Communicable

Communicable is launching a new series on everything related to pharmacokinetics (PK) and pharmacodynamics (PD). Kicking off this series are hosts Thomas Tängdén, Erin McCreary and Angela Huttner, and invited guests Amy Legg and Rekha Pai Mangalore. They walk us through key parameters and terms of PK/PD, such as volume of distribution, minimum inhibitory concentration (MIC), epidemiological cut-off value (ECOFF), and PK/PD indices, laying the foundation to better comprehend clinical applications such as setting a clinical breakpoint and how it guides therapeutic drug monitoring (TDM). This first episode encompasses a broad scope across PK/PD th...

This is the first episode of the 'Quarterly catchup' series, in which CMI Communications editors discuss important and useful articles that have come out in the last 3 months to understand their results and potential clinical impact. In this inaugural episode of 'Quarterly catchup', Emily McDonald (Canada), Thomas Tängdén (Sweden) and Navaneeth Narayanan (USA) convene to discuss clinical microbiology and infectious diseases studies published in the first quarter of 2026 [1-6]. From Wolbachia-infected mosquitoes reducing dengue infection to exploration of antibiotic combination therapies against multidrug-resistant organisms, our hosts summarize six articles they found the most interesting, and discuss whether th...

In this episode of Communicable, hosts Angela Huttner and Marc Bonten invite two members of the ESCMID Emerging Infections Subcommittee, Martin Grobusch (Amsterdam, Netherlands) and Pikka Jokelainen (Copenhagen, Denmark), to discuss infectious disease outbreaks. Sparked by the Subcommittee's beloved 'Epi Alert', which identifies and tracks outbreaks around the world, the episode covers common missteps and underestimated challenges in handling new outbreaks, the effects of climate change, and what 'One Health' really means. 

This episode was peer reviewed by Ummu Afeera Zainulabid of the International Islamic University Malaysia, Kuantan, Malaysia.

Further reading

Yesterday was International Women's Day. In light of that, Communicable prepared a special episode in which hosts Erin McCreary and Annie Joseph are joined by Esmita Charani (South Africa) and Annette Westgeest (Netherlands) for a discussion on gender- and sex-dependent patient-care disparities in the infectious diseases space. Together they review recent research findings that identified gender and sex as important determinants influencing patient outcomes and even decision making by prescribers. They also explore how societal and cultural norms may introduce further nuance and complexities. The panel remains optimistic in reaching equal healthcare for all, reflecting also on progressive steps...

In this third collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma (Philadelphia, USA) and Benedikt Huttner (WHO, Geneva, Switzerland) [1-3]. Together, they deconstruct the complex landscape of developing and implementing guidelines into digestible components: they discuss why different organizations develop guidelines and what need they hope to fulfil, the framework including the GRADE methodology under which guidelines are written, and major barriers in the uptake of guidelines. The conversation also details the distinction between guideline and guidance as well as the art...

In this episode of Communicable, Navaneeth Narayanan and Josh Nosanchuk invite Virginie Lemiale and Elie Azoulay (Paris, France) as well as fellow editor Emily McDonald (Montreal, Canada)—this time as guest—to discuss adjunctive steroid therapy for pneumocystis pneumonia (PCP) in HIV-negative individuals. In 2025, Lemiale and Azoulay published results from their double-blind, randomised controlled trial investigating steroid treatment for severe Pneumocystis jirovecii pneumonia (PIC trial) in the Lancet Respiratory Medicine [1]. At first glance, one might dismiss the study’s clinical impact due the ‘negative' result of  the primary outcome, mortality at 28 days, which just missed a statistically significant difference between g...

In this episode of Communicable, Josh Davis (Newcastle, Australia) and Emily McDonald (Montreal, Canada), plus invited guest, Steven Tong (Melbourne, Australia)—all practicing physicians and clinical trialists—assemble to discuss some of their ‘top infectious diseases papers published in 2025’. Bassam Ghanem (Jeddah Lol, Saudi Arabia), whom one might know better as Antibiotic Steward on social media, was also invited to share his favourite publications of 2025.

Six papers that were most consistently picked by the panel are presented, explaining why they were picked and how they have shifted paradigms or changed their practice. This episode complements the previous episode...

In the first Communicable episode of 2026, Annie Joseph and Josh Nosanchuk invite Robin Patel (Rochester, USA) and Fidelma Fitzpatrick (Dublin, Ireland) to discuss some of their favourite clinical microbiology papers published in 2025. These six papers highlight everything from technological advances of genomics and molecular diagnostic testing to the importance of patient and public involvement in research as well as effective communication [1-6]. The panel also discusses whether or not any of these papers have changed their practice.

This episode was edited by Kathryn Hostettler and peer reviewed by Sinéad Kilgarriff of the National Virus Reference Laboratory U...

In this final episode of 2025, hosts Annie Joseph (Nottingham, UK) and Angela Huttner (Geneva, Switzerland), interview Communicable's producer, Katie Hostettler-Oi (Zurich, Switzerland), to learn which episodes she liked best this year. Their discussion provides a behind-the-scenes look at some of the episodes--including the strange surprises that sometimes came with them. Finally, the CMI Comms editors and editorial fellows send in their perspectives on 2025 and their wishes for 2026.

During the COVID-19 pandemic with lockdown mandates and social distancing, doctors, researchers, and the public were able to find refuge and community online; for the infectious disease community, it was on the social media platform Twitter, and more specifically under the widely used hashtag, #IDTwitter. Under new ownership from 2022, however, Twitter’s name and brand changed to what we now know as X, and “the heyday of #IDTwitter is long since gone”. In this special episode of Communicable, Angela Huttner and Marc Bonten invite doctors and science communicators, Neil Stone (London, UK), Ilan Schwartz (Durham, USA), and Tara Smith (Kent...

In the last ten years, 'diagnostic stewardship' has emerged as a core principle of good clinical practice whose implementation impacts both the individual patient and public health at large. In this episode of Communicable, hosts Angela Huttner and Annie Joseph invite two experts in the field, Daniel Morgan (Maryland, USA) and Valerie Vaughn (Utah, USA), to discuss diagnostic stewardship in the context of infectious diseases, hospital medicine, and healthcare in general. Other topics covered include practical interventions for better testing practices and the role of artificial intelligence in the future of diagnostics. The episode highlights how thoughtful, intentional diagnostic...

It’s World AMR Awareness Week (WAAW) and we have prepared a special episode in light of that. In this week's Communicable, Navaneeth Narayanan and Thomas Tängdén host Aula Abbara (London, UK), Guido Granata (Rome, Italy) and Tuomas Aro (Helsinki, Finland) to discuss the phenomenon of AMR in conflict and crisis zones. They elaborate on how difficult conditions and austere environments amplify the spread of AMR, drawing on findings from the ongoing conflicts in Ukraine, Gaza, Syria and other regions. Other topics covered include adapting antimicrobial stewardship and infection prevention and control (IPC) practices as well as the...

Once confined to the tropics, dengue is spreading via its vector, the Aedes mosquito, to more temperate regions, causing increases in global morbidity, mortality and cost. In 2019, the WHO recognised dengue as one of the top ten global health threats alongside climate change and antimicrobial resistance [1]. In this episode of Communicable, Annie Joseph and Nav Narayanan welcome two dengue experts, André Siqueira of the non-profit Drugs for Neglected Diseases Initiative based in Geneva, Switzerland (Rio de Janeiro, Brazil), and Steven Lim of the Raja Permaisuri Bainun Hospital (Ipoh, Malaysia). Together, they discuss the epidemiology, clinical presentation and management of d...

In this episode of Communicable, Erin McCreary and Angela Huttner are joined by Barbara Trautner (St. Louis, USA) and Valéry Lavergne (Vancouver, Canada), the co-chairs and leading authors of the first IDSA guideline on complicated urinary tract infection (cUTI), which was published a few months ago [1]. Together, they discuss the process of developing the guideline from its conception in 2018, the new definition of cUTI, their stepwise approach to clinical decision-making, and some case-by-case scenarios for common antibiotics. They also elaborate on how this guideline compares (and contrasts) to other existing UTI guidelines—including the previous IDSA guideline for UTI...

Contrary to popular belief, peer review has only recently become an integral step in scientific publishing. Currently seen by many as a badge of honour ensuring valid, innovative and honest research, peer review seems in reality to be increasingly thankless, exploitative, and sometimes invisible. How did we get here? In this episode of Communicable, Annie Joseph and Angela Huttner are joined by two experts, Melinda Baldwin (University of Maryland, USA) and Serge Horbach (Radboud University, Netherlands), to unpack and examine the role of peer review, why it is still essential, and how it fits within the greater editorial process...

In this second-ever collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite the two principal investigators and visionaries who spearheaded the Bacteraemia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) trial, Nick Daneman and Rob Fowler (Sunnybrook Health Sciences Centre, Toronto), for a “deep dive into all things that went into this trial” (1). The BALANCE trial spanned over ten years investigating - as the acronym title suggests - whether a shorter treatment duration of seven days was non-inferior to the standard of care of fourteen days for bacteraemia. The conversation covers everythi...

In this episode of Communicable, Angela Huttner and Erin McCreary invite two titans of vaccinology, Barney Graham (Atlanta, USA), former deputy director of the NIH NIAID Vaccine Research Center and architect of the mRNA vaccines against COVID-19, and Gary Kobinger (Galveston, USA), leading virologist in the development of the first effective Ebola vaccine, rVSV-ZEBOV, for a candid conversation about their direct experience building two of the most well known vaccines to date, and deploying them to the public. The episode also reviews the different vaccine platforms and addresses vaccine hesitancy, equitable access to vaccines, and global health equity. 

Fungal infections and disease have long been overlooked in terms of healthcare burden, with poor diagnostics and limited options for treatment and management. In 2022, the WHO published its first Fungal Priority Pathogens List as an effort to establish a global prioritised framework that addresses unmet research and development needs in fungal disease and antifungal resistance, as well as guides public health action [1]. In this episode of Communicable, Angela Huttner and Josh Nosanchuk invite Hatim Sati (WHO), the project lead in creating this list, and Dimitrios Kontoyiannis (MD Anderson Cancer Center, Houston, Texas), a clinician researcher studying fungal diagnostics and...

Ethics in the field of infectious disease can be a delicate interplay between treating the individual patient and protecting the collective health of a society. Sometimes these two mandates go hand in hand; at other times they can appear to be in conflict. In this episode of Communicable, Dr. Angela Huttner invites Drs. Zeb Jamrozik (Melbourne, Australia) and Beenish Syed (Karachi, Pakistan), two members of ESCMID’s Ethics Advisory Committee, to unpack different scenarios encountered in the field of infectious disease from an ethics standpoint: how one ethically allocates scarce resources like antimicrobials; whether there is ethical justification for co...

Fluoroquinolones (FQs) are valuable given their broad-spectrum activity against Gram-positive and Gram-negative bacteria and their high penetration into various tissues. Yet FQs have also caused concern, with some market withdrawals, important and sometimes long-lasting adverse drug events, and substantial collateral effects on the microbiota. In this episode of Communicable, hosts Emily McDonald and Thomas Tängdén invite Staffan Tevell (Karlstad, Sweden) and Bernadette Young (Oxford, UK) to weigh in on the pro-con debate of FQ use, especially for periprosthetic joint infections (PJIs), which can entail longer treatment durations. They review the standard of care for PJIs, including FQs in...

The adaptability of fungi to warmer temperatures is an obvious consequence of climate change. Perhaps less obvious is the role climate change has played on fungal pathogens emerging as a global health concern. While humans are mostly protected from fungal infections by our immune system and body temperature, a warming global climate could subvert the status quo. Some fungi are already adapted to warmer temperatures and causing invasive acute infections in humans: Candidozyma auris, Cryptococcus neoformans, and Aspergillus fumigatus, to name a few.  In this episode of Communicable, Angela Huttner and Josh Nosanchuk invite Arturo Casadevall, a Bloomberg Distinguished P...

Meningitis remains a major global health threat, with an estimated 2.5 million cases each year; of these, one in six results in death and one in five in long-term disabilities. Although meningitis “can strike anyone, anywhere in the world,” outbreaks disproportionately impact low- and middle-income countries, where diagnostic and treatment resources are limited. In efforts to address this, WHO launched its first-ever guideline on meningitis diagnosis and management in April this year. In this episode of Communicable, hosts Emily McDonald and Marc Bonten are joined by two experts directly involved in creating the guideline, Lorenzo Pezzoli and Nicolò Binello (WHO), as we...

Bacterial vaginosis (BV) was long considered not to be a sexually transmitted infection (STI), and treatment was only for women to bear. That was the convention at least until Catriona Bradshaw and her team at the Melbourne Sexual Health Centre published their groundbreaking clinical trial results earlier this year, demonstrating that treating male partners of women with BV prevented recurrence in those women. In this episode of Communicable, hosts Angela Huttner and Annie Joseph welcome back Bradshaw to discuss her trial’s design, results, and clinical implications—with some guidelines already updated to include male partners in BV treatment regi...

Editors of CMI Comms, Josh Davis, Erin McCreary and Emily McDonald return for round 2 taking turns to summarise and discuss late-breaker trials presented at ESCMID Global 2025 in Vienna, and whether or not these trials should change your practice. Part 2 covers the ALABAMA trial exploring the safety of penicillin-allergy delabelling using the penicillin allergy assessment pathway, the SOLARIO trial investigating short (≤7 days!) versus long (≥4 weeks) antibiotic courses for orthopaedic infections, the EAGLE-1 trial assessing oral gepotidacin for gonorrhoea, a randomised clinical trial (RCT) from Thailand on oral fosfomycin as carbapenem-sparing, de-escalating therapy in complicated UTIs, and a double-blind RCT from Isra...

This episode of Communicable takes on a special format where editors of CMI Comms, Marc Bonten, Josh Davis, Erin McCreary, Emily McDonald, all clinical trialists in their own right, take turns to summarise and discuss late-breaker trials presented at ESCMID Global 2025 in Vienna. These include the CloCeBa trial on Staphylococcus aureus bacteraemia treatment options, the Taper V trial on vancomycin as prophylaxis for Clostridioides difficile infection, the ASTARTÉ trial on temocillin versus meropenem for bacteraemia due to third-generation cephalosporin-resistant Enterobacterales, the HARVEST trial investigating high doses of rifampicin for tuberculosis meningitis, and the CAP5 trial on shortening antibiotic treatment f...

In this first-ever collaboration between Communicable and Breakpoints, the podcast of the US Society of Infectious Diseases Pharmacists, hosts Angela Huttner (Geneva, Switzerland) and Erin McCreary (Pittsburgh, USA) join trial investigators Josh Davis (Newcastle, Australia) and Steve Tong (Melbourne, Australia) to unpack the first results coming from the SNAP adaptive platform trial, which were recently presented at ESCMID Global in Vienna. Learn whether penicillin and cefazolin are non-inferior to—and maybe even safer than—flucloxacillin for penicillin-susceptible and methicillin-susceptible Staphylococcus aureus, respectively.

This episode was edited by Julie Anne Justo, transcribed by Katie Lambert and Sarah Groome, and...

In this episode of Communicable, hosts Angela Huttner and Annie Joseph join experts Kerrigan McCarthy of South Africa’s National Institute for Communicable Diseases and Natasha Crowcroft of the World Health Organisation to discuss the resurgence of measles as a consequence of misinformation campaigns and waning vaccination rates, how to diagnose and manage active measles cases, and post-exposure control measures to take to reduce further spread. They also address the broader challenges of the moment, including generalised vaccine hesitancy and sudden, sweeping budget cuts, underscoring the message that “measles anywhere is a problem everywhere.”

This episode was edited...

ESCMID Global, ESCMID’s flagship congress, kicks off this Friday in Vienna. In light of that, Angela Huttner and Thomas Tängdén sit down with ESCMID leadership, President Robert Skov and Immediate-Past President Annelies Zinkernagel in this episode of Communicable. Together they discuss the roles of medical societies like ESCMID in shaping healthcare policy, the importance of scientific communication, and lessons learned from the COVID pandemic. The conversation highlights ESCMID’s priorities for the future on addressing antimicrobial resistance, fostering international collaboration and new educational initiatives. The episode also features personal anecdotes about what makes coming together at ESCMID...

Communicable returns to the topic of gender dynamics in medicine in the second half of this special. This round, Angela Huttner wants to hear from the men, CMI Comms editors Marc Bonten, Josh Davis, Navaneeth Narayanan and Thomas Tängdén, about tackling issues like the evolving expectations at home and work, the impact of parental-leave policies, and the systemic biases that continue to shape careers. Personal anecdotes and reflections highlight both the progress made and the hurdles that still exist in striving for true gender equity in the medical profession. Editors Erin McCreary and Annie Joseph of CMI Co...

In honour of International Women's Day, Communicable releases the first of a two-part special on gender dynamics within the fields of infectious diseases and clinical microbiology. Moderated by Angela Huttner, part 1 focuses on the women's perspectives, featuring CMI Comms editors Erin McCreary, Annie Joseph, and Huttner herself, who together reflect on personal experiences of gender bias in the workplace. They discuss differential (mis)treatment, break down common gendered situations in the workplace, and explore what individuals, institutes and society can do to promote a more inclusive, supportive environment for all. Editors Marc Bonten, Josh Davis, Navaneeth Narayanan and Thomas...

Several publications have described wondrous therapeutic effects of faecal microbiota transplant (FMT) on Clostridioides difficile infection. Yet the recent randomised trial assessing FMT in US veterans was terminated early for futility. In this episode, hosts Angela Huttner and Marc Bonten delve into the history, application, and complexities of FMT with experts Maria Vehreschild (Frankfurt University Hospital, Germany) and Dimitri Drekonja (Minneapolis Veteran Affairs Care System and University of Minnesota, US), who led the US trial. From the regulatory challenges and trial nuances to important new research, this conversation sheds light on a potentially revolutionary yet controversial treatment. 

E...

Despite being preventable and curable, tuberculosis remains a major global health threat, infecting over 10 million people and claiming more than 1 million lives every year. In this episode of Communicable, hosts Angela Huttner and Navaneeth Narayanan discuss tuberculosis with experts Lorenzo Guglielmetti of Doctors without Borders and Olha Konstantynovska of Kharkiv National University, Ukraine. Key topics include the history, transmission, and pathophysiology of tuberculosis, as well as current diagnostic challenges and treatments for drug-resistant strains. The conversation highlights Lorenzo's work on the endTB project and Olha's experiences managing tuberculosis during the war in Ukraine. Despite advancements in treatment, the episode...

Sexually transmitted infections (STIs) affect millions globally daily, and multidrug-resistant strains are complicating treatment. Hosts Angela Huttner and Josh Davis welcome experts Dr. Teodora Elvira Wi from WHO and Professor Catriona Bradshaw from Monash University to discuss critical issues surrounding ‘super gonorrhoea,’ chlamydia, syphilis, Mycoplasma genitalium, and bacterial vaginosis. The episode reviews the latest epidemiology and highlights the need to innovate diagnostics and treatment options, destigmatise STIs, and promote people-centred healthcare strategies to manage and prevent these infections. 

This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Arjana Zerja of Mother Theresa University Hospit...

Rising anti-vaccine sentiment and dissemination of misinformation are threats to public health. In the US, calls to revoke certain public health mandates have been proposed by likely members of the incoming administration, among them vaccination against polio. The fourth instalment of the Nightmare Series is both a cautionary tale and an effort to preserve and share clinical expertise on how to diagnose and manage polio and rubella in a world where, until now, few doctors have had to face these illnesses in the clinical setting. Host Angela Huttner welcomes Professor Emeritus of Infectious Diseases Bernard Hirschel at the University...

The last episode of the year carries a special end-of-year message from the CMI Comms editors and replays the very first episode of Communicable aired on 10 May 2024, in which editors Angela Huttner, Marc Bonten, and Erin McCreary discuss late-breaker clinical trials presented at ESCMID Global 2024 in Barcelona, providing insights into the trials’ designs, results, and implications. The DOTS trial compared two doses of long-acting dalbavancin to standard of care in patients with complicated S. aureus bacteraemia. GAME-CHANGER compared cefiderocol to standard of care for Gram-negative infections. PediCAP compared oral step-down therapy with amoxicillin with or without clavulanic acid at sh...

The topic of climate change can engender a ‘doom and gloom’ narrative, as many climate and health consequences are already manifesting. Our host, Dr. Navaneeth Narayanan is joined by two ID physicians passionate about climate change and sustainable clinical practice, Dr. Shreya Doshi (Washington DC, US) and Dr. Laura Jung (Leipzig, Germany). Together they discuss new trends in infectious diseases observed in clinical practice as a direct consequence of climate change, including how tropical diseases are not so tropical anymore. They also outline ways individual clinicians and hospitals can be more sustainable and offer additional resources for the listeners (see...

Wastewater surveillance is a powerful epidemiological tool that “mirrors our life,” and has gained wide attention in recent years due to its application during the COVID-19 pandemic. The hosts this week, Drs. Navaneeth Narayanan and Emily McDonald, are joined by two wastewater surveillance experts, Dr. Nasreen Hassoun-Kheir of Geneva University Hospitals, a WHO Collaborating Centre on antimicrobial resistance (AMR), as well as Professor David Graham of Newcastle University, United Kingdom, to discuss how this surveillance method—as well as a multidisciplinary approach—are central to understanding community health, infection control and pandemic preparedness.

This episode was edite...

Substandard and falsified (SF) antimicrobials are a neglected global health problem and have been implicated as drivers of antimicrobial resistance (AMR). Substandard medicines are authorized medical products that fail to meet either their quality standards or their specifications, whereas falsified medicines are those that deliberately and fraudulently misrepresent their identity, composition or source. Host Angela Huttner is joined by Pernette Bourdillon Esteve, Technical Officer for the World Health Organization’s Substandard/falsified Medical Products group, and Ben Cooper, epidemiologist at Oxford University and head of its Drug-Resistant Infection and Disease Dynamics (DRIaDD), to explore the effects of SF antimicrobials on...

The market of predatory publishing is as lucrative as it is unethical. Predatory journals are disguised as legitimate entities, and prey on both early-career academics and the naïve. In this episode of Communicable, hosts Angela Huttner and Marc Bonten are joined by Editors-in-chief Ursula Hofer (Lancet Infect Dis) and Leonard Leibovici (CMI) to discuss the various schemes of the ‘Wild West’ of publishing, and how to avoid them. 

This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Özlem Türkmen Recen, Izmir Public Health Laboratory, Izmir, Türkiye.

Literature ...

Enterococci are commensal microbes, part of the healthy microflora populating the human gut. But they are also opportunistic pathogens and notorious nosocomial agents with intrinsic traits that promote their pathogenesis and make them difficult to kill. In the third instalment of the Nightmare Series, hosts Angela Huttner and Thomas Tängdén are joined by enterococcal experts Kimberly Kline (University of Geneva) and Louis Rice (Brown University) to discuss what make vancomycin-resistant enterococci, or VRE, such a clinical nightmare. Enterococcus faecalis and Enterococcus faecium are the focus.

This episode was edited by Kathryn Hostettler and pee...