In this episode of Let's Talk Micro, we break down metagenomic next-generation sequencing (mNGS) and how it's changing the way we diagnose complex infectious diseases.

I'm joined by Steve Miller, MD, PhD—Chief Medical Officer at Delve Bio—to discuss how unbiased metagenomics moved from research labs into real-world clinical practice.

We cover what metagenomics is, how it differs from targeted PCR and sequencing, and where it adds the most value—especially in meningitis and encephalitis, immunocompromised patients, and cases where routine testing comes back negative.

Dr. Miller shares insights from years of clinical experience, including how mNGS can improve diagnostic yield, shorten time to diagnosis, guide targeted therapy, and reduce unnecessary testing and hospital stays. We also touch on challenges like cost, result interpretation, diagnostic stewardship, and where metagenomics is headed next—including its role in public health and emerging infections.

• Clinical metagenomics for meningitis and encephalitis (Nature Medicine)
  https://www.nature.com/articles/s41591-024-03275-1

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PEA agar is often treated as "the gram-positive plate," but that shortcut can lead to real bench-level mistakes.

In this MicroMinutes episode, we break down what phenylethyl alcohol agar actually does, why growth on PEA does not automatically mean an organism is gram-positive, and how selective media can change colony appearance and behavior.

You'll hear about:

• What PEA inhibits — and what it doesn't

• Why Pseudomonas aeruginosa can grow quite well on PEA

• How colony morphology and hemolysis may differ from blood agar

• Why Lancefield grouping should never be performed directly from PEA
  
  

PEA is a powerful recovery tool — but only when you understand its limitations.
Short, focused, and straight from the bench, this is your Micro minutes.

Stay connected with Let's Talk Micro:

• Website: letstalkmicro.com

• Questions or feedback? Email me at letstalkmicro@outlook.com

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In this special episode, I'm joined by three leaders who helped shape the conversation at the 2025 Antimicrobial Resistance (AMR) Summit in Detroit: Dr. Lauren Hunt, Dr. Linoj Samuel, and Dr. Robert Tibbetts. Together, we explore how this intimate, multidisciplinary summit brought together clinical microbiology, infectious diseases, stewardship, public health, policy, and veterinary medicine to tackle the growing challenges of antimicrobial resistance.

We break down the key themes that emerged throughout the meeting—shared accountability, One Health collaboration, diagnostic innovation, payer perspectives, and the urgent need for equitable access to testing. You'll hear about surprising insights, personal stories that brought AMR's impact into sharp focus, and the collaborative projects already taking root as a result of this year's summit.

Whether you're on the bench, managing stewardship programs, shaping policy, or simply passionate about the future of diagnostics, this episode offers a behind-the-scenes look at the conversations and partnerships driving AMR action forward.

Thank you to Lauren, Linoj, and Robert for joining me—and to everyone committed to advancing the fight against AMR. One Health, one fight.

If you'd like to explore more background from last year's summit, here are two excellent resources:

• 2024 AMR Summit Article
  Antimicrobial Stewardship & Healthcare Epidemiology (ASHE)
  DOI:10.1017/ash.2025.10039
  
  

• ASHE Podcast Episode Recapping the 2024 Summit
  🎧 https://open.spotify.com/episode/0YBcDwgfYIy75pTVjCZZ5Y?si=jb8N_3AIQdOmcC2YaOvOag
  
  

If you're interested in contributing ideas, collaborating on AMR initiatives, or learning more about future AMR Summits, you can reach out directly to:

Dr. Lauren Hunt

📧 lauren.hunt@biomerieux.com

Stay connected with Let's Talk Micro:

• Website: letstalkmicro.com

• Questions or feedback? Email me at letstalkmicro@outlook.com

• Interested in being a guest on Let's Talk Micro? Fill out the form here: https://forms.gle/V2fT3asjfyusmqyi

Support the podcast:

• Venmo
  
  

• Buy me a Ko-fi