The Infection section is led by Andrew Conway Morris.
Infection News
Resources
EDUCATION
Sepsis and Severe Infections
This 2-day e-course blends techniques that encourage maximum learning. Special attention is given to interactive activities, case-based discussions, workshops and problem-oriented approaches.
Quality Improvement in Antimicrobial Stewardship Pathway
Antibiotic stewardship programmes are an indispensable tool for improving antibiotic prescription in critically ill patients. In the era of increasing antibiotic resistance, the importance of this approach will only increase.
This programme will provide training on quality and safety in the hospital setting to improve Antimicrobial Stewardship in Critical Care. The programme is FREE of charge for participants, whether they hold an ESICM membership or not.
Educational webinar series on sepsis management
This initiative covered the management of patients suffering from sepsis with a strong focus on the role & value of diagnostic tests. It was designed as an educational journey from the early signs of sepsis to the post-sepsis syndrome.
Programme
- Clinical presentation of sepsis, early signs & patients at risk
- Sepsis: early diagnosis & management
- Sepsis complications
- Sepsis and Antimicrobial Resistance: two sides of the same coin
- Post-Sepsis Syndrome (PSS) & life after sepsis: the patient voice
Other past webinars
- Lessons from covid-19 experience for the management of (non-viral) sepsis
- New risk factors for invasive fungal infections
- Practical microbiology diagnosis & management of blood stream infections (/sepsis) in icu
- Antibiotic de-escalation: how, why, what and how
- Optimising antibiotic therapy in COVID-19 patients
Top Sessions from LIVES 2021 selected for you:
- Empirical therapy in carbapenem-resistant Enterobacteriaceae
- Optimising the antimicrobial therapy to improve the prognosis
- The role of “old antibiotics” for MDR-GNB
- Approach of severe respiratory infections in immunocompromised patients – DIRECT approach
- Early bacterial co-infection in COVID-19 patients
- Immunotherapy/immunostimulation for control of infections in ICU
- Novel antibiotics for infections by Gram-negative pathogens
- CMV and HSV infection in immunocompetent critically ill patients
- When do I stop antibiotic therapy in severe infections? I use a fixed duration
- When do I stop antibiotic therapy in severe infections? I use omics
RESEARCH
Ongoing
AB-ICU
Led by the working group on antibiotics. Retrospective study of antibiotic use across ESICM nations, with the investigation of variation by type of ICU and antimicrobial resistance. Led by the working group on antibiotics.
PIs: Fredrik Sjövall / Jeroen Schouten
BLING-3
A phase III randomised controlled trial of continuous beta-lactam infusion compared with intermittent beta-lactam dosing in critically ill patients, to determine whether continuous infusion of a beta-lactam antibiotic (piperacillin-tazobactam or meropenem) results in decreased all-cause day 90 mortality compared with intermittent beta-lactam antibiotic infusion in critically ill patients with sepsis (NCT03213990).
PIs: Jeff Lippman / Jan De Waele
COVIDHGE
The “COVID Human Genetic Effort” is an international consortium aiming to discover monogenic inborn errors of immunity, rare or common, underlying severe forms of COVID-19 in previously healthy individuals (< 50 years without co-morbidity).
This programme is inspired by previous genetic studies of other severe viral infections such as life-threatening influenza pneumonitis or herpes simplex encephalitis.
PIs: Jean-Laurent Casanova / Laurent Abel
Bastard P. et al. Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths. Sci Immunol. 2021 Aug 19;6(62):eabl4340.
Asano T. et al. X-linked recessive TLR7 deficiency in ~1% of men under 60 years old with life-threatening COVID-19. Sci Immunol. 2021 Aug 19;6(62):eabl4348.
UNITE-COVID
The ESICM COVID-19 Project is an observational study of ICU management of COVID-19.
2020 edition (Feb 2020-June 2020): data collection and initial analysis are completed, 4994 patients were included, from 280 ICUs in 46 countries, the first publication is under review, and sub-studies are underway.
2021 edition, for wave 2 (January 2021-June 2021): data collection is ongoing.
PI: Jan De Waele
HAP2
Host-targeted Approaches for the Prevention and the treatment of Hospital-Acquired Pneumonia, a project investigating immunostimulatory therapies in pneumonia. Led by the working group on pneumonia.
PI: Antoine Roquilly
Completed
EUROBACT II
Epidemiology and determinants of outcomes of Hospital Acquired Blood Stream Infections in the Intensive Care.
PIs: Jean-François Timsit / Alexis Tabah
Results: Data collection is completed, with >2200 patients included across 282 centres from 46 countries, and analysis is ongoing.
PneumoINSPIRE
The International study on NoSocomial Pneumonia in Intensive CaRE (PneumoINSPIRE) is a prospective, international, multicentre, observational, cohort study. The study aims to provide up-to-date and generalisable information on current worldwide epidemiology and clinical practice associated with the diagnosis and management of nosocomial pneumonia in Intensive Care Unit (ICU) patients.
PI: Despoina Koulenti
Results: Data collection is completed, with 1400 patients included, and analysis is ongoing.
EURECA
The EURopean study on Encephalitis in intensive CAre units is a prospective, cross-sectional, multinational, cohort study aiming at evaluating epidemiology and outcomes of patients admitted to the ICU with all-cause (meningo-)encephalitis (NCT03144570).
PI: Romain Sonneville
Results: Data collection is completed, with 599 patients included from 67 ICUs in 6 countries, and analysis is ongoing.
DIANA
DetermInants of Antimicrobial use aNd de-escalAtion in critical care
PI: Jan De Waele
Publication: De Bus L. et al. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study. Intensive Care Med. 2020 Jul;46(7):1404-1417.
PROSAFE
The aim of the project was to promote patient safety and quality improvement in critical care towards a significant reduction of observed mortality rates and economic costs.
Publication: Finazzi S. et al. PROSAFE: a European endeavor to improve quality of critical care medicine in seven countries. Minerva Anestesiol. 2020 Dec;86(12):1305-1320.
EPIC III
The aim of EPIC III was to provide information about the prevalence and outcomes of infection and the available resources in ICUs worldwide.
Publication: Vincent J-L. et al. Prevalence and Outcomes of Infection Among Patients in Intensive Care Units in 2017. JAMA. 21 avr 2020;323(15):1478‑87.
Decolonisation strategies
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).
Publication: Wittekamp B.H. et al. Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial. JAMA. 2018 Nov 27;320(20):2087-2098.
Completed
D-PRISM
Diagnostic approaches in severe pneumonia, a multi-national survey.
PI: Andrew Conway Morris
ISOREA
International survey aiming to evaluate the structures and the organization systems of the ICUs in a big sample from high, middle, and low-income countries.
PI: Armand Mekontso Dessap
Results: Survey ended, currently under analysis.
PRACT-INF-ICU
Current Practice of infectious disease management in the ICU – International survey.
PI: Ashraf Roshdy
Publication: Roshdy A. et al. Intensivists’ perceptions and attitudes towards infectious diseases management in the ICU: An international survey. Med Intensiva (Engl Ed). 2021 Aug 17:S0210-5691(21)00174-1. English, Spanish.
A-TEAMICU
Antibiotic Stewardship, Therapeutic Drug Monitoring and Early Appropriate infection Management in European ICUs. Led by the working group on antibiotics.
PIs: Hendrik Bracht / Christian Lanckohr
Publication: Lanckohr C. et al. Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey. Ann Intensive Care. 2021 Aug 26;11(1):131.
CLABSI
Prevention Of Central Line-Associated Bloodstream Infections In Intensive Care Units: an International Online Survey
PI: Marie-Laurence Lambert
Publication: Valencia C. et al. Poor adherence to guidelines for preventing central line-associated bloodstream infections (CLABSI): results of a worldwide survey. Antimicrob Resist Infect Control. 2016 Nov 22;5:49.
Bloos F. et SepNet Study Group. (1 → 3)-β-D-Glucan-guided antifungal therapy in adults with sepsis: the CandiSep randomized clinical trial. Intensive Care Med. 2022 Jul;48(7):865-875.
Bouglé A. et iDIAPASON Trial Investigators. Comparison of 8 versus 15 days of antibiotic therapy for Pseudomonas aeruginosa ventilator-associated pneumonia in adults: a randomized, controlled, open-label trial. Intensive Care Med. 2022 Jul;48(7):841-849.
Meduri G.U. et ESCAPe Study Group. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia. Intensive Care Med. 2022 Aug;48(8):1009-1023.
Kousathanas A. et al. Whole-genome sequencing reveals host factors underlying critical COVID-19. Nature. 2022 Jul;607(7917):97-103.
WHO Solidarity Trial Consortium. Remdesivir and three other drugs for hospitalised patients with COVID-19: final results of the WHO Solidarity randomised trial and updated meta-analyses. Lancet. 2022 May 21;399(10339):1941-1953.
Jarvis J.N. et al. Ambition Study Group. Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis. N Engl J Med. 2022 Mar 24;386(12):1109-1120.
Hagel S. et al. TARGET Trial Investigators. Effect of therapeutic drug monitoring-based dose optimization of piperacillin/tazobactam on sepsis-related organ dysfunction in patients with sepsis: a randomized controlled trial. Intensive Care Med. 2022 Mar;48(3):311-321.
Gangneux J.P. et al. Fungal infections in mechanically ventilated patients with COVID-19 during the first wave: the French multicentre MYCOVID study. Lancet Respir Med. 2022 Feb;10(2):180-190.
Darkoh C. et al. Emergence of Clinical Clostridioides difficile Isolates With Decreased Susceptibility to Vancomycin. Clin Infect Dis. 2022 Jan 7;74(1):120-126.
Peters-Sengers H. et al. MARS consortium. Source-specific host response and outcomes in critically ill patients with sepsis: a prospective cohort study. Intensive Care Med. 2022 Jan;48(1):92-102.
Meghraoui-Kheddar A. et al. Two New Neutrophil Subsets Define a Discriminating Sepsis Signature. Am J Respir Crit Care Med. 2022 Jan 1;205(1):46-59.
Marconi V.C. et al. COV-BARRIER Study Group. Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): a randomised, double-blind, parallel-group, placebo-controlled phase 3 trial. Lancet Respir Med. 2021 Dec;9(12):1407-1418.
COVID STEROID 2 Trial Group, Munch M.W. et al. Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia: The COVID STEROID 2 Randomized Trial. JAMA. 2021 Nov 9;326(18):1807-1817.
Garbero E. et al. High dose coupled plasma filtration and adsorption in septic shock patients. Results of the COMPACT-2: a multicentre, adaptive, randomised clinical trial. Intensive Care Med. 2021 Nov;47(11):1303-1311.
Johnstone J. et al. Prevention of Severe Pneumonia and Endotracheal Colonization Trial (PROSPECT) Investigators and the Canadian Critical Care Trials Group. Effect of Probiotics on Incident Ventilator-Associated Pneumonia in Critically Ill Patients: A Randomized Clinical Trial. JAMA. 2021 Sep 21;326(11):1024-1033.
McArdle A.J. et al. BATS Consortium. Treatment of Multisystem Inflammatory Syndrome in Children. N Engl J Med. 2021 Jul 1;385(1):11-22.
Grant R.A. et al. NU SCRIPT Study Investigators. Circuits between infected macrophages and T cells in SARS-CoV-2 pneumonia. Nature. 2021 Feb;590(7847):635-641.
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
