Section and Project Group
The Infection section is led by Pedro Povoa and Andrew Conway Morris.
Infection News
Research – Research Projects
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
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.
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
Candida bloodstream infections in the intensive care units: Analysis of the extended prevalence of infection in the ICU study
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
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?
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.
Research – Surveys
Current Practice of infectious disease management in the ICU – International survey.
It is recommended to start antimicrobial early and appropriately to improve outcome. However, overuse is leading to a widespread resistance.
The aim of this survey is to understand the current infectious disease practice in the ICU in order to improve infectious disease management including training and role allocation.
Complete , here.
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.
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.
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.
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
Awards
DALI project
Jeffrey Lipman
Eurobact project
Alexis Tabah
Education
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