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1. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

Author: Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., Montravers, P., Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., and Montravers, P.
Abstract: Contains fulltext : 249005.pdf (Publisher’s version ) (Open Access), INTRODUCTION: Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. METHODS: We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. RESULTS: During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. CONCLUSIONS: Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability
Published: 2022

2. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

Author: Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., Montravers, P., Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., and Montravers, P.
Abstract: Contains fulltext : 249005.pdf (Publisher’s version ) (Open Access), INTRODUCTION: Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. METHODS: We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. RESULTS: During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. CONCLUSIONS: Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability
Published: 2022

3. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

Author: Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., Montravers, P., Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., and Montravers, P.
Abstract: Contains fulltext : 249005.pdf (Publisher’s version ) (Open Access), INTRODUCTION: Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. METHODS: We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. RESULTS: During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. CONCLUSIONS: Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability
Published: 2022

4. Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper#

Author: Abdul-Aziz, M.H. Alffenaar, J.-W.C. Bassetti, M. Bracht, H. Dimopoulos, G. Marriott, D. Neely, M.N. Paiva, J.-A. Pea, F. Sjovall, F. Timsit, J.F. Udy, A.A. Wicha, S.G. Zeitlinger, M. De Waele, J.J. Roberts, J.A. the Infection Section of European Society of Intensive Care Medicine (ESICM) Pharmacokinetic/pharmacodynamic Critically Ill Patient Study Groups of European Society of Clinical Microbiology Infectious Diseases (ESCMID) Infectious Diseases Group of International Association of Therapeutic Drug Monitoring Clinical Toxicology (IATDMCT) Infections in the ICU Sepsis Working Group of International Society of Antimicrobial Chemotherapy (ISAC) and Abdul-Aziz, M.H. Alffenaar, J.-W.C. Bassetti, M. Bracht, H. Dimopoulos, G. Marriott, D. Neely, M.N. Paiva, J.-A. Pea, F. Sjovall, F. Timsit, J.F. Udy, A.A. Wicha, S.G. Zeitlinger, M. De Waele, J.J. Roberts, J.A. the Infection Section of European Society of Intensive Care Medicine (ESICM) Pharmacokinetic/pharmacodynamic Critically Ill Patient Study Groups of European Society of Clinical Microbiology Infectious Diseases (ESCMID) Infectious Diseases Group of International Association of Therapeutic Drug Monitoring Clinical Toxicology (IATDMCT) Infections in the ICU Sepsis Working Group of International Society of Antimicrobial Chemotherapy (ISAC)
Abstract: Purpose: This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in critically ill adult patients in the intensive care unit (ICU). This Position Paper also provides a practical guide on how TDM can be applied in routine clinical practice to improve therapeutic outcomes in critically ill adult patients. Methods: Literature review and analysis were performed by Panel Members nominated by the endorsing organisations, European Society of Intensive Care Medicine (ESICM), Pharmacokinetic/Pharmacodynamic and Critically Ill Patient Study Groups of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), International Association for Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT) and International Society of Antimicrobial Chemotherapy (ISAC). Panel members made recommendations for whether TDM should be applied clinically for different antimicrobials/classes. Results: TDM-guided dosing has been shown to be clinically beneficial for aminoglycosides, voriconazole and ribavirin. For most common antibiotics and antifungals in the ICU, a clear therapeutic range has been established, and for these agents, routine TDM in critically ill patients appears meritorious. For the antivirals, research is needed to identify therapeutic targets and determine whether antiviral TDM is indeed meritorious in this patient population. The Panel Members recommend routine TDM to be performed for aminoglycosides, beta-lactam antibiotics, linezolid, teicoplanin, vancomycin and voriconazole in critically ill patients. Conclusion: Although TDM should be the standard of care for most antimicrobials in every ICU, important barriers need to be addressed before routine TDM can be widely employed worldwide. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Published: 2020

5. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

Author: Bus, L. De, Depuydt, P., Steen, J. van der, Dhaese, S., Smet, K. De, Tabah, A., Akova, M., Cotta, M.O., Pascale, G. De, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J.A., Schouten, J.A., Sjövall, F., Timsit, J.F., Roberts, J.A., Zahar, J.R., Zand, F., Zirpe, K., Waele, J.J. De, Bus, L. De, Depuydt, P., Steen, J. van der, Dhaese, S., Smet, K. De, Tabah, A., Akova, M., Cotta, M.O., Pascale, G. De, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J.A., Schouten, J.A., Sjövall, F., Timsit, J.F., Roberts, J.A., Zahar, J.R., Zand, F., Zirpe, K., and Waele, J.J. De
Abstract: Contains fulltext : 225430.pdf (Publisher’s version ) (Open Access), PURPOSE: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. METHODS: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. RESULTS: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60-1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14-1.64). CONCLUSION: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely.
Published: 2020

6. Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP)

Author: Tabah, A., Bassetti, M., Kollef, M.H., Zahar, J.R., Paiva, J.A., Timsit, J.F., Roberts, J.A., Schouten, J.A., Giamarellou, H., Rello, J., Waele, J. De, Shorr, A.F., Leone, M., Poulakou, G., Depuydt, P., Garnacho-Montero, J., Tabah, A., Bassetti, M., Kollef, M.H., Zahar, J.R., Paiva, J.A., Timsit, J.F., Roberts, J.A., Schouten, J.A., Giamarellou, H., Rello, J., Waele, J. De, Shorr, A.F., Leone, M., Poulakou, G., Depuydt, P., and Garnacho-Montero, J.
Abstract: Contains fulltext : 218616.pdf (Publisher’s version ) (Closed access), BACKGROUND: Antimicrobial de-escalation (ADE) is a strategy of antimicrobial stewardship, aiming at preventing the emergence of antimicrobial resistance (AMR) by decreasing the exposure to broad-spectrum antimicrobials. There is no high-quality research on ADE and its effects on AMR. Its definition varies and there is little evidence-based guidance for clinicians to use ADE in the intensive care unit (ICU). METHODS: A task force of 16 international experts was formed in November 2016 to provide with guidelines for clinical practice to develop questions targeted at defining ADE, its effects on the ICU population and to provide clinical guidance. Groups of 2 experts were assigned 1-2 questions each within their field of expertise to provide draft statements and rationale. A Delphi method, with 3 rounds and an agreement threshold of 70% was required to reach consensus. RESULTS: We present a comprehensive document with 13 statements, reviewing the evidence on the definition of ADE, its effects in the ICU population and providing guidance for clinicians in subsets of clinical scenarios where ADE may be considered. CONCLUSION: ADE remains a topic of controversy due to the complexity of clinical scenarios where it may be applied and the absence of evidence to the effects it may have on antimicrobial resistance.
Published: 2020

7. Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Author: Bastard, P., Zhang, Q., Michailidis, E., Hoffmann, H.H., Zhang, Y., Dorgham, Karim, Philippot, Q., Rosain, J., Béziat, V., Manry, J., Shaw, E., Haljasmägi, L., Peterson, P., Lorenzo, L., Bizien, L., Trouillet-Assant, S., Dobbs, K., de Jesus, A.A., Belot, A., Kallaste, A., Catherinot, E., Tandjaoui-Lambiotte, Y., Le Pen, J., Kerner, G., Bigio, B., Seeleuthner, Y., Yang, R., Bolze, A., Spaan, A.N., Delmonte, O.M., Abers, M.S., Aiuti, A., Casari, G., Lampasona, V., Piemonti, L., Ciceri, F., Bilguvar, K., Lifton, R.P., Vasse, M., Smadja, D.M., Migaud, M., Hadjadj, J., Terrier, B., Duffy, D., Quintana-Murci, L., van de Beek, D., Roussel, L., Vinh, D.C., Tangye, S., Haerynck, F., Dalmau, D., Martinez-Picado, J., Brodin, P., Nussenzweig, M.C., Boisson-Dupuis, S., Rodríguez-Gallego, C., Vogt, G., Mogensen, T.H., Oler, A.J., Gu, J., Burbelo, P.D., Cohen, J.I., Biondi, A., Bettini, L.R., DÁngio, M., Bonfanti, P., Rossignol, P., Mayaux, J., Rieux-Laucat, F., Husebye, E.S., Fusco, F., Ursini, M.V., Imberti, L., Sottini, A., Paghera, S., Quiros-Roldan, E., Rossi, C., Castagnoli, R., Montagna, D., Licari, A., Marseglia, G.L., Duval, X., Ghosn, J., Tsang, J.S., Goldbach-Mansky, R., Kisand, K., Lionakis, M.S., Puel, A., Zhang, S.Y., Holland, S.M., Gorochov, G., Jouanguy, E., Rice, C.M., Cobat, A., Notarangelo, L.D., Abel, L., Su, H.C., Casanova, J.L., Arias, A.A., Boisson, B., Boucherit, S., Bustamante, J., Chbihi, M., Chen, J., Chrabieh, M., Kochetkov, T., Le Voyer, T., Liu, D., Nemirovskaya, Y., Ogishi, M., Papandrea, D., Patissier, C., Rapaport, F., Roynard, M., Vladikine, N., Woollett, M., Zhang, P., Kashyap, A., Ding, L., Bosticardo, M., Wang, Q., Ochoa, S., Liu, H., Chauvin, S.D., Stack, M., Koroleva, G., Bansal, N., Dalgard, C.L., Snow, A.L., Abad Capa, Jorge, Aguilera-Albesa, S., Akcan, O.M., Darazam, I.A., Aldave, J.C., Ramos, M.A., Nadji, S.A., Alkan, G., Allardet-Servent, J., Allende, L.M., Alsina, L., Alyanakian, M.A., Amador-Borrero, B., Amoura, Z., Antolí, A., Arslan, S., Assant, S., Auguet, T., Azot, A., Bajolle, F., Baldolli, A., Ballester, M., Feldman, H.B., Barrou, B., Beurton, A., Bilbao, A., Blanchard-Rohner, G., Blanco, I., Blandinières, A., Blazquez-Gamero, D., Bloomfield, M., Bolivar-Prados, Mireia, Borie, R., Bousfiha, A.A., Bouvattier, C., Boyarchuk, O., Bueno, M.R.P., Agra, J.J.C., Calimli, S., Capra, R., Carrabba, M., Casasnovas, Carlos, Caseris, M., Castelle, M., Castelli, F., de Vera, M.C., Castro, M.V., Chalumeau, M., Charbit, B., Cheng, M.P., Clavé, P., Clotet, B., Codina, A., Colkesen, F., Colobrán Oriol, Roger, Comarmond, C., Corsico, A.G., Darley, D.R., Dauby, N., Dauger, S., de Pontual, L., Dehban, A., Delplancq, G., Demoule, A., Di Sabatino, A., Diehl, J.L., Dobbelaere, S., Durand, S., Eldars, W., Elgamal, M., Elnagdy, M.H., Emiroglu, M., Erdeniz, E.H., Aytekin, S.E., Euvrard, R., Evcen, R., Fabio, G., Faivre, L., Falck, A., Fartoukh, M., Faure, M., Arquero, M.F., Flores, Carlos, Francois, B., Fumadó, V., Solis, B.G., Gaussem, P., Gil-Herrera, J., Gilardin, L., Alarcon, M.G., Girona-Alarcón, M., Goffard, J.C., Gok, F., González-Montelongo, R., Guerder, A., Gul, Y., Guner, S.N., Gut, M., Halwani, R., Hammarström, L., Hatipoglu, N., Hernandez-Brito, E., Holanda-Peña, M.S., Horcajada, J.P., Hraiech, S., Humbert, L., Iglesias, A.D., Íñigo-Campos, A., Jamme, M., Arranz, M.J., Jordan, I., Kanat, F., Kapakli, H., Kara, I., Karbuz, A., Yasar, K.K., Keles, S., Demirkol, Y.K., Klocperk, A., Król, Z.J., Kuentz, P., Kwan, Y.W.M., Lagier, J.C., Lau, Y.L., Le Bourgeois, F., Leo, Y.S., Lopez, R.L., Leung, D., Levin, M., Levy, M., Lévy, R., Li, Z., Linglart, A., Lorenzo-Salazar, J.M., Louapre, C., Lubetzki, C., Luyt, C.E., Lye, D.C., Mansouri, D., Marjani, M., Pereira, J.M., Martin, A., Pueyo, D.M., Marzana, I., Mathian, A., Matos, L.R.B., Matthews, G.V., Mège, J.L., Melki, I., Meritet, J.F., Metin, O., Meyts, I., Mezidi, M., Migeotte, I., Millereux, M., Mirault, T., Mircher, C., Mirsaeidi, M., Melián, A.M., Martinez, A.M., Morange, P., Mordacq, C., Morelle, G., Mouly, S., Muñoz-Barrera, A., Nafati, C., Neves, J.F., Ng, L.F.P., Medina, Y.N., Cuadros, E.N., Gonzalo Ocejo-Vinyals, J., Orbak, Z., Oualha, M., Ozcelik, T., Hammarström, Q.P., Parizot, C., Pascreau, T., Paz-Artal, E., de Diego, R.P., Philippe, A., Philippota, Q., Planas-Serra, L., Ploin, D., Poissy, J., Poncelet, G., Pouletty, M., Quentric, P., Raoult, D., Rebillat, A.S., Reisli, I., Ricart, P., Richard, J.C., Rivet, N., Rivière, J.G., Blanch, G.R., Rodrigo, C., Rodriguez-Gallego, C., Rodríguez-Palmero, A., Romero, C.S., Rothenbuhler, A., Rozenberg, F., del Prado, M.Y.R., Riera, J.S., Sanchez, O., Sánchez-Ramón, S., Schluter, A., Schmidt, M., Schweitzer, C.E., Scolari, F., Sediva, A., Seijo, L.M., Sene, D., Senoglu, S., Seppänen, M.R.J., Ilovich, A.S., Shahrooei, M., Smadja, D., Sobh, A., Moreno, X.S., Solé-Violán, J., Soler, C., Soler-Palacín, P., Stepanovskiy, Y., Stoclin, A., Taccone, F., Tandjaoui-Lambiottea, Y., Taupin, J.L., Tavernier, S.J., Thumerelle, C., Tomasoni, G., Toubiana, J., Alvarez, J.T., Trouillet-Assanta, S., Troya, J., Tucci, A., Uzunhan, Y., Vabres, P., Valencia-Ramos, J., van Den Rym, A.M., Vandernoot, I., Vatansev, H., Vélez-Santamaria, V., Viel, S., Vilain, C., Vilaire, M.E., Vincent, A., Voiriot, G., Vuotto, F., Yosunkaya, A., Young, B.E., Yucel, F., Zannad, F., Zatz, M., Belota, A., Foti, Giuseppe, Bellani, G., Citerio, G., Contro, E., Pesci, A., Valsecchi, M.G., Cazzaniga, M., Bole-Feysot, C., Lyonnet, S., Masson, C., Nitschke, P., Pouliet, A., Schmitt, Y., Tores, F., Zarhrate, M., Abela, L., Andrejak, C., Angoulvant, F., Bachelet, D., Basmaci, R., Behillil, S., Beluze, M., Benkerrou, D., Bhavsar, K., Bompart, F., Bouadma, L., Bouscambert, M., Caralp, M., Cervantes-Gonzalez, M., Chair, A., Coelho, A., Couffignal, C., Couffin-Cadiergues, S., D'ortenzio, E., da Silveira, C., Debray, M.P., Deplanque, D., Descamps, D., Desvallées, M., Diallo, 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de Brabander, J., Bree, G., Brouwer, M.C., de Bruin, S., Bugiani, M., Bulle, E., Chouchane, O., Cloherty, A., Elbers, P., Fleuren, L., Geerlings, S., Geerts, B., Geijtenbeek, T., Girbes, A., Goorhuis, B., Grobusch, M.P., Hafkamp, F., Hagens, L., Hamann, J., Harris, V., Hemke, R., Hermans, S.M., Heunks, L., Hollmann, M.W., Horn, J., Hovius, J.W., de Jong, M.D., Koning, R., van Mourik, N., Nellen, J., Paulus, F., Peters, E., van der Poll, T., Preckel, B., Prins, J.M., Raasveld, J., Reijnders, T., Schinkel, M., Schultz, M.J., Schuurman, A., Sigaloff, K., Smit, M., Stijnis, C.S., Stilma, Willemke, Teunissen, C., Thoral, P., Tsonas, A., van der Valk, M., Veelo, D., Vlaar, A.P.J., de Vries, H., van Vugt, M., Joost Wiersinga, W., Wouters, D., Zwinderman, A.H., Abelb, L., Iuti, F., Muhsen, S.A., Al-Mulla, F., Anderson, M.S., Bogunovic, D., Bondarenko, A., Bryceson, Y., Bustamante, C.D., Butte, M., Chakravorty, S., Christodoulou, J., Cirulli, E., Condino-Neto, A., Cooper, M.A., DeRisi, J.L., 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M.J., Jordan, I., Kanat, F., Kapakli, H., Kara, I., Karbuz, A., Yasar, K.K., Keles, S., Demirkol, Y.K., Klocperk, A., Król, Z.J., Kuentz, P., Kwan, Y.W.M., Lagier, J.C., Lau, Y.L., Le Bourgeois, F., Leo, Y.S., Lopez, R.L., Leung, D., Levin, M., Levy, M., Lévy, R., Li, Z., Linglart, A., Lorenzo-Salazar, J.M., Louapre, C., Lubetzki, C., Luyt, C.E., Lye, D.C., Mansouri, D., Marjani, M., Pereira, J.M., Martin, A., Pueyo, D.M., Marzana, I., Mathian, A., Matos, L.R.B., Matthews, G.V., Mège, J.L., Melki, I., Meritet, J.F., Metin, O., Meyts, I., Mezidi, M., Migeotte, I., Millereux, M., Mirault, T., Mircher, C., Mirsaeidi, M., Melián, A.M., Martinez, A.M., Morange, P., Mordacq, C., Morelle, G., Mouly, S., Muñoz-Barrera, A., Nafati, C., Neves, J.F., Ng, L.F.P., Medina, Y.N., Cuadros, E.N., Gonzalo Ocejo-Vinyals, J., Orbak, Z., Oualha, M., Ozcelik, T., Hammarström, Q.P., Parizot, C., Pascreau, T., Paz-Artal, E., de Diego, R.P., Philippe, A., Philippota, Q., Planas-Serra, L., Ploin, D., 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Yucel, F., Zannad, F., Zatz, M., Belota, A., Foti, Giuseppe, Bellani, G., Citerio, G., Contro, E., Pesci, A., Valsecchi, M.G., Cazzaniga, M., Bole-Feysot, C., Lyonnet, S., Masson, C., Nitschke, P., Pouliet, A., Schmitt, Y., Tores, F., Zarhrate, M., Abela, L., Andrejak, C., Angoulvant, F., Bachelet, D., Basmaci, R., Behillil, S., Beluze, M., Benkerrou, D., Bhavsar, K., Bompart, F., Bouadma, L., Bouscambert, M., Caralp, M., Cervantes-Gonzalez, M., Chair, A., Coelho, A., Couffignal, C., Couffin-Cadiergues, S., D'ortenzio, E., da Silveira, C., Debray, M.P., Deplanque, D., Descamps, D., Desvallées, M., Diallo, A., Diouf, A., Dorival, C., Dubos, F., Eloy, P., Enouf, V.V.E., Espérou, H., Esposito-Farese, M., Etienne, M., Ettalhaoui, N., Gault, N., Gaymard, A., Gigante, T., Gorenne, I., Guedj, J., Hoctin, A., Hoffmann, I., Jaafoura, S., Kafif, O., Kaguelidou, F., Kali, S., Khalil, A., Khan, C., Laouénan, C., Laribi, S., Le, M., Le Hingrat, Q., Le Mestre, S., Le Nagard, H., Lescure, F.X., Lévy, Y., Levy-Marchal, C., Lina, B., Lingas, G., Lucet, J.C., Malvy, D., Mambert, M., Mentré, F., Mercier, N., Meziane, A., Mouquet, H., Mullaert, J., Neant, N., Noret, M., Pages, J., Papadopoulos, A., Paul, C., Peiffer-Smadja, N., Petrov-Sanchez, V., Peytavin, G., Picone, O., Puéchal, O., Rosa-Calatrava, M., Rossignol, B., Roy, C., Schneider, M., Semaille, C., Mohammed, N.S., Tagherset, L., Tardivon, C., Tellier, M.C., Téoulé, F., Terrier, O., Timsit, J.F., Treoux, T., Tual, C., Tubiana, S., van der Werf, S., Vanel, N., Veislinger, A., Visseaux, B., Wiedemann, A., Yazdanpanah, Y., Abelc, L., Alcover, A., Aschard, H., Astrom, K., Bousso, P., Bruhns, P., Cumano, A., Demangel, C., Deriano, L., Santo, J.D., Dromer, F., Eberl, G., Enninga, J., Fellay, Jacques, Gomperts-Boneca, I., Hasan, M., Hercberg, S., Lantz, O., Patin, E., Pellegrini, S., Pol, S., Rausell, A., Rogge, L., Sakuntabhai, A., Schwartz, O., Schwikowski, B., Shorte, S., Tangy, F., Toubert, A., Touvier, M., Ungeheuer, M.N., Albert, M.L., Alavoine, L., Amat, K.K.A., Bielicki, J., Bruijning, P., Burdet, C., Caumes, E., Charpentier, C., Coignard, B., Costa, Y., Damond, F., Dechanet, A., Delmas, C., Ecobichon, J.L., Enouf, V., Frezouls, W., Houhou, N., Ilic-Habensus, E., Kikoine, J., Lebeaux, D., Leclercq, A., Lehacaut, J., Letrou, S., Manchon, P., Mandic, M., Meghadecha, M., Motiejunaite, J., Nouroudine, M., Piquard, V., Postolache, A., Quintin, C., Rexach, J., Roufai, L., Terzian, Z., Thy, M., Vignali, V., van Agtmael, M., Algera, A.G., van Baarle, F., Bax, D., Beudel, M., Bogaard, H.J., Bomers, M., Bos, Lieuwe D, Botta, M., de Brabander, J., Bree, G., Brouwer, M.C., de Bruin, S., Bugiani, M., Bulle, E., Chouchane, O., Cloherty, A., Elbers, P., Fleuren, L., Geerlings, S., Geerts, B., Geijtenbeek, T., Girbes, A., Goorhuis, B., Grobusch, M.P., Hafkamp, F., Hagens, L., Hamann, J., Harris, V., Hemke, R., Hermans, S.M., Heunks, L., Hollmann, M.W., Horn, J., Hovius, J.W., de Jong, M.D., Koning, R., van Mourik, N., Nellen, J., Paulus, F., Peters, E., van der Poll, T., Preckel, B., Prins, J.M., Raasveld, J., Reijnders, T., Schinkel, M., Schultz, M.J., Schuurman, A., Sigaloff, K., Smit, M., Stijnis, C.S., Stilma, Willemke, Teunissen, C., Thoral, P., Tsonas, A., van der Valk, M., Veelo, D., Vlaar, A.P.J., de Vries, H., van Vugt, M., Joost Wiersinga, W., Wouters, D., Zwinderman, A.H., Abelb, L., Iuti, F., Muhsen, S.A., Al-Mulla, F., Anderson, M.S., Bogunovic, D., Bondarenko, A., Bryceson, Y., Bustamante, C.D., Butte, M., Chakravorty, S., Christodoulou, J., Cirulli, E., Condino-Neto, A., Cooper, M.A., DeRisi, J.L., Desai, M., Drolet, B.A., Espinosa, S., Franco, J.L., Gregersen, P.K., Hagin, D., Heath, J., Henrickson, S.E., Hsieh, E., Imai, K., Itan, Y., Karamitros, T., Kisanda, K., Ku, C.L., Ling, Y., Lucas, C.L., Maniatis, T., Marodi, L., Milner, J.D., Mironska, K., Morio, T., Notarangeloa, L.D., Novelli, G., Novelli, A., O'Farrelly, C., Okada, S., Planas, A.M., Prando, C., Pujol, A., Renia, L., Renieri, A., Sancho-Shimizu, V., Sankaran, V., Barrett, K.S., Snow, A., Turvey, S., Uddin, F., Uddin, M.J., Vazquez, S.E., von Bernuth, H., Washington, N., Zawadzki, P., Sua, H.C., Casanovaa, J.L., Rosen, L.B., and Universitat Autònoma de Barcelona
Abstract: Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men.
Published: 2020

8. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

Author: Bus, L. De, Depuydt, P., Steen, J. van der, Dhaese, S., Smet, K. De, Tabah, A., Akova, M., Cotta, M.O., Pascale, G. De, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J.A., Schouten, J.A., Sjövall, F., Timsit, J.F., Roberts, J.A., Zahar, J.R., Zand, F., Zirpe, K., Waele, J.J. De, Bus, L. De, Depuydt, P., Steen, J. van der, Dhaese, S., Smet, K. De, Tabah, A., Akova, M., Cotta, M.O., Pascale, G. De, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J.A., Schouten, J.A., Sjövall, F., Timsit, J.F., Roberts, J.A., Zahar, J.R., Zand, F., Zirpe, K., and Waele, J.J. De
Abstract: Contains fulltext : 225430.pdf (Publisher’s version ) (Open Access), PURPOSE: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. METHODS: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. RESULTS: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60-1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14-1.64). CONCLUSION: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely.
Published: 2020

9. Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP)

Author: Tabah, A., Bassetti, M., Kollef, M.H., Zahar, J.R., Paiva, J.A., Timsit, J.F., Roberts, J.A., Schouten, J.A., Giamarellou, H., Rello, J., Waele, J. De, Shorr, A.F., Leone, M., Poulakou, G., Depuydt, P., Garnacho-Montero, J., Tabah, A., Bassetti, M., Kollef, M.H., Zahar, J.R., Paiva, J.A., Timsit, J.F., Roberts, J.A., Schouten, J.A., Giamarellou, H., Rello, J., Waele, J. De, Shorr, A.F., Leone, M., Poulakou, G., Depuydt, P., and Garnacho-Montero, J.
Abstract: Contains fulltext : 218616.pdf (Publisher’s version ) (Closed access), BACKGROUND: Antimicrobial de-escalation (ADE) is a strategy of antimicrobial stewardship, aiming at preventing the emergence of antimicrobial resistance (AMR) by decreasing the exposure to broad-spectrum antimicrobials. There is no high-quality research on ADE and its effects on AMR. Its definition varies and there is little evidence-based guidance for clinicians to use ADE in the intensive care unit (ICU). METHODS: A task force of 16 international experts was formed in November 2016 to provide with guidelines for clinical practice to develop questions targeted at defining ADE, its effects on the ICU population and to provide clinical guidance. Groups of 2 experts were assigned 1-2 questions each within their field of expertise to provide draft statements and rationale. A Delphi method, with 3 rounds and an agreement threshold of 70% was required to reach consensus. RESULTS: We present a comprehensive document with 13 statements, reviewing the evidence on the definition of ADE, its effects in the ICU population and providing guidance for clinicians in subsets of clinical scenarios where ADE may be considered. CONCLUSION: ADE remains a topic of controversy due to the complexity of clinical scenarios where it may be applied and the absence of evidence to the effects it may have on antimicrobial resistance.
Published: 2020

10. Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP)

Author: Tabah, A., Bassetti, M., Kollef, M.H., Zahar, J.R., Paiva, J.A., Timsit, J.F., Roberts, J.A., Schouten, J.A., Giamarellou, H., Rello, J., Waele, J. De, Shorr, A.F., Leone, M., Poulakou, G., Depuydt, P., Garnacho-Montero, J., Tabah, A., Bassetti, M., Kollef, M.H., Zahar, J.R., Paiva, J.A., Timsit, J.F., Roberts, J.A., Schouten, J.A., Giamarellou, H., Rello, J., Waele, J. De, Shorr, A.F., Leone, M., Poulakou, G., Depuydt, P., and Garnacho-Montero, J.
Abstract: Contains fulltext : 218616.pdf (Publisher’s version ) (Closed access), BACKGROUND: Antimicrobial de-escalation (ADE) is a strategy of antimicrobial stewardship, aiming at preventing the emergence of antimicrobial resistance (AMR) by decreasing the exposure to broad-spectrum antimicrobials. There is no high-quality research on ADE and its effects on AMR. Its definition varies and there is little evidence-based guidance for clinicians to use ADE in the intensive care unit (ICU). METHODS: A task force of 16 international experts was formed in November 2016 to provide with guidelines for clinical practice to develop questions targeted at defining ADE, its effects on the ICU population and to provide clinical guidance. Groups of 2 experts were assigned 1-2 questions each within their field of expertise to provide draft statements and rationale. A Delphi method, with 3 rounds and an agreement threshold of 70% was required to reach consensus. RESULTS: We present a comprehensive document with 13 statements, reviewing the evidence on the definition of ADE, its effects in the ICU population and providing guidance for clinicians in subsets of clinical scenarios where ADE may be considered. CONCLUSION: ADE remains a topic of controversy due to the complexity of clinical scenarios where it may be applied and the absence of evidence to the effects it may have on antimicrobial resistance.
Published: 2020

11. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

Author: Bus, L. De, Depuydt, P., Steen, J. van der, Dhaese, S., Smet, K. De, Tabah, A., Akova, M., Cotta, M.O., Pascale, G. De, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J.A., Schouten, J.A., Sjövall, F., Timsit, J.F., Roberts, J.A., Zahar, J.R., Zand, F., Zirpe, K., Waele, J.J. De, Bus, L. De, Depuydt, P., Steen, J. van der, Dhaese, S., Smet, K. De, Tabah, A., Akova, M., Cotta, M.O., Pascale, G. De, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J.A., Schouten, J.A., Sjövall, F., Timsit, J.F., Roberts, J.A., Zahar, J.R., Zand, F., Zirpe, K., and Waele, J.J. De
Abstract: Contains fulltext : 225430.pdf (Publisher’s version ) (Open Access), PURPOSE: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. METHODS: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. RESULTS: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60-1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14-1.64). CONCLUSION: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely.
Published: 2020

12. Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

Author: Bassetti, M., Scudeller, L., Giacobbe, D.R., Lamoth, F., Righi, E., Zuccaro, V., Grecchi, C., Rebuffi, C., Akova, M., Alastruey-Izquierdo, A., Arikan-Akdagli, S., Azoulay, E., Blot, S.I., Cornely, O.A., Lass-Florl, C., Koehler, P., Cuenca-Estrella, M., Lange, D.W. de, Rosa, F.G. De, Waele, J.J. De, Dimopoulos, G., Garnacho-Montero, J., Hoenigl, M., Kanj, S.S., Maertens, J., Martin-Loeches, I., Munoz, P., Kullberg, B.J., Agvald-Ohman, C., Poulakou, G., Rello, J., Sanguinetti, M., Taccone, F.S., Timsit, J.F., Torres, A. Cedillo, Vazquez, J.A., Calandra, T., Bassetti, M., Scudeller, L., Giacobbe, D.R., Lamoth, F., Righi, E., Zuccaro, V., Grecchi, C., Rebuffi, C., Akova, M., Alastruey-Izquierdo, A., Arikan-Akdagli, S., Azoulay, E., Blot, S.I., Cornely, O.A., Lass-Florl, C., Koehler, P., Cuenca-Estrella, M., Lange, D.W. de, Rosa, F.G. De, Waele, J.J. De, Dimopoulos, G., Garnacho-Montero, J., Hoenigl, M., Kanj, S.S., Maertens, J., Martin-Loeches, I., Munoz, P., Kullberg, B.J., Agvald-Ohman, C., Poulakou, G., Rello, J., Sanguinetti, M., Taccone, F.S., Timsit, J.F., Torres, A. Cedillo, Vazquez, J.A., and Calandra, T.
Abstract: Contains fulltext : 202896.pdf (publisher's version ) (Closed access), BACKGROUND: The reliability of diagnostic criteria for invasive fungal diseases (IFD) developed for severely immunocompromised patients is questionable in critically ill adult patients in intensive care units (ICU). OBJECTIVES: To develop a standard set of definitions for IFD in critically ill adult patients in ICU. METHODS: Based on a systematic literature review, a list of potential definitions to be applied to ICU patients will be developed by the ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) and the ESCMID Fungal Infection Study Group (EFISG) chairpersons. The proposed definitions will be evaluated by a panel of 30 experts using the RAND/UCLA appropriateness methods. The panel will rank each of the proposed definitions on a 1-9 scale trough a dedicated questionnaire, in two rounds: one remote and one face-to-face. Based on their median rank and the level of agreement across panel members, selected definitions will be organised in a main consensus document and in an executive summary. The executive summary will be made available online for public comments. CONCLUSIONS: The present consensus project will seek to provide standard definitions for IFD in critically ill adult patients in ICU, with the ultimate aims of improving their clinical outcome and facilitating the comparison and generalizability of research findings.
Published: 2019

13. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Author: Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., Montravers, P., Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., and Montravers, P.
Abstract: Contains fulltext : 206779.pdf (publisher's version ) (Open Access), BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.
Published: 2019

14. Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

Author: Bassetti, M., Scudeller, L., Giacobbe, D.R., Lamoth, F., Righi, E., Zuccaro, V., Grecchi, C., Rebuffi, C., Akova, M., Alastruey-Izquierdo, A., Arikan-Akdagli, S., Azoulay, E., Blot, S.I., Cornely, O.A., Lass-Florl, C., Koehler, P., Cuenca-Estrella, M., Lange, D.W. de, Rosa, F.G. De, Waele, J.J. De, Dimopoulos, G., Garnacho-Montero, J., Hoenigl, M., Kanj, S.S., Maertens, J., Martin-Loeches, I., Munoz, P., Kullberg, B.J., Agvald-Ohman, C., Poulakou, G., Rello, J., Sanguinetti, M., Taccone, F.S., Timsit, J.F., Torres, A. Cedillo, Vazquez, J.A., Calandra, T., Bassetti, M., Scudeller, L., Giacobbe, D.R., Lamoth, F., Righi, E., Zuccaro, V., Grecchi, C., Rebuffi, C., Akova, M., Alastruey-Izquierdo, A., Arikan-Akdagli, S., Azoulay, E., Blot, S.I., Cornely, O.A., Lass-Florl, C., Koehler, P., Cuenca-Estrella, M., Lange, D.W. de, Rosa, F.G. De, Waele, J.J. De, Dimopoulos, G., Garnacho-Montero, J., Hoenigl, M., Kanj, S.S., Maertens, J., Martin-Loeches, I., Munoz, P., Kullberg, B.J., Agvald-Ohman, C., Poulakou, G., Rello, J., Sanguinetti, M., Taccone, F.S., Timsit, J.F., Torres, A. Cedillo, Vazquez, J.A., and Calandra, T.
Abstract: Contains fulltext : 202896.pdf (publisher's version ) (Closed access), BACKGROUND: The reliability of diagnostic criteria for invasive fungal diseases (IFD) developed for severely immunocompromised patients is questionable in critically ill adult patients in intensive care units (ICU). OBJECTIVES: To develop a standard set of definitions for IFD in critically ill adult patients in ICU. METHODS: Based on a systematic literature review, a list of potential definitions to be applied to ICU patients will be developed by the ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) and the ESCMID Fungal Infection Study Group (EFISG) chairpersons. The proposed definitions will be evaluated by a panel of 30 experts using the RAND/UCLA appropriateness methods. The panel will rank each of the proposed definitions on a 1-9 scale trough a dedicated questionnaire, in two rounds: one remote and one face-to-face. Based on their median rank and the level of agreement across panel members, selected definitions will be organised in a main consensus document and in an executive summary. The executive summary will be made available online for public comments. CONCLUSIONS: The present consensus project will seek to provide standard definitions for IFD in critically ill adult patients in ICU, with the ultimate aims of improving their clinical outcome and facilitating the comparison and generalizability of research findings.
Published: 2019

15. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Author: Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., Montravers, P., Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., and Montravers, P.
Abstract: Contains fulltext : 206779.pdf (publisher's version ) (Open Access), BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.
Published: 2019

16. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Author: Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., Montravers, P., Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., and Montravers, P.
Abstract: Contains fulltext : 206779.pdf (publisher's version ) (Open Access), BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.
Published: 2019

17. Erratum: Antimicrobials: A global alliance for optimizing their rational use in intra-abdominal infections (AGORA). [World J Emerg Surg. 11, (2016) (33)] DOI: 10.1186/s13017-016-0089-y

Author: Sartelli, M. Weber, D.G. Ruppé, E. Bassetti, M. Wright, B.J. Ansaloni, L. Catena, F. Coccolini, F. Abu-Zidan, F.M. Coimbra, R. Moore, E.E. Moore, F.A. Maier, R.V. De Waele, J.J. Kirkpatrick, A.W. Griffiths, E.A. Eckmann, C. Brink, A.J. Mazuski, J.E. May, A.K. Sawyer, R.G. Mertz, D. Montravers, P. Kumar, A. Roberts, J.A. Vincent, J.L. Watkins, R.R. Lowman, W. Spellberg, B. Abbott, I.J. Adesunkanmi, A.K. Al-Dahir, S. Al-Hasan, M.N. Agresta, F. Althani, A.A. Ansari, S. Ansumana, R. Augustin, G. Bala, M. Balogh, Z.J. Baraket, O. Bhangu, A. Beltrán, M.A. Bernhard, M. Biffl, W.L. Boermeester, M.A. Brecher, S.M. Cherry-Bukowiec, J.R. Buyne, O.R. Cainzos, M.A. Cairns, K.A. Camacho-Ortiz, A. Chandy, S.J. Che Jusoh, A. Chichom-Mefire, A. Colijn, C. Corcione, F. Cui, Y. Curcio, D. Delibegovic, S. Demetrashvili, Z. De Simone, B. Dhingra, S. Diaz, J.J. Di Carlo, I. Dillip, A. Di Saverio, S. Doyle, M.P. Dorj, G. Dogjani, A. Dupont, H. Eachempati, S.R. Enani, M.A. Egiev, V.N. Elmangory, M.M. Ferrada, P. Fitchett, J.R. Fraga, G.P. Guessennd, N. Giamarellou, H. Ghnnam, W. Gkiokas, G. Goldberg, S.R. Gomes, C.A. Gomi, H. Guzmán-Blanco, M. Haque, M. Hansen, S. Hecker, A. Heizmann, W.R. Herzog, T. Hodonou, A.M. Hong, S.K. Kafka-Ritsch, R. Kaplan, L.J. Kapoor, G. Karamarkovic, A. Kees, M.G. Kenig, J. Kiguba, R. Kim, P.K. Kluger, Y. Khokha, V. Koike, K. Kok, K.Y. Kong, V. Knox, M.C. Inaba, K. Isik, A. Iskandar, K. Ivatury, R.R. Labbate, M. Labricciosa, F.M. Laterre, P.F. Latifi, R. Lee, J.G. Lee, Y.R. Leone, M. Leppaniemi, A. Li, Y. Liang, S.Y. Loho, T. Maegele, M. Malama, S. Marei, H.E. Martin-Loeches, I. Marwah, S. Massele, A. McFarlane, M. Melo, R.B. Negoi, I. Nicolau, D.P. Nord, C.E. Ofori-Asenso, R. Omari, A.H. Ordonez, C.A. Ouadii, M. Pereira Júnior, G.A. Piazza, D. Pupelis, G. Rawson, T.M. Rems, M. Rizoli, S. Rocha, C. Sakakushev, B. Sanchez-Garcia, M. Sato, N. Segovia Lohse, H.A. Sganga, G. Siribumrungwong, B. Shelat, V.G. Soreide, K. Soto, R. Talving, P. Tilsed, J.V. Timsit, J.F. and Sartelli, M. Weber, D.G. Ruppé, E. Bassetti, M. Wright, B.J. Ansaloni, L. Catena, F. Coccolini, F. Abu-Zidan, F.M. Coimbra, R. Moore, E.E. Moore, F.A. Maier, R.V. De Waele, J.J. Kirkpatrick, A.W. Griffiths, E.A. Eckmann, C. Brink, A.J. Mazuski, J.E. May, A.K. Sawyer, R.G. Mertz, D. Montravers, P. Kumar, A. Roberts, J.A. Vincent, J.L. Watkins, R.R. Lowman, W. Spellberg, B. Abbott, I.J. Adesunkanmi, A.K. Al-Dahir, S. Al-Hasan, M.N. Agresta, F. Althani, A.A. Ansari, S. Ansumana, R. Augustin, G. Bala, M. Balogh, Z.J. Baraket, O. Bhangu, A. Beltrán, M.A. Bernhard, M. Biffl, W.L. Boermeester, M.A. Brecher, S.M. Cherry-Bukowiec, J.R. Buyne, O.R. Cainzos, M.A. Cairns, K.A. Camacho-Ortiz, A. Chandy, S.J. Che Jusoh, A. Chichom-Mefire, A. Colijn, C. Corcione, F. Cui, Y. Curcio, D. Delibegovic, S. Demetrashvili, Z. De Simone, B. Dhingra, S. Diaz, J.J. Di Carlo, I. Dillip, A. Di Saverio, S. Doyle, M.P. Dorj, G. Dogjani, A. Dupont, H. Eachempati, S.R. Enani, M.A. Egiev, V.N. Elmangory, M.M. Ferrada, P. Fitchett, J.R. Fraga, G.P. Guessennd, N. Giamarellou, H. Ghnnam, W. Gkiokas, G. Goldberg, S.R. Gomes, C.A. Gomi, H. Guzmán-Blanco, M. Haque, M. Hansen, S. Hecker, A. Heizmann, W.R. Herzog, T. Hodonou, A.M. Hong, S.K. Kafka-Ritsch, R. Kaplan, L.J. Kapoor, G. Karamarkovic, A. Kees, M.G. Kenig, J. Kiguba, R. Kim, P.K. Kluger, Y. Khokha, V. Koike, K. Kok, K.Y. Kong, V. Knox, M.C. Inaba, K. Isik, A. Iskandar, K. Ivatury, R.R. Labbate, M. Labricciosa, F.M. Laterre, P.F. Latifi, R. Lee, J.G. Lee, Y.R. Leone, M. Leppaniemi, A. Li, Y. Liang, S.Y. Loho, T. Maegele, M. Malama, S. Marei, H.E. Martin-Loeches, I. Marwah, S. Massele, A. McFarlane, M. Melo, R.B. Negoi, I. Nicolau, D.P. Nord, C.E. Ofori-Asenso, R. Omari, A.H. Ordonez, C.A. Ouadii, M. Pereira Júnior, G.A. Piazza, D. Pupelis, G. Rawson, T.M. Rems, M. Rizoli, S. Rocha, C. Sakakushev, B. Sanchez-Garcia, M. Sato, N. Segovia Lohse, H.A. Sganga, G. Siribumrungwong, B. Shelat, V.G. Soreide, K. Soto, R. Talving, P. Tilsed, J.V. Timsit, J.F.
Abstract: The original article [1] contains an error whereby a co-author, Boris Sakakushev has their family name spelt incorrectly as 'Sakakhushev'. The authors would therefore like it known that the correct spelling of the family name is 'Sakakushev'. © The Author(s).
Published: 2017

18. Intensive care medicine research agenda on invasive fungal infection in critically ill patients.

Author: Bassetti, M., Garnacho-Montero, J., Calandra, T., Kullberg, B.J., Dimopoulos, G., Azoulay, E., Chakrabarti, A, Kett, D., Leon, C., Ostrosky-Zeichner, L., Sanguinetti, M., Timsit, J.F., Richardson, M.D., Shorr, A., Cornely, O.A., Bassetti, M., Garnacho-Montero, J., Calandra, T., Kullberg, B.J., Dimopoulos, G., Azoulay, E., Chakrabarti, A, Kett, D., Leon, C., Ostrosky-Zeichner, L., Sanguinetti, M., Timsit, J.F., Richardson, M.D., Shorr, A., and Cornely, O.A.
Abstract: 1 september 2017, Contains fulltext : 182569.pdf (publisher's version ) (Closed access), PURPOSE: To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. METHODS: A systematic review of the medical literature taking account of national and international guidelines and expert opinion. RESULTS: Severe invasive fungal infections (IFIs) are becoming increasingly frequent in critically ill patients. Approximately 80% of IFIs are due to Candida spp. and 0.3-19% to Aspergillus spp. Recent observations emphasize the necessity of building a worldwide sentinel network to monitor the emergence of new fungal species and changes in susceptibility. Robust data on the attributable mortality are essential for the design of clinical studies with mortality endpoints. Although early antifungal therapy for Candida has been recommended in patients with risk factors, sepsis of unknown cause, and positive Candida serum biomarkers [beta-1 --> 3-D-glucan (BDG) and Candida albicans germ tube antibody (CAGTA)], its usefulness and influence on outcome need to be confirmed. Future studies may specifically address the optimal diagnostic and therapeutic strategies for patients with abdominal candidiasis. Better knowledge of the pharmacokinetics of antifungal molecules and tissue penetration is a key issue for intensivists. Regarding invasive aspergillosis, further investigation is needed to determine its incidence in the ICU, its relationship with influenza outbreaks, the clinical impact of rapid diagnosis, and the significance of combination treatment. CONCLUSIONS: Fundamental questions regarding IFI have to be addressed over the next decade. The clinical studies described in this research agenda should provide a template and set priorities for the clinical investigations that need to be per
Published: 2017

19. Intensive care medicine research agenda on invasive fungal infection in critically ill patients.

Author: Bassetti, M., Garnacho-Montero, J., Calandra, T., Kullberg, B.J., Dimopoulos, G., Azoulay, E., Chakrabarti, A, Kett, D., Leon, C., Ostrosky-Zeichner, L., Sanguinetti, M., Timsit, J.F., Richardson, M.D., Shorr, A., Cornely, O.A., Bassetti, M., Garnacho-Montero, J., Calandra, T., Kullberg, B.J., Dimopoulos, G., Azoulay, E., Chakrabarti, A, Kett, D., Leon, C., Ostrosky-Zeichner, L., Sanguinetti, M., Timsit, J.F., Richardson, M.D., Shorr, A., and Cornely, O.A.
Abstract: 01 september 2017, Contains fulltext : 182569.pdf (publisher's version ) (Closed access), PURPOSE: To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. METHODS: A systematic review of the medical literature taking account of national and international guidelines and expert opinion. RESULTS: Severe invasive fungal infections (IFIs) are becoming increasingly frequent in critically ill patients. Approximately 80% of IFIs are due to Candida spp. and 0.3-19% to Aspergillus spp. Recent observations emphasize the necessity of building a worldwide sentinel network to monitor the emergence of new fungal species and changes in susceptibility. Robust data on the attributable mortality are essential for the design of clinical studies with mortality endpoints. Although early antifungal therapy for Candida has been recommended in patients with risk factors, sepsis of unknown cause, and positive Candida serum biomarkers [beta-1 --> 3-D-glucan (BDG) and Candida albicans germ tube antibody (CAGTA)], its usefulness and influence on outcome need to be confirmed. Future studies may specifically address the optimal diagnostic and therapeutic strategies for patients with abdominal candidiasis. Better knowledge of the pharmacokinetics of antifungal molecules and tissue penetration is a key issue for intensivists. Regarding invasive aspergillosis, further investigation is needed to determine its incidence in the ICU, its relationship with influenza outbreaks, the clinical impact of rapid diagnosis, and the significance of combination treatment. CONCLUSIONS: Fundamental questions regarding IFI have to be addressed over the next decade. The clinical studies described in this research agenda should provide a template and set priorities for the clinical investigations that need to be per
Published: 2017

20. Task force on management and prevention of Acinetobacter baumannii infections in the ICU

Author: Garnacho-Montero, J. Dimopoulos, G. Poulakou, G. Akova, M. Cisneros, J.M. De Waele, J. Petrosillo, N. Seifert, H. Timsit, J.F. Vila, J. Zahar, J.-R. Bassetti, M. and Garnacho-Montero, J. Dimopoulos, G. Poulakou, G. Akova, M. Cisneros, J.M. De Waele, J. Petrosillo, N. Seifert, H. Timsit, J.F. Vila, J. Zahar, J.-R. Bassetti, M.
Abstract: Introduction: Acinetobacterbaumannii constitutes a dreadful problem in many ICUs worldwide. The very limited therapeutic options available for these organisms are a matter of great concern. No specific guidelines exist addressing the prevention and management of A. baumannii infections in the critical care setting. Methods: Clinical microbiologists, infectious disease specialists and intensive care physicians were invited by the Chair of the Infection Section of the ESICM to participate in a multidisciplinary expert panel. After the selection of clinically relevant questions, this document provides recommendations about the use of microbiological techniques for identification of A. baumannii in clinical laboratories, antibiotic therapy for severe infections and recommendations to control this pathogen in outbreaks and endemic situations. Evidence supporting each statement was graded according to the European Society of Clinical Microbiology and Infection Diseases (ESCMID) grading system. Results: Empirical coverage of A. baumannii is recommended in severe infections (severe sepsis or septic shock) occurring during an A. baumannii outbreak, in an endemic setting, or in a previously colonized patient. For these cases, a polymyxin is suggested as part of the empirical treatment in cases of a high suspicion of a carbapenem-resistant (CR) A. baumannii strain. An institutional program including staff education, promotion of hand hygiene, strict contact and isolation precautions, environmental cleaning, targeted active surveillance, and antimicrobial stewardship should be instituted and maintained to combat outbreaks and endemic situations. Conclusions: Specific recommendations about prevention and management of A. baumannii infections in the ICU were elaborated by this multidisciplinary panel. The paucity of randomized controlled trials is noteworthy, so these recommendations are mainly based on observational studies and pharmacodynamics modeling. © 2015, Springer-Verlag
Published: 2015

21. WSES guidelines for management of Clostridium difficile infection in surgical patients

Author: Sartelli, M., Malangoni, M.A., Abu-Zidan, F.M., Griffiths, E.A., Bella, S. Di, McFarland, L.V., Eltringham, I., Shelat, V.G., Velmahos, G.C., Kelly, C.P., Khanna, S., Abdelsattar, Z.M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W.L., Brecher, S.M., Camacho-Ortiz, A., Cainzos, M.A., Canterbury, L.A., Catena, F., Chan, S., Cherry-Bukowiec, J.R., Clanton, J., Coccolini, F., Cocuz, M.E., Coimbra, R., Cook, C.H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Carlo, I. Di, Saverio, S. Di, Dumitru, I.M., Eckert, C., Eckmann, C., Eiland, E.H., Enani, M.A., Faro, M., Ferrada, P., Forrester, J.D., Fraga, G.P., Frossard, J.L., Galeiras, R., Ghnnam, W., Gomes, C.A., Gorrepati, V., Ahmed, M.H., Herzog, T., Humphrey, F., Kim, J.I., Isik, A., Ivatury, R., Lee, Y.Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P.K., Kluger, Y., Ko, W.C., LaBarbera, F.D., Lee, J.G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J.E., Metan, G., Moore, E.E., Moore, F.A., Nord, C.E., Ordonez, C.A., Junior, G.A., Petrosillo, N., Portela, F., Puri, B.K., Ray, A., Raza, M., Rems, M., Sakakushev, B.E., Sganga, G., Spigaglia, P., Stewart, D.B., Tattevin, P., Timsit, J.F., To, K.B., Trana, C., Uhl, W., Urbanek, L., Goor, H. van, Vassallo, A., Zahar, J.R., Caproli, E., Viale, P., Sartelli, M., Malangoni, M.A., Abu-Zidan, F.M., Griffiths, E.A., Bella, S. Di, McFarland, L.V., Eltringham, I., Shelat, V.G., Velmahos, G.C., Kelly, C.P., Khanna, S., Abdelsattar, Z.M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W.L., Brecher, S.M., Camacho-Ortiz, A., Cainzos, M.A., Canterbury, L.A., Catena, F., Chan, S., Cherry-Bukowiec, J.R., Clanton, J., Coccolini, F., Cocuz, M.E., Coimbra, R., Cook, C.H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Carlo, I. Di, Saverio, S. Di, Dumitru, I.M., Eckert, C., Eckmann, C., Eiland, E.H., Enani, M.A., Faro, M., Ferrada, P., Forrester, J.D., Fraga, G.P., Frossard, J.L., Galeiras, R., Ghnnam, W., Gomes, C.A., Gorrepati, V., Ahmed, M.H., Herzog, T., Humphrey, F., Kim, J.I., Isik, A., Ivatury, R., Lee, Y.Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P.K., Kluger, Y., Ko, W.C., LaBarbera, F.D., Lee, J.G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J.E., Metan, G., Moore, E.E., Moore, F.A., Nord, C.E., Ordonez, C.A., Junior, G.A., Petrosillo, N., Portela, F., Puri, B.K., Ray, A., Raza, M., Rems, M., Sakakushev, B.E., Sganga, G., Spigaglia, P., Stewart, D.B., Tattevin, P., Timsit, J.F., To, K.B., Trana, C., Uhl, W., Urbanek, L., Goor, H. van, Vassallo, A., Zahar, J.R., Caproli, E., and Viale, P.
Abstract: Contains fulltext : 154431.pdf (publisher's version ) (Open Access), In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.
Published: 2015

22. WSES guidelines for management of Clostridium difficile infection in surgical patients

Author: Sartelli, M., Malangoni, M.A., Abu-Zidan, F.M., Griffiths, E.A., Bella, S. Di, McFarland, L.V., Eltringham, I., Shelat, V.G., Velmahos, G.C., Kelly, C.P., Khanna, S., Abdelsattar, Z.M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W.L., Brecher, S.M., Camacho-Ortiz, A., Cainzos, M.A., Canterbury, L.A., Catena, F., Chan, S., Cherry-Bukowiec, J.R., Clanton, J., Coccolini, F., Cocuz, M.E., Coimbra, R., Cook, C.H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Carlo, I. Di, Saverio, S. Di, Dumitru, I.M., Eckert, C., Eckmann, C., Eiland, E.H., Enani, M.A., Faro, M., Ferrada, P., Forrester, J.D., Fraga, G.P., Frossard, J.L., Galeiras, R., Ghnnam, W., Gomes, C.A., Gorrepati, V., Ahmed, M.H., Herzog, T., Humphrey, F., Kim, J.I., Isik, A., Ivatury, R., Lee, Y.Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P.K., Kluger, Y., Ko, W.C., LaBarbera, F.D., Lee, J.G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J.E., Metan, G., Moore, E.E., Moore, F.A., Nord, C.E., Ordonez, C.A., Junior, G.A., Petrosillo, N., Portela, F., Puri, B.K., Ray, A., Raza, M., Rems, M., Sakakushev, B.E., Sganga, G., Spigaglia, P., Stewart, D.B., Tattevin, P., Timsit, J.F., To, K.B., Trana, C., Uhl, W., Urbanek, L., Goor, H. van, Vassallo, A., Zahar, J.R., Caproli, E., Viale, P., Sartelli, M., Malangoni, M.A., Abu-Zidan, F.M., Griffiths, E.A., Bella, S. Di, McFarland, L.V., Eltringham, I., Shelat, V.G., Velmahos, G.C., Kelly, C.P., Khanna, S., Abdelsattar, Z.M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W.L., Brecher, S.M., Camacho-Ortiz, A., Cainzos, M.A., Canterbury, L.A., Catena, F., Chan, S., Cherry-Bukowiec, J.R., Clanton, J., Coccolini, F., Cocuz, M.E., Coimbra, R., Cook, C.H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Carlo, I. Di, Saverio, S. Di, Dumitru, I.M., Eckert, C., Eckmann, C., Eiland, E.H., Enani, M.A., Faro, M., Ferrada, P., Forrester, J.D., Fraga, G.P., Frossard, J.L., Galeiras, R., Ghnnam, W., Gomes, C.A., Gorrepati, V., Ahmed, M.H., Herzog, T., Humphrey, F., Kim, J.I., Isik, A., Ivatury, R., Lee, Y.Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P.K., Kluger, Y., Ko, W.C., LaBarbera, F.D., Lee, J.G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J.E., Metan, G., Moore, E.E., Moore, F.A., Nord, C.E., Ordonez, C.A., Junior, G.A., Petrosillo, N., Portela, F., Puri, B.K., Ray, A., Raza, M., Rems, M., Sakakushev, B.E., Sganga, G., Spigaglia, P., Stewart, D.B., Tattevin, P., Timsit, J.F., To, K.B., Trana, C., Uhl, W., Urbanek, L., Goor, H. van, Vassallo, A., Zahar, J.R., Caproli, E., and Viale, P.
Abstract: Contains fulltext : 154431.pdf (publisher's version ) (Open Access), In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.
Published: 2015

23. WSES guidelines for management of Clostridium difficile infection in surgical patients

Author: Sartelli, M., Malangoni, M.A., Abu-Zidan, F.M., Griffiths, E.A., Bella, S. Di, McFarland, L.V., Eltringham, I., Shelat, V.G., Velmahos, G.C., Kelly, C.P., Khanna, S., Abdelsattar, Z.M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W.L., Brecher, S.M., Camacho-Ortiz, A., Cainzos, M.A., Canterbury, L.A., Catena, F., Chan, S., Cherry-Bukowiec, J.R., Clanton, J., Coccolini, F., Cocuz, M.E., Coimbra, R., Cook, C.H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Carlo, I. Di, Saverio, S. Di, Dumitru, I.M., Eckert, C., Eckmann, C., Eiland, E.H., Enani, M.A., Faro, M., Ferrada, P., Forrester, J.D., Fraga, G.P., Frossard, J.L., Galeiras, R., Ghnnam, W., Gomes, C.A., Gorrepati, V., Ahmed, M.H., Herzog, T., Humphrey, F., Kim, J.I., Isik, A., Ivatury, R., Lee, Y.Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P.K., Kluger, Y., Ko, W.C., LaBarbera, F.D., Lee, J.G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J.E., Metan, G., Moore, E.E., Moore, F.A., Nord, C.E., Ordonez, C.A., Junior, G.A., Petrosillo, N., Portela, F., Puri, B.K., Ray, A., Raza, M., Rems, M., Sakakushev, B.E., Sganga, G., Spigaglia, P., Stewart, D.B., Tattevin, P., Timsit, J.F., To, K.B., Trana, C., Uhl, W., Urbanek, L., Goor, H. van, Vassallo, A., Zahar, J.R., Caproli, E., Viale, P., Sartelli, M., Malangoni, M.A., Abu-Zidan, F.M., Griffiths, E.A., Bella, S. Di, McFarland, L.V., Eltringham, I., Shelat, V.G., Velmahos, G.C., Kelly, C.P., Khanna, S., Abdelsattar, Z.M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W.L., Brecher, S.M., Camacho-Ortiz, A., Cainzos, M.A., Canterbury, L.A., Catena, F., Chan, S., Cherry-Bukowiec, J.R., Clanton, J., Coccolini, F., Cocuz, M.E., Coimbra, R., Cook, C.H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Carlo, I. Di, Saverio, S. Di, Dumitru, I.M., Eckert, C., Eckmann, C., Eiland, E.H., Enani, M.A., Faro, M., Ferrada, P., Forrester, J.D., Fraga, G.P., Frossard, J.L., Galeiras, R., Ghnnam, W., Gomes, C.A., Gorrepati, V., Ahmed, M.H., Herzog, T., Humphrey, F., Kim, J.I., Isik, A., Ivatury, R., Lee, Y.Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P.K., Kluger, Y., Ko, W.C., LaBarbera, F.D., Lee, J.G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J.E., Metan, G., Moore, E.E., Moore, F.A., Nord, C.E., Ordonez, C.A., Junior, G.A., Petrosillo, N., Portela, F., Puri, B.K., Ray, A., Raza, M., Rems, M., Sakakushev, B.E., Sganga, G., Spigaglia, P., Stewart, D.B., Tattevin, P., Timsit, J.F., To, K.B., Trana, C., Uhl, W., Urbanek, L., Goor, H. van, Vassallo, A., Zahar, J.R., Caproli, E., and Viale, P.
Abstract: Contains fulltext : 154431.pdf (publisher's version ) (Open Access), In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.
Published: 2015

24. Diagnosis and management of temperature abnormality in ICUs: a EUROBACT investigators' survey.

Author: EUROBACT Investigators, Lipman, J., Leditschke, A., Rodgers, H., Milliss, D., Gottlieb, T., Baker, S., Roberts, B., Krafft, P., Bernreiter, S., Depuydt, P., Jamaer, P., Lebbinck, H., De Carvalho, F.B., Pereira, J., Yehia, A.C., Machado, F.C., Carneiro, A.L., Fagundes, A., Rodriguez, F., Soares, M., Salluh, J., Beranger, R., Lugarinho, M., Carvalho, A., Reis, L., de Lima, C., Piras, C., Caser, E., Falcão, J., Laupland, K.B., Zhang, Z., Ma, X., Wan, X.Y., Zhang, J.Z., Qian, K.J., Xia, L., Yang, C., Lijing, D., Duan, M., Zhanhong, T., Yiping, P., Yongqiang, W., Ning, L., Li-Xin, Z., Jin-Quan, L., Gornik, I., Degoricija, V., Kouatchet, A., Plantefeve, G., Pajot, O., Kallel, H., Thierry, L., Pierre, K., Petitpas, D., Lessire, H., Brun-Buisson, C., Pham, T., Annane, D., Maxime, V., Herault, M.C., Merceron, S., Kipnis, E., Boyer-Besseyre, M., Tavernier, B., Faivre, S., Francois, V., Ercole, R.L., Willems, V., Klouche, K., Delabre, J.P., Julien, C., Brigitte, G., Gibot, S., Mégarbane, B., Seguin, P., Launoy, A., Vincent, T., Jamali, S., Calvino, S., Tabah, A., Durand, M., Rossi-Blancher, M., Debrumetz, A., Azoulay, E., Charpentier, J., Chiche, J.D., Garrouste-Orgeas, M., Misset, B., Marx, G., Krueger, W.A., Felbinger, T., Heininger, A., Voigt, I., Schroeder, T., Pneumatikos, I., Theodorou, V., Koulenti, D., Armaganidis, A., Myrianthefs, P., Gavala, A., Nikolaou, C., Kounougeri, K., Routsi, C., Liapikou, A., Nathanail, C., Tsakas, P., Karabinis, A., Tsakalakis, C., Mandragos, K., Katsenos, C., Anthopoulos, G., Choutas, G., Koutsikou, A., Nikolaidou, I., Bekos, V., Spring, A., Paskalis, H., Psallida, V., Ioakeimidou, A., Lahana, A., Plantza, P., Nodarou, A., Koutsoukou, A., Kyriakopoulou, M., Michalia, M., Clouva-Molyvdas, P., Sfyras, D., Georgiadis, C., Polakis, P., Papanikolaou, S., Christopoulos, C., Vrettou, E., Arvaniti, K., Matamis, D., Paraforou, T., Spiropoulou, K., Georgopoulos, D., Klimathianaki, M., Nakos, G., Koulouras, V., Komnos, A., Chovas, A., Prekates, A., Magira, E., Giannakoy, M., Gkeka, E., Antoniadou, E., Antypa, E., Gritsi-Gerogianni, N., Kydona, C., Zakynthinos, E., Tzovaras, N., Csomos, A., Gábor, C., Mikos, B., Velkey, G., Vitális, E., Kovács, N.Á., Bogar, L., Kiss, T., Eva, Z., Mangani, V., Tulli, G., Stefania, G., Chiara, R., Antonelli, M., Montini, L., Rocco, M., Citterio, G., Fujitani, S., Hosokawa, K., Said, M., Boubaker, C., Schultz, M., Van Der Veen, A., Aardema, H., Bergmans, D., Schoemakers, R., Wesselink, R., Oostdijk, E.A., Bonten, M.J., Dragan, I., Kostyrka, W., Tamowicz, B., Mikstacki, A., Smuszkiewicz, P., Nadolski, J., It, O.I., Choma, R., Koscielniak, W., Pietraszek, P., Maul, E., Bártolo, A., Martins, S., Miranda, I., Oliveira, M., França, C., Tornada, A., Telo, L., Ferreira, L., Cardoso, T., Santos, L., Ferreira, A., Pereira, J.M., Dias, C., Dias, M.C., Marques, A.J., Castelões, P., Batranovic, U., Gavrilovic, S., Filipescu, D., Alvarez-Lerma, F., Gracia, M.P., Armestar-Rodriguez, F., Mesalles-Sanjuán, E., De Arbina, N.L., Sirvent, J., Garro, P., Cañones, J.R., Blanco, A., Marqués, L., Insausti, J., Martija, I., Valles, J., Ferrer, R., Ubeda, A., Lucena, F., Cuevas, M.G., Zaragoza, R., Sancho, S., Laube, M., Rothen, M., Eggimann, P., Pagani, J.L., Ayed, S., Ouanes, I., Abroug, F., Özcengiz, D., Yağar, S., Ünver, S., Tunçel, Y.I., Buyukkocak, U., Aykac, E., Coşar, A., Yilmaz, H.O., Pirat, A., Zeyneloglu, P., Girgin, N.K., Akalın, H., Sungurtekin, H., Serin, S., Akinci, I., Adanir, T., Sencan, A., Dilek, A., Kati, I., Goktas, U., El Houfi, A., Niven, D.J., Vesin, A., Rello, J., Dimopoulos, G., de Waele, J., Timsit, J.F., EUROBACT Investigators, Lipman, J., Leditschke, A., Rodgers, H., Milliss, D., Gottlieb, T., Baker, S., Roberts, B., Krafft, P., Bernreiter, S., Depuydt, P., Jamaer, P., Lebbinck, H., De Carvalho, F.B., Pereira, J., Yehia, A.C., Machado, F.C., Carneiro, A.L., Fagundes, A., Rodriguez, F., Soares, M., Salluh, J., Beranger, R., Lugarinho, M., Carvalho, A., Reis, L., de Lima, C., Piras, C., Caser, E., Falcão, J., Laupland, K.B., Zhang, Z., Ma, X., Wan, X.Y., Zhang, J.Z., Qian, K.J., Xia, L., Yang, C., Lijing, D., Duan, M., Zhanhong, T., Yiping, P., Yongqiang, W., Ning, L., Li-Xin, Z., Jin-Quan, L., Gornik, I., Degoricija, V., Kouatchet, A., Plantefeve, G., Pajot, O., Kallel, H., Thierry, L., Pierre, K., Petitpas, D., Lessire, H., Brun-Buisson, C., Pham, T., Annane, D., Maxime, V., Herault, M.C., Merceron, S., Kipnis, E., Boyer-Besseyre, M., Tavernier, B., Faivre, S., Francois, V., Ercole, R.L., Willems, V., Klouche, K., Delabre, J.P., Julien, C., Brigitte, G., Gibot, S., Mégarbane, B., Seguin, P., Launoy, A., Vincent, T., Jamali, S., Calvino, S., Tabah, A., Durand, M., Rossi-Blancher, M., Debrumetz, A., Azoulay, E., Charpentier, J., Chiche, J.D., Garrouste-Orgeas, M., Misset, B., Marx, G., Krueger, W.A., Felbinger, T., Heininger, A., Voigt, I., Schroeder, T., Pneumatikos, I., Theodorou, V., Koulenti, D., Armaganidis, A., Myrianthefs, P., Gavala, A., Nikolaou, C., Kounougeri, K., Routsi, C., Liapikou, A., Nathanail, C., Tsakas, P., Karabinis, A., Tsakalakis, C., Mandragos, K., Katsenos, C., Anthopoulos, G., Choutas, G., Koutsikou, A., Nikolaidou, I., Bekos, V., Spring, A., Paskalis, H., Psallida, V., Ioakeimidou, A., Lahana, A., Plantza, P., Nodarou, A., Koutsoukou, A., Kyriakopoulou, M., Michalia, M., Clouva-Molyvdas, P., Sfyras, D., Georgiadis, C., Polakis, P., Papanikolaou, S., Christopoulos, C., Vrettou, E., Arvaniti, K., Matamis, D., Paraforou, T., Spiropoulou, K., Georgopoulos, D., Klimathianaki, M., Nakos, G., Koulouras, V., Komnos, A., Chovas, A., Prekates, A., Magira, E., Giannakoy, M., Gkeka, E., Antoniadou, E., Antypa, E., Gritsi-Gerogianni, N., Kydona, C., Zakynthinos, E., Tzovaras, N., Csomos, A., Gábor, C., Mikos, B., Velkey, G., Vitális, E., Kovács, N.Á., Bogar, L., Kiss, T., Eva, Z., Mangani, V., Tulli, G., Stefania, G., Chiara, R., Antonelli, M., Montini, L., Rocco, M., Citterio, G., Fujitani, S., Hosokawa, K., Said, M., Boubaker, C., Schultz, M., Van Der Veen, A., Aardema, H., Bergmans, D., Schoemakers, R., Wesselink, R., Oostdijk, E.A., Bonten, M.J., Dragan, I., Kostyrka, W., Tamowicz, B., Mikstacki, A., Smuszkiewicz, P., Nadolski, J., It, O.I., Choma, R., Koscielniak, W., Pietraszek, P., Maul, E., Bártolo, A., Martins, S., Miranda, I., Oliveira, M., França, C., Tornada, A., Telo, L., Ferreira, L., Cardoso, T., Santos, L., Ferreira, A., Pereira, J.M., Dias, C., Dias, M.C., Marques, A.J., Castelões, P., Batranovic, U., Gavrilovic, S., Filipescu, D., Alvarez-Lerma, F., Gracia, M.P., Armestar-Rodriguez, F., Mesalles-Sanjuán, E., De Arbina, N.L., Sirvent, J., Garro, P., Cañones, J.R., Blanco, A., Marqués, L., Insausti, J., Martija, I., Valles, J., Ferrer, R., Ubeda, A., Lucena, F., Cuevas, M.G., Zaragoza, R., Sancho, S., Laube, M., Rothen, M., Eggimann, P., Pagani, J.L., Ayed, S., Ouanes, I., Abroug, F., Özcengiz, D., Yağar, S., Ünver, S., Tunçel, Y.I., Buyukkocak, U., Aykac, E., Coşar, A., Yilmaz, H.O., Pirat, A., Zeyneloglu, P., Girgin, N.K., Akalın, H., Sungurtekin, H., Serin, S., Akinci, I., Adanir, T., Sencan, A., Dilek, A., Kati, I., Goktas, U., El Houfi, A., Niven, D.J., Vesin, A., Rello, J., Dimopoulos, G., de Waele, J., and Timsit, J.F.
Abstract: Although fever and hypothermia are common abnormal physical signs observed in patients admitted to intensive care units (ICU), little data exist on their optimal management. The objective of this study was to describe contemporary practices and determinants of management of temperature abnormalities among patients admitted to ICUs. Site leaders of the multi-national EUROBACT study were surveyed regarding diagnosis and management of temperature abnormalities among patients admitted to their ICUs. Of the 162 ICUs originally included in EUROBACT, responses were received from 139 (86%) centers in 23 countries in Europe (117), South America (8), Asia (5), North America (4), Australia (3) and Africa (2). A total of 117 (84%) respondents reported use of a specific temperature threshold in their ICU to define fever. A total of 14 different discrete levels were reported with a median of 38.2°C (inter-quartile range, IQR, 38.0°C to 38.5°C). The use of thermometers was protocolized in 91 (65%) ICUs and a wide range of methods were reportedly used, with axillary, tympanic and urinary bladder sites as the most common as primary modalities. Only 31 (22%) of respondents indicated that there was a formal written protocol for temperature control among febrile patients in their ICUs. In most or all cases practice was to control temperature, to use acetaminophen, and to perform a full septic workup in febrile patients and that this was usually directed by physician order. While reported practice was to treat nearly all patients with neurological impairment and most patients with acute coronary syndromes and infections, severe sepsis and septic shock, this was not the case for most patients with liver failure and fever. A wide range of definitions and management practices were reported regarding temperature abnormalities in the critically ill. Documenting temperature abnormality management practices, including variability in clinical care, is important to inform planning of future stud
Published: 2013

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24 results on '"Timsit, J.F."'

1. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

2. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

3. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

4. Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper#

5. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

6. Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP)

7. Autoantibodies against type I IFNs in patients with life-threatening COVID-19

8. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

9. Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP)

10. Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP)

11. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

12. Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

13. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

14. Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

15. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

16. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

17. Erratum: Antimicrobials: A global alliance for optimizing their rational use in intra-abdominal infections (AGORA). [World J Emerg Surg. 11, (2016) (33)] DOI: 10.1186/s13017-016-0089-y

18. Intensive care medicine research agenda on invasive fungal infection in critically ill patients.

19. Intensive care medicine research agenda on invasive fungal infection in critically ill patients.

20. Task force on management and prevention of Acinetobacter baumannii infections in the ICU

21. WSES guidelines for management of Clostridium difficile infection in surgical patients

22. WSES guidelines for management of Clostridium difficile infection in surgical patients

23. WSES guidelines for management of Clostridium difficile infection in surgical patients

24. Diagnosis and management of temperature abnormality in ICUs: a EUROBACT investigators' survey.

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24 results on '"Timsit, J.F."'

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