Tom Lewis

Consultant Microbiologist
Interested in UTI, using data to explore variation and the general overuse of medicine

[Tom Lewis @theunknownpath]

"Dose dependent susceptible" is perhaps the most irritating nonsense ever produced by the world of microbiology. And that's saying something.

[Tom Lewis @theunknownpath]

@ajosephnotts I thought I might see how many BC have detectable abx in concurrent clotted blood. We need way more attention to quality not quantity

[Tom Lewis @theunknownpath]

When should you take blood cultures?
https://t.co/Bl7h4jSWiv

[Tom Lewis @theunknownpath]

@gpollara @mugecevik @uclh @HTropDis I would love to hear this. Always provided clarity in the madness. Don't suppose there's a recording?

[Tom Lewis @theunknownpath]

Dutch guidelines for managing UTI in the elderly lead to better outcomes and lower antibiotic use https://t.co/bgIl90JyVD

[Tom Lewis @theunknownpath]

@ajosephnotts @gpollara @CMIJournal @Avi_Baraz @UriObolski We looked at "half life" of resistance in urinary isolates a few years ago. Cipro indeed about 6 months. Nitro 2 months. Gent a very long time >>1 year

[Tom Lewis @theunknownpath]

@ajosephnotts But let's get down to where no microbiologist likes to go. When do you think blood cultures are actually useful? I'm going for
1. NEWS>5 + fever history.
2. PUO with no abx in last 2/52
3. Maybe suspected line infection
Not much else

[Tom Lewis @theunknownpath]

The push by NHSE to get better blood cultures must be good. But the flip side is more attention to when blood cultures don't add value and stop them. They are expensive and large opportunity cost. Does anyone have a good strategy for this?

[Tom Lewis @theunknownpath]

The importance of working with patients with recurrent UTI https://t.co/6Z8vkaAxdS

[Tom Lewis @theunknownpath]

Poor guidance on management of recurrent UTI from US. Won't be using this. https://t.co/MoVl80vjYz

[Tom Lewis @theunknownpath]

Proper science meets UTI pathogenesis
https://t.co/TIIPcb4DKb

[Tom Lewis @theunknownpath]

I feel underqualified to talk about WGS approaches to pathogenesis these days, but this paper on recurrent UTI and the microbiome looks excellent https://t.co/Cwu8ljrlHK

[Tom Lewis @theunknownpath]

If urine culture adds value in patients with UTI, then there is no reason to accept a turn around time of days https://t.co/OJu0x041c0

[Tom Lewis @theunknownpath]

Do pathologists on here feel they get any meaningful assurance from knowing that a lab is accredited to 15189 by UKAS?
All I can tell you about North Devon since last week is you can't actually be confident that our rulers are the right length.

[Tom Lewis @theunknownpath]

This is probably a good time to see whether things like this are nonsense or not.
‘Physiological age’ a better predictor of survival than chronological age https://t.co/rM5Qu8otJr

[Tom Lewis @theunknownpath]

"Tell a lie often enough and it will become truth". Is Goebbels part of the curriculum at Eton?

[Tom Lewis @theunknownpath]

@elizbeech @LauraPiddock @antibugdoc Devastating. He was a great teacher. I owe him a lot.

[Tom Lewis @theunknownpath]

@PeterNorthDevon @AngelaPedderNHS @sundaypolitics @ndht trauma unit highly commended. Nothing do to with rurality. Has this been corrected?

[Tom Lewis @theunknownpath]

Focus on national priorities including E coli bacteraemia and sepsis sounds like sensible way to start AMR programme #amrsw