Section and working groups

The Infection section is led by Jan De Waele and Jose Garnacho-Montero.

> Learn more about this section

Research – Trials

The Intensive Care GLObal Study on Severe Acute Respiratory Infection is a multicentre, prospective, observational,14-day inception cohort study.

This European-wide multicentre ICU trial aimed to determine the effect and safety of three decolonisation strategies:
Selective Digestive tract Decontamination (SDD), Selective Oropharyngeal Decontamination (SOD), Chlorhexidine mouthwash (Oro-CHX)

Results:
Selective decontamination and antibiotic resistance in ICUs

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The aim of the project is to promote patient safety and quality improvement in critical care towards a significant reduction of observed mortality rates and economic costs.

Further information at prosafe.marionegri.it.

Publication:
Center for Disease Control and Prevention guidelines for preventing central venous catheter-related infection: Results of a knowledge test among 3405 European intensive care nurses.

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The impact of hospital infection is greatest in the intensive care unit and an effective response to the problem relies on the availability of up-to-date, adequate epidemiological data. European Prevalence of Infection in Intensive Care II.

For more information: www.intensive.org/epic2/index.asp

Publications
EPIC II: Sepsis around the world

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Candida bloodstream infections in the intensive care units: Analysis of the extended prevalence of infection in the ICU study

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DetermInants of Antimicrobial use aNd de-escalAtion in critical care. De-escalation is applied in no more than 15-50% of patients in most studies, and may consist of different components.

The trial will give us further insights into the actual use of de-escalation in a global sample of patients, inform us about the determinants of de-escalation


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The aim of the project was to determine whether contemporary antibiotic dosing for critically-ill patients is achieving concentrations associated with maximal activity.

Publications
Roberts JA. et al. DALI: defining antibiotic levels in intensive care unit patients: are current β-lactam antibiotic doses sufficient for critically ill patients?

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Initiated by the working group on Pneumonia of the ESICM INF Section, the aim of this project is to perform an international multicentre prospective observational cohort study of nosocomial pneumonia in intensive care units (ICUs) worldwide in order to provide up-to-date and comprehensive descriptive data on the diagnosis, microbiology, time course of resolution, management and outcomes in a global ICU population.

Primary objectives:
– Evaluate the global epidemiology of nosocomial pneumonia in ICU patients, analysing responsible pathogens and resistance pattern by type of pneumonia and geographical region.
-Describe current clinical practice regarding diagnosis and determine the degree of concordance between the diagnosis of nosocomial pneumonia in routine clinical practise and official definitions, including:
a) ATS/IDSA 2005 guidelines;
b) CDC/NHSN Surveillance Definitions, 2015.

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Research – Surveys

PREVENTION OF CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS IN INTENSIVE CARE UNITS: AN INTERNATIONAL ONLINE SURVEY

Results:
Valencia et al. Poor adherence to guidelines for preventing central line-associated bloodstream infections (CLABSI): results of a worldwide survey.

 > Read the article

EuroFasciitis survey: Management of necrotising fasciitis in European ICUs. Necrotising fasciitis (NF) is a rare and severe soft tissue infection that has no epidemiological data available in Europe.

Publications:
de Prost N et al. Management of necrotising soft tissue infections in the intensive care unit: results of an international survey.

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Nicolas de Prost et al. Therapeutic targets in necrotising soft tissue infections.

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Multi-drug resistant bacteria risk perception by European intensivits (MDR-ICU) provided an overview of multi-drug resistant bacteria risk perception by intensivists working in European ICUs.

Publication:
Japoni A et al. Multidrug-resistant bacteria isolated from intensive-care-unit patient samples.

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A survey on antimicrobial dosing and administration approaches aimed aim to obtain information on differences between intensive care units and countries on dosing and administration approaches for several anti-microbials.

Publication:
The ADMIN-ICU survey: a survey on antimicrobial dosing and monitoring in ICUs.

Read the article

Relevant research

Urayeneza, O. et al. Increasing evidence-based interventions in patients with acute infections in a resource-limited setting: a before-and-after feasibility trial in Gitwe, Rwanda. 
> Read article (Free Access)

De Waele et al. Antimicrobial Resistance and antibiotic stewardship programmes in the ICU: Insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR Round Table on Multi-Drug Resistance.
> Read article (Free Access)

van der Kooi T et al. Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster-randomised multicentre study to reduce central venous catheter-related bloodstream infections.
> Read article (Free Access)

Matteo Bassetti et al. Intensive care medicine research agenda on invasive fungal infection in critically ill patients.
> Read article (Free Access)

Marin H. Kollef et al. The intensive care medicine research agenda on multidrug-resistant bacteria, antibiotics, and stewardship.
> Read article (Free Access)

José-Artur Paiva and Kevin B. Laupland. Real-time PCR for early microbiological diagnosis: is it time?
> Read more

Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonisation, and Multiple Organ FailureThe EMPIRICUS Randomised Clinical Trial
> Read more

Tängdén T et al. The role of infection models and PK/PD modelling for optimising care of critically ill patients with severe infections.
> Read the article

Article Reviews

Ventilator-associated complications in patients with ESBLE infections
> Read this article review

Augmented renal clearance, antibiotic exposure & clinical outcome: What is the impact on septic patients receiving high doses of β-lactams in ICU?
> Read this article review

Procalcitonin-guided antibiotic therapy in intensive care unit patients: a systematic review and meta-analysis
> Read this article review

Reducing CRBSIs in ICUs: What’s the best strategy?
Hospitals in 11 European countries were computer-randomised to receive one of three interventions in the Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project.
> Read this article review

Prevention and Control of Multidrug-Resistant Gram-Negative Bacteria in ICUs
This Systematic Review of Clinical Studies compared  Prevention & Control interventions for Multidrug Resistant Gram-Negative Bacteria in adults admitted to ICUs including RCTs, Cohort Studies, Interrupted time-series studies and before-and-after studies.
> Read the article review

Invasive Candida infections
Invasive Candida infections are leading causes of mortality among critically ill patients. The diagnosis of such diseases is challenging and a delayed start of the appropriate antifungal therapy was associated with a poor prognosis.
> Read the article review

Optimising Infection Care
ICU environment requires existing antimicrobial agents to be used more judiciously with the aim at the reduction of antimicrobial resistance.
> Read the article review

Evaluating new antibiotic therapy endpoints
Antimicrobial resistance is a growing problem in medicine.
> Read this article review

The risk and clinical outcome of candidemia
Prospective multicentric hospital-based surveillance programme investigated candidemia distribution and outcome in a large cohort of critically ill patients according to their underlying disease.
> Read this article review

Clinical outcome of critically ill cirrhotic patients with invasive candidiasis
> Read this article review

Therapeutic management of peritonitis: a comprehensive guide for intensivists
> Read this article review

Is probiotic therapy a safe and effective way to prevent VAP?
> Read this article review

Dressing Changes for Central Venous Catheters: How Often Should They Be Performed?
> Read this article review

Suggested videos

Multi Drug Resistance

Chair of ESICM’s Infection Section Jan De Waele discusses Multi Drug Resistance (MDR) as a major healthcare issue, and one of particular relevance in intensive care medicine. He provides some encouraging guidance for clinicians managing patients with MDR and outlines plans for development of clinical guidelines and multidisciplinary research into this area.

Appropriate Antibiotic Therapy Strategies

Considerate antibiotic use and halting antimicrobial resistance (AMR) remains a responsibility shared by all healthcare workers, from physicians to maintenance personnel, from nurses to physiotherapists, from consultants to medical students.

This video includes strategies for appropriate antibiotic therapy that intensive care professionals can start using today.

For more information, click here.

#EAAD #AntibioticResistance

What can you do to halt AMR in your unit?

In this icTV video, ESICM Infection section Chair Jan De Waele discusses the prevalence of antimicrobial resistant infections in intensive care and offers 3 top strategies that intensive care professionals can start using today to help fight the development of AMR in their ICU.

The EMPIRICUS trial

Jean-François Timsit (Paris, France) discusses results presented at the HOT TOPICS Session at LIVES 2016 from “Effect of empiric treatment with micafungin on survival without invasive fungal infection among adults with ICU-acquired sepsis, Candida colonisation at multiple sites, and multiple organ failure: The EMPIRICUS randomised clinical trial”.

Read the article published in JAMA here.

The GRAVITY VAP trial

Gianluigi Li Bassi (Barcelona, Spain) and Mauro Panigada (Milan, Italy) discuss the rationale, results and clinical impact of the GRAVITY VAP trial. Results from this study were first presented at in Milan at LIVES 2016, the annual congress of ESICM.

Visit our e-LIVES platform to see more…

What can you do to halt AMR in your unit?

In this icTV video, ESICM Infection section Chair Jan De Waele discusses the prevalence of antimicrobial resistant infections in intensive care and offers 3 top strategies that intensive care professionals can start using today to help fight the development of AMR in their ICU.

Education

Master Classes

Managing Pneumonia in the ICU – State of the Art

In this one and a half day course, participants will get an up-to-date, complete and in-depth review of all aspects of pneumonia in the critically ill.

Top experts in different areas of infection management will provide state of the art lectures and discuss real life cases with the participants. Recently updated guidelines have been published, and practical implications of these will be discussed.

Infection Course for Nurses & AHP

The new webinar-based ESICM Infection Course is a series of 12 modular webinars. The entire programme is open to all Intensive Care Nurses and Allied Health Professionals and is completely free of charge.

This advanced course in infectious diseases covers basic epidemiology and pathogenic mechanisms of disease, infection prevention and therapy. Special attention is given to high risk patients, such as immuno-compromised and burn patients, neonates and the elderly.

Starting November 2017
Online course

Webinars