ESCMID Publications

ESCMID Panorama

Medical Guideline Publications in 2019

For a complete list of medical guideline publications in 2019, please have a look at the Publications page

09 August 2019

Joint EANM/ESNR and ESCMID-endorsed consensus document for the diagnosis of spine infection (spondylodiscitis) in adults.

Clin Infect Dis.

Joint EANM/ESNR and ESCMID-endorsed consensus document for the diagnosis of spine infection (spondylodiscitis) in adults.

Lazzeri E, Bozzao A, Cataldo MA et al. Eur J Nucl Med Mol Imaging. 2019 Nov;46(12):2464-2487. doi: 10.1007/s00259-019-04393-6. Epub 2019 Aug 9.

 

PURPOSE:

Diagnosis of spondylodiscitis (SD) may be challenging due to the nonspecific clinical and laboratory findings and the need to perform various diagnostic tests including serologic, imaging, and microbiological examinations. Homogeneous management of SD diagnosis through international, multidisciplinary guidance would improve the sensitivity of diagnosis and lead to better patient outcome.

METHODS:

An expert specialist team, comprising nuclear medicine physicians appointed by the European Association of Nuclear Medicine (EANM), neuroradiologists appointed by the European Society of Neuroradiology (ESNR), and infectious diseases specialists appointed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), reviewed the literature from January 2006 to December 2015 and proposed 20 consensus statements in answer to clinical questions regarding SD diagnosis. The statements were graded by level of evidence level according to the 2011 Oxford Centre for Evidence-based Medicine criteria and included in this consensus document for the diagnosis of SD in adults. The consensus statements are the result of literature review according to PICO (P:population/patients, I:intervention/indicator, C:comparator/control, O:outcome) criteria. Evidence-based recommendations on the management of adult patients with SD, with particular attention to radiologic and nuclear medicine diagnosis, were proposed after a systematic review of the literature in the areas of nuclear medicine, radiology, infectious diseases, and microbiology.

RESULTS:

A diagnostic flow chart was developed based on the 20 consensus statements, scored by level of evidence according to the Oxford Centre for Evidence-based Medicine criteria.

CONCLUSIONS:

This consensus document was developed with a final diagnostic flow chart for SD diagnosis as an aid for professionals in many fields, especially nuclear medicine physicians, radiologists, and orthopaedic and infectious diseases specialists.

 

25 March 2019

ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients.

Intensive Care Med.

ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients.

Martin-Loeches I, Antonelli M, Cuenca-Estrella M et al. Intensive Care Med. 2019 Jun;45(6):789-805. doi: 10.1007/s00134-019-05599-w. Epub 2019 Mar 25.

 

INTRODUCTION:

The term invasive candidiasis (IC) refers to both bloodstream and deep-seated invasive infections, such as peritonitis, caused by Candida species. Several guidelines on the management of candidemia and invasive infection due to Candida species have recently been published, but none of them focuses specifically on critically ill patients admitted to intensive care units (ICUs).

MATERIAL AND METHODS:

In the absence of available scientific evidence, the resulting recommendations are based solely on epidemiological and clinical evidence in conjunction with expert opinion. The task force used the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to evaluate the recommendations and assign levels of evidence. The recommendations and their strength were decided by consensus and, if necessary, by vote (modified Delphi process). Descriptive statistics were used to analyze the results of the Delphi process. Statements obtaining > 80% agreement were considered to have achieved consensus.

CONCLUSIONS:

The heterogeneity of this patient population necessitated the creation of a mixed working group comprising experts in clinical microbiology, infectious diseases and intensive care medicine, all chosen on the basis of their expertise in the management of IC and/or research methodology. The working group's main goal was to provide clinicians with clear and practical recommendations to optimize microbiological diagnosis and treatment of IC. The Systemic Inflammation and Sepsis and Infection sections of the European Society of Intensive Care Medicine (ESICM) and the Critically Ill Patients Study Group of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) therefore decided to develop a set of recommendations for application in non-immunocompromised critically ill patients.

 

21 March 2019

Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America.

Clin Infect Dis.

Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America.

Nicolle LE, Gupta K, Bradley SF et al. Clin Infect Dis. 2019 May 2;68(10):e83-e110. doi: 10.1093/cid/ciy1121.

 

Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities. The 2005 guideline from the Infectious Diseases Society of America recommended that ASB should be screened for and treated only in pregnant women or in an individual prior to undergoing invasive urologic procedures. Treatment was not recommended for healthy women; older women or men; or persons with diabetes, indwelling catheters, or spinal cord injury. The guideline did not address children and some adult populations, including patients with neutropenia, solid organ transplants, and nonurologic surgery. In the years since the publication of the guideline, further information relevant to ASB has become available. In addition, antimicrobial treatment of ASB has been recognized as an important contributor to inappropriate antimicrobial use, which promotes emergence of antimicrobial resistance. The current guideline updates the recommendations of the 2005 guideline, includes new recommendations for populations not previously addressed, and, where relevant, addresses the interpretation of nonlocalizing clinical symptoms in populations with a high prevalence of ASB.

 

02 February 2019

International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the ACCP, ESCMID, IDSA, ISAP, SCCM, SIDP.

Intensive Care Med.

International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the ACCP, ESCMID, IDSA, ISAP, SCCM, SIDP.

Tsuji BT, Pogue JM, Zavascki AP et al. Pharmacotherapy. 2019 Jan;39(1):10-39. doi: 10.1002/phar.2209.

 

The polymyxin antibiotics colistin (polymyxin E) and polymyxin B became available in the 1950s and thus did not undergo contemporary drug development procedures. Their clinical use has recently resurged, assuming an important role as salvage therapy for otherwise untreatable gram-negative infections. Since their reintroduction into the clinic, significant confusion remains due to the existence of several different conventions used to describe doses of the polymyxins, differences in their formulations, outdated product information, and uncertainties about susceptibility testing that has led to lack of clarity on how to optimally utilize and dose colistin and polymyxin B. We report consensus therapeutic guidelines for agent selection and dosing of the polymyxin antibiotics for optimal use in adult patients, as endorsed by the American College of Clinical Pharmacy (ACCP), Infectious Diseases Society of America (IDSA), International Society of Anti-Infective Pharmacology (ISAP), Society for Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) endorses this document as a consensus statement. The overall conclusions in the document are endorsed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). We established a diverse international expert panel to make therapeutic recommendations regarding the pharmacokinetic and pharmacodynamic properties of the drugs and pharmacokinetic targets, polymyxin agent selection, dosing, dosage adjustment and monitoring of colistin and polymyxin B, use of polymyxin-based combination therapy, intrathecal therapy, inhalation therapy, toxicity, and prevention of renal failure. The treatment guidelines provide the first ever consensus recommendations for colistin and polymyxin B therapy that are intended to guide optimal clinical use.

 

09 February 2019

Correction to: Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement).

Eur J Nucl Med Mol Imaging.

Correction to: Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement).

Signore A, Sconfienza LM, Borens O et al. Eur J Nucl Med Mol Imaging.  2019 May;46(5):1203. doi: 10.1007/s00259-019-04281-z.

 

The authors regret to inform the readers that one of the author's name in the original publication of this article was spelled incorrectly as Victor Casar-Pullicino. The correct spelling is Victor N. Cassar-Pullicino and is now presented correctly in this article.

 

26 January 2019

Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement).

Eur J Nucl Med Mol Imaging.

Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement).

Signore A, Sconfienza LM, Borens O et al. Eur J Nucl Med Mol Imaging. 2019 Apr;46(4):971-988. doi: 10.1007/s00259-019-4263-9.

 

BACKGROUND: For the diagnosis of prosthetic joint infection, real evidence-based guidelines to aid clinicians in choosing the most accurate diagnostic strategy are lacking.


AIM AND METHODS: To address this need, we performed a multidisciplinary systematic review of relevant nuclear medicine, radiological, orthopaedic, infectious, and microbiological literature to define the diagnostic accuracy of each diagnostic technique and to address and provide evidence-based answers on uniform statements for each topic that was found to be important to develop a commonly agreed upon diagnostic flowchart.


RESULTS AND CONCLUSION:

The approach used to prepare this set of multidisciplinary guidelines was to define statements of interest and follow the procedure indicated by the Oxford Centre for Evidence-based Medicine (OCEBM).

 

Clin Microbiol Infect 2019:

Escmid-ecmm guideline: diagnosis and management of invasive aspergillosis in neonates and children.
Warris A, Lehrnbecher T, Roilides E et al. Clin Microbiol Infect 2019. pii: S1198-743X(19)30282-4. doi: 10.1016/j.cmi.2019.05.019.

Abstract

SCOPE:

Presenting symptoms, distributions and patterns of diseases and vulnerability to invasive aspergillosis (IA) are similar between children and adults. However, differences exist in the epidemiology and underlying conditions, the usefulness of newer diagnostic tools, the pharmacology of antifungal agents and in the evidence from interventional phase III clinical trials. Therefore, the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM) have developed a paediatric specific guideline for the diagnosis and management of IA in neonates and children.

METHODS:

Review and discussion of the scientific literature and grading of the available quality of evidence was performed by the paediatric subgroup of the ESCMID-ECMM-European Respiratory Society (ERS) Aspergillus disease guideline working group, which was assigned the mandate for the development of neonatal and paediatric specific recommendations.

QUESTIONS:

Questions addressed by the guideline included the epidemiology of IA in neonates and children; which paediatric patients may benefit from antifungal prophylaxis; how to diagnose IA in neonates and children; which antifungal agents are available for use in neonates and children; which antifungal agents are suitable for prophylaxis and treatment of IA in neonates and children; what is the role of therapeutic drug monitoring of azole antifungals and which management strategies are suitable to be used in paediatric patients. This guideline provides recommendations for the diagnosis, prevention and treatment of IA in the paediatric population, including neonates. The aim of this guideline is to facilitate optimal management of neonates and children at risk for or diagnosed with IA.

Guideline development history:

29 January 2019

ESCMID-EUCIC clinical guidelines on decolonization of multidrug-resistant Gram-negative bacteria carriers.

Clin Microbiol Infect 2019:

ESCMID-EUCIC clinical guidelines on decolonization of multidrug-resistant Gram-negative bacteria carriers.
Tacconelli E, Mazzaferri F, de Smet AM et al. Clin Microbiol Infect. 2019 Jul;25(7):807-817. doi: 10.1016/j.cmi.2019.01.005. Epub 2019 Jan 29.

SCOPE:
The aim of these guidelines is to provide recommendations for decolonizing regimens targeting multidrug-resistant Gram-negative bacteria (MDR-GNB) carriers in all settings.


METHODS:

These evidence-based guidelines were produced after a systematic review of published studies on decolonization interventions targeting the following MDR-GNB: third-generation cephalosporin-resistant Enterobacteriaceae (3GCephRE), carbapenem-resistant Enterobacteriaceae (CRE), aminoglycoside-resistant Enterobacteriaceae (AGRE), fluoroquinolone-resistant Enterobacteriaceae (FQRE), extremely drug-resistant Pseudomonas aeruginosa (XDRPA), carbapenem-resistant Acinetobacter baumannii (CRAB), cotrimoxazole-resistant Stenotrophomonas maltophilia (CRSM), colistin-resistant Gram-negative organisms (CoRGNB), and pan-drug-resistant Gram-negative organisms (PDRGNB). The recommendations are grouped by MDR-GNB species. Faecal microbiota transplantation has been discussed separately. Four types of outcomes were evaluated for each target MDR-GNB:(a) microbiological outcomes (carriage and eradication rates) at treatment end and at specific post-treatment time-points; (b) clinical outcomes (attributable and all-cause mortality and infection incidence) at the same time-points and length of hospital stay; (c) epidemiological outcomes (acquisition incidence, transmission and outbreaks); and (d) adverse events of decolonization (including resistance development). The level of evidence for and strength of each recommendation were defined according to the GRADE approach. Consensus of a multidisciplinary expert panel was reached through a nominal-group technique for the final list of recommendations.


RECOMMENDATIONS:
The panel does not recommend routine decolonization of 3GCephRE and CRE carriers. Evidence is currently insufficient to provide recommendations for or against any intervention in patients colonized with AGRE, CoRGNB, CRAB, CRSM, FQRE, PDRGNB and XDRPA. On the basis of the limited evidence of increased risk of CRE infections in immunocompromised carriers, the panel suggests designing high-quality prospective clinical studies to assess the risk of CRE infections in immunocompromised patients. These trials should include monitoring of development of resistance to decolonizing agents during treatment using stool cultures and antimicrobial susceptibility results according to the EUCAST clinical breakpoints.

 

Guideline development history:

  • Guideline document
    The draft guideline was under public consultation (31 October - 28 November 2018).

Medical Guideline Publications before 2019

An overview of medical guidelines published before 2019 is given below

02 January 2018

Diagnosis and management of Aspergillus diseases: executive summary
of the 2017 ESCMID-ECMM-ERS guideline.

20 February 2018

Guidance document for prevention of Clostridium difficile infection in acute
healthcare settings.

01 March 2017

Surviving Sepsis Campaign:
International Guidelines for Management of Sepsis and Septic Shock

  • Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and
    Septic Shock: 2016
    . Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP. Intensive Care Med. 2017;43(3):304-377 and Crit Care Med. 2017 Mar;45(3):486-552.

Clin Microbiol Infect 2016; 22 (Suppl. 4)

Published guideline (published online: 22 July 2016)

This guideline was coordinated by the ESCMID Study Group for Clostridium difficile (ESGCD)

Guideline development history:

Clin Microbiol Infect 2016; 22 (Suppl. 3)

Published guideline (published online: 7 April 2016)

This guideline was coordinated by the ESCMID Study Group for Infections of the Brain (ESGIB)

Guideline development history:

Clin Microbiol Infect 2015; 21 (Suppl. 1)

Coordinated by the ESCMID Study Group for Biofilms (ESGB)

ESCMID and ECMM guidelines for the management of rare and emerging fungal infections

Clin Microbiol Infect 2014; 20 (Suppl. 3)

Coordinated by the ESCMID Fungal Infection Study Group (EFISG)

Editorial

O. A. Cornely et al.

Pages 1-4

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013

O. A. Cornely et al.

Pages 5-26

ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others

A. M. Tortorano et al.

Pages 27-46

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi

A. Chowdhary et al.

Pages 47-75

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of rare invasive yeast infections

M. C. Arendrup et al.

Pages 76-98

Clin Microbiol Infect 2014; Vol 20 (Suppl s2), pp 1–26

The previous European Society of Clinical Microbiology and Infection (ESCMID) guidance document, which has been applied widely in clinical practice, dates from 2009. Meanwhile, new treatments for Clostridium difficile infection (CDI) have been developed and limitations of the currently recommended treatment options of CDI are considered. As the current ESCMID treatment guidance document is already implemented in clinical practice, an update of this widely applied guidance document is essential to further improve uniformity of national hospital infection treatment policies for CDI in Europe.

Clin Microbiol Infect 2014; Vol 20 (Suppl s1), pp 1–55

Healthcare-associated infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB) are a leading cause of morbidity and mortality worldwide. These evidence-based guidelines have been produced after a systematic review of published studies on infection prevention and control interventions aimed at reducing the transmission of MDR-GNB. The recommendations are stratified by type of infection prevention and control intervention and species of MDR-GNB and are presented in the form of ‘basic’ practices, recommended for all acute care facilities, and ‘additional special approaches’ to be considered when there is still clinical and/or epidemiological and/or molecular evidence of ongoing transmission, despite the application of the basic measures. The level of evidence for and strength of each recommendation, were defined according to the GRADE approach.

ESCMID guideline for the diagnosis and management of Candida diseases 2012

Clin Microbiol Infect 2012; 18 (Suppl. 7)

Coordinated by the ESCMID Fungal Infection Study Group (EFISG)

Developing European guidelines in clinical microbiology and infectious diseases

A. J. Ullmann et al.

Pages 1-8

Diagnostic procedures

M. Cuenca-Estrella et al.

Pages 9-18

Non-neutropenic adult patients

O. A. Cornely et al.

Pages 19-37

Prevention and management of invasive infections in neonates and children caused by Candida spp.

W. W. Hope et al.

Pages 38-52

Adults with haematological malignancies and after haematopoietic stem cell transplantation (HCT)

A. J. Ullmann et al.

Pages 53-67

Patients with HIV infection or AIDS

O. Lortholary et al.

Pages 68-77

ESCMID Sore Throat Guideline Group

C. Pelucchi, L. Grigoryan, C. Galeone, S. Esposito, P. Huovinen, P. Little and T. Verheij. Clin Microbiol Infect 2012; 18 (Suppl. 1): 1–27

Full text

M. P. Bauer, E. J. Kuijper and J. T. van Dissel, Clin Microbiol Infect 2009; 15: 1067–1079

M. J. T. Crobach, O. M. Dekkers, M. H. Wilcox and E. J. Kuijper, Clin Microbiol Infect 2009; 15: 1053–1066

Guidelines for the validation and application of typing methods for use in bacterial epidemiology

A. van Belkum et. al on behalf of the ESCMID Study Group on Epidemiological Markers (ESGEM), Clin Micro Biol Infect 2007: 13 (Suppl. 3): 1-46

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Guidelines for the management of adult lower respiratory tract infections

M. Woodhead et al., Eur Respir J 2005 26: 1138-1180

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Guidelines for the management of adult lower respiratory tract infections. Appendices

M. Woodhead et al.

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European recommendations for antimicrobial resistance surveillance

G. Cornaglia et al., ESCMID Study Group for Antimicrobial Resistance Surveillance (ESGARS), Clin Microbiol Infect 2004 10: 349-383

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Guidelines for the diagnosis of tick-borne bacterial diseases in Europe

P. Brouqui et al., ESCMID Study Group on Coxiella, Anaplasma, Rickettsia and Bartonella (ESCAR) and the European Network for Surveillance of Tick-Borne Diseases, Clin Microbiol Infect 2004 10: 1108-1132

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A European survey of diagnostic methods and testing protocols for Clostridium dificile

Barbut et al., ESCMID Study Group on Clostridium difficile (ESGCD), Clin Microbiol Infect 2003 9: 989-996

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