Stewardship of Metagenomic Sequencing

In this episode of the SHEA Podcast, host Dr. Jonathan Ryder moderates a lively pro/con debate on one of the most discussed biomarkers in infectious diseases: procalcitonin. Joining the conversation are two experts with distinct perspectives: Dr. Michael Mansour, Clinician Investigator and Associate Professor of Infectious Diseases at Massachusetts General Hospital and Harvard Medical School, and Dr. Sheetal Kandiah, Senior Physician and Assistant Clinical Professor of Medicine in the Division of Infectious Diseases at Emory University; Director of the Antibiotic Stewardship Program at Grady Hospital. Together, they explore where PCT may (or may not) add value in antimicrobial stewardship programs. Tune in for an insightful exchange that will help stewards, clinicians, and ID professionals better understand where PCT fits into today’s rapidly evolving diagnostic landscape.

In this episode of The SHEA Podcast, host Dr. Jonathan Ryder (University of Nebraska Medical Center) speaks with Dr. Aditi Ramakrishnan (Washington University in St. Louis) about how antimicrobial stewardship programs can play a vital role in managing and preventing resistant sexually transmitted infections. They explore the challenges and opportunities at this intersection — from the promise and controversy surrounding doxycycline post-exposure prophylaxis (DoxyPEP), to the debate over routine STI screening among populations on PrEP, and the broader stewardship considerations beyond antibiotic use.

In this episode, Dr. Madhuri Sopirala, Medical Director and Chief of Infection Prevention at Parkland Health and Chair of SHEA’s Infection Prevention and Control Burn Unit Special Interest Group, moderates a timely conversation on the unique challenges of infection prevention in burn units. She is joined by Dr. Samuel Mandell, Associate Professor of Surgery at UT Southwestern and Director of the Parkland Regional Burn Center, and Dr. David Weber, Distinguished Professor of Medicine and Medical Director of Infection Prevention at UNC Medical Center, as well as current SHEA Board of Trustees President. Together, they explore why burn units require specialized approaches to infection prevention, the nuances of distinguishing outbreaks from baseline infection risks, and strategies for optimizing burn unit design to improve patient safety. The discussion also highlights often-overlooked vectors of infection, emerging research priorities, and what the future may hold for advancing infection prevention in burn care.

In this episode of The SHEA Podcast, Dr. Katie Chiotos (Children’s Hospital of Philadelphia) and Dr. Trevor Van Schooneveld (University of Nebraska Medical Center) discuss the stewardship of metagenomic sequencing (mNGS) in infectious disease care. They explore how to make results clinically actionable, avoid overuse or misinterpretation, and integrate mNGS into stewardship and infection prevention programs. The conversation also looks ahead to the future of mNGS and the role stewardship leaders will play in guiding its responsible use.

This episode of The SHEA Podcast was created with the SHEA Pediatric Epidemiologists and Antibiotic Stewards (PEAS) group specifically for Ronald McDonald House, but the principals would apply to any resident care facility. As of June 2025, the world is experiencing a significant resurgence of measles. The US has documented 1,319 cases across 40 jurisdictions, marking the largest outbreak since 2020. In Europe, there were 12,694 confirmed cases over the last 12 months of reporting – the highest since 1997. Southeast Asia is also heavily affected and, Australia faces its worst outbreak since 2019. Canada has over 3,977 cases reported nationwide – the highest number since the disease was declared to be eliminated in 1998. Together, Matthew Chater, CEO of the Ronald McDonald House in Southwestern Ontario, and Dr. Ayelet Rosenthal from Lurie Children’s Hospital of Chicago representing SHEA’s PEAS group, walk through a case study on what to do if someone infected with measles visited or stayed in a Ronald McDonald House.

SHEA President Dr. David Weber talks with Dr. Preeti Mehrotra and Dr. Marci Drees about their experiences as SHEA liaisons to the Advisory Committee on Immunization Practices (ACIP). They discuss reviewing vaccine data, lessons from COVID, and what the future holds for vaccines and public health.

Host Dr. Jonathan Ryder speaks with Dr. Jamie Wagner and Dr. Sheetal Kandiah about the macro- and micro-influences driving antimicrobial costs. They explore how the ACA, pharmacy benefit managers, formulary restrictions, and socioeconomic disparities shape access and prescribing patterns. The discussion highlights real-world challenges for stewardship programs and practical steps to improve affordability and equity in antimicrobial use, with a look ahead at future reforms.

In this episode of the SHEA Podcast, host Dr. Jonathan Ryder, Assistant Professor in the Division of Infectious Diseases at the University of Nebraska Medical Center, speaks with Dr. Milner Staub, Assistant Professor of Medicine in the Division of Infectious Diseases at Vanderbilt University Medical Center. Their conversation explores practical, high-impact strategies for improving antimicrobial stewardship in outpatient and ambulatory care settings. With the majority of antibiotic prescribing occurring outside of hospitals, outpatient stewardship is a critical area for reducing unnecessary antibiotic use and improving patient outcomes. Dr. Staub shares insights into her work and research, which focus on helping providers and patients optimize antibiotic prescribing in ambulatory settings. She highlights stewardship interventions that are relatively easy to implement but offer strong returns on investment. A significant part of the discussion centers around the persistent impact of penicillin allergy labels and how outpatient settings can better address this issue. Dr. Staub also discusses antibiotic overuse for acute uncomplicated bronchitis (AUB), offering recommendations for interventions to reduce inappropriate prescribing. The episode concludes with a look ahead at where more research is needed to test assumptions and develop new stewardship strategies. Listeners are encouraged to explore SHEA’s free CDC-supported Penicillin Allergy Delabeling Course for more information. Thank you for tuning in to the SHEA Podcast.

This episode of the SHEA Podcast, presented by the SHEA Community Healthcare Epidemiologists and Stewards (CHES) group, explores career paths and professional growth in healthcare epidemiology and infection. Moderator Dr. Katie Passaretti is joined by Dr. Erica Shenoy and Dr. Louann Bruno-Murtha to discuss their career paths, key challenges, and strategies for success in infection prevention. The guests share insights on training for a career in healthcare epi, the biggest IPC challenges they face—staffing shortages, maintaining core practices post-pandemic, and constant disruptions—and how they find support through SHEA, CHES resources, and professional networks. They wrap up with advice for those entering or advancing in the field. Tune in for expert perspectives on thriving in healthcare epidemiology!

In this episode of the SHEA Podcast, moderator Dr. Sheetal Kandiah, Director of the Antimicrobial Stewardship Program at Emory University Hospital, explores the role of Artificial Intelligence (AI) in antimicrobial stewardship with Dr. Richard Medford, ECU Health’s Chief Medical Informatics and Digital Health Officer (CMIDHO). Dr. Medford discusses how AI-driven tools are transforming antibiotic stewardship, improving prescribing accuracy, patient outcomes, and resistance management. The conversation highlights current applications, including predictive analytics and clinical decision support, as well as the impact of big data on stewardship programs. The episode also examines real-world successes where AI has optimized antibiotic use and enhanced patient care, along with key challenges in AI adoption, such as data reliability, ethical concerns, and provider trust. Looking ahead, Dr. Medford shares insights on future AI advancements that could further shape antimicrobial stewardship and healthcare innovation.