those, you have to do gradient strips or some other method to get MICs, you don't have any data on disk. So that's something that can be challenging. And also, since it hasn't been updated since 2016, maybe we need to see how much that information has changed, right, how those break points have changed. I mean, you get the CLSI in 100 that it gets evaluated yearly, right, there's constant changes to it. So that's something that, but there's always great people working on that. So I'm just gonna leave it on very general terms because some of these things that I noticed, they haven't been published yet. So out of respect for that, I'm just gonna leave it like that. Anyway, what I have to say is, I really enjoy the posters. You know, there are so many, I wish that there was more time to see them, but great, great content. And all I can tell you is that out of some of these posters, I'm gonna be making some upcoming episodes. So stay tuned. I don't know when specifically, but I am, I am gonna be very rich out to people. I'm gonna try to bring some content to you of that. This year, I kind of attended list talks that I did last year because I was really trying to connect, right? So I'm trying to let people know that the list of micro podcasts out there, that is a source that you can use it. So I definitely talk to people, you know, get handed out stickers information about list of micro. And the coolest thing that always for me is that I get to meet people that listen to the podcast. And this time, I met more, more than last year. And I'm very grateful for that. So if you're listening to this, thank you so much for the support. This means a lot. I'm doing this to bring more information to that we can all grow as a microbiologist. And you can have something in one place that you can access that you can, that it can be easy to understand. And, and doing this is very fulfilling to me. So I'm happy that people are listening to it and meeting someone and they tell you, Hey, you know, I listen to it. I like it. It's helped me a lot. That's always very rewarding. Right. I love doing this. So I appreciate your support. And of course, I had a second event, which was my abstract that got accepted, you know, as I mentioned, and I talked about this on social media, but my employer has no relationship with the podcast. But we did a study, basically, where we evaluated, we'll back them the low back them, which is a drug that it is used to treat. What is called crab caropanin-resistant acidobacter bromaniii isolates. It was approved by the FDA last year. And now it's ready for use. And so we compare that against stuffy derocal. Another agent that's used to treat on the multi drug resistant isolates. One of them being caropanin-resistant acidobacter bromaniii, and we compare that. So we did. So back them, they're low back them, compare it against stuffy derocal, and also as synergy of ampicinin, so back them and seftasticity of the back them. And with the results, so back them, they're low back them ended up being the superior agent. So it didn't hire that. And with the numbers, you know, stuffy derocal wasn't the 60th percent. And then slow back them, the low back them wasn't the 80, 80-ish percent. So it was definitely higher and it did better. So as you know, asking the doctor bromaniii, it's a very resistant organism definition. It can be very resistant and caropanin-resistant, asking the doctor bromaniii is defined as being resistant to most antimicrobials, including the caropanins. This is a very serious infection, serious organism, because, you know, it can be recovered in hospital equipment. And as you know, this is something that is trending, that is normal with non-fermenting from negative rods. That's a big across the board kind of. A lot of the organisms are, they tend to survive hospital equipment. But it was great. It was a great feeling, you know, standing there and sharing, you know, my abstract about that. And of course, my employer has no relationship, like I said, but it was, we got a lot of stuff accepted. So I'm very proud of my team at Advent Health, Orlando, that we're definitely doing a lot of great things on the direction of our director, Dr. Alexander. So shout out to everyone. So definitely, we're keeping up the good work. We got to show all the cool things that we're doing to help in patient care. So I'm very happy about that. And that my audience is the end of the live episode. As always, you know, I'm very, I'm always happy to talk with you and share some information with you. I enjoy this event again, another wonderful microbe. So I'm looking forward to the next one. So in the meantime, continue bringing that passion to what you do. It's so important. You do such great work. And remember, as always, stay motivated, stay safe. And of course, continue talking micro until the next time. Bye.