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ESCMID Panorama

News

Here you will find the latest news from the Society, its network and partners.

The registration is now open for the conference on antimicrobial resistance from bench to practice, which takes place in Havana, Cuba, from 26 – 28 September 2018. Latin America is a hotbed for many well-known and emerging infectious diseases. It is also a region that contributes greatly to both the global spread of and the cultural debate on antimicrobial resistance. This conference aims to bring together local scientists and renowned international experts to address this important global health issue. It targets clinical microbiologists, as well as infectious disease and public health specialists. ESCMID co-organises the conference with Sociedad Cubana de Microbiología y Parasitología, Asociación panamericana de Infectología, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, and The Lancet Infectious Diseases.

Zanicelli et al assessed patient-related determinants potentially influencing antibiotic use. They included 87 studies from 33 countries in their systematic review. Seventy-five were quantitative and described self-reported, objectively assessed or self-reported and objectively assessed patient-related determinants. Twelve were qualitative studies or had a qualitative and quantitative component. Eighty-six studies concerned the outpatient setting. They identified seven broad categories of determinants having an impact on different aspects of antibiotic use (in descending order of frequency): demographic and socio/economic characteristics, patient-doctor interactions (e.g. counselling), treatment characteristics (e.g. administration frequency), attitudes (e.g. expecting antibiotics), access to treatment (e.g. patients’ direct costs), characteristics of the condition for which the antibiotic was prescribed (e.g. duration of symptoms), knowledge (e.g. regarding indications for treatment). Most determinants were classified as “barriers” to responsible antibiotic use. The authors concluded that a large variety of patient-related determinants impact antibiotic use. The most easily “modifiable” determinants concern patient-doctor interactions, treatment characteristics and knowledge. Data from the inpatient setting and low- and middle-income countries were underrepresented.

The European Centre for Disease Prevention and Control published the 2016 EULabCap report, which on an annual basis assesses key public health microbiology capabilities and capacities for surveillance and epidemic preparedness in the European Union and the European Economic Area. This fourth report shows continuing progress of the capacities across the European clinical and public health community in diagnosing and monitoring infection and antimicrobial resistance for health protection. The average EULabCap 2016 index for all EU/EEA countries was 7.5 on a scale of 0–10, the same as in 2015 and higher than the 7.3 in 2014, and 6.9 in 2013. The ECDC also publishes interactive capacity maps by country. Individual EULabCap indices per country ranged from 5.6 to 9.6 as compared to 4.7 to 9.2 in 2013, indicating that differences between national systems gradually decreased from 2013 to 2016. Ten countries improved their EULabCap index; five climbed from low to fair, and another five countries went from fair to high. The goal of the survey is to ascertain how well microbiology laboratories are equipped to detect, assess and monitor infectious disease threats. The results help policymakers at all levels identify possible areas for action and evaluate the impact of capacity strengthening activities and health system reform.

ESCMID is seeking applications from qualified candidates for the position of Programme Director for its annual European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) starting 2020 or 2021 – after at least a one-year transition period as deputy. He or she will then be responsible for identifying the main topics, selecting the speakers and chairpersons and evaluating submitted proposals and abstracts to develop an attractive scientific programme. The programme director will manage and coordinate the ECCMID Programme Committee and liaise with the ESCMID Executive Committee, subcommittees and study groups.

ESCMID Immediate Past President & Publication Officer Mario Poljak received a prestigious career achievement award from the Pan American Society for Clinical Virology (PASCV). The PASCV Diagnostic Virology Award acknowledges an individual whose contributions to viral diagnosis have had a major impact on the discipline. He received the award on 7 May at the 34th Clinical Virology Symposium, which was co-organized by PASCV and American Society of Microbiology (ASM). The other laureate was Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), who won this year’s PASCV Clinical Virology Award. Congratulations!

Del Toro et al developed and validated baseline, perioperative and at-discharge risk-scoring systems for postsurgical prosthetic joint infection (PJI) in patients undergoing total hip arthroplasty and revision arthroplasty. The models included scores for hip arthroplasty (THA), revision arthroplasty (RA), obesity, nosocomial infection surveillance, significant wound bleeding, and superficial surgical site infection. The simple scores for predicting PJI at three different moments of care in patients undergoing arthroplasty allow early and accurate identification of high-risk individuals in whom enhanced preventive measures and follow-up may be needed, the researchers concluded.

Antimicrobial and vaccine shortages have been increasingly reported both in the U.S. and in Europe, and are probably going to become more and more common. ESCMID’s study groups for antimicrobial stewardship ESGAP and vaccines EVASG are conducting a survey to assess the impact of antimicrobial and vaccine shortages on physicians’ practice. You are encouraged to participate in the survey and to spread this invitation among hospital and community-based specialists. The survey will take less than 10 minutes to complete. The study groups plan to present the results at ECCMID 2019 and use them to provide guidance on antimicrobial and vaccine shortage management. Country-specific data will be provided to interested researchers. 

During the one-week course postgraduate and continuing medical education participants may enjoy excellent lectures by renowned experts in the field and network with peers in a relaxed setting. The programme covers a broad range of topics in clinical microbiology and infectious diseases and will interest young medical doctors at the end of their specialty training as well as biologists, pharmacists, PhD students and postdoctoral fellows working in the infection field.

Early- to mid-career scientists with ten or less years of full-time employment (not including training) may now apply for an observership visit at the European Centre for Disease Prevention and Control (ECDC) in Stockholm, Sweden. The five-day programme takes place from 3 – 7 September 2018. The goal of the programme is to familiarise observers with surveillance, epidemic intelligence systems and key outputs including risk assessments, scientific advice and laboratory network activities. Application from candidates with a proven interest in public health, e.g. a degree, research interest or experience, are accepted until 30 May 2018 at 12.00 noon CET. Members may apply via the ESCMID website.

MacFadden et al assessed if readily available electronic medical records could be used to predict the success of antibiotic therapy in patients with Gram-negative bloodstream infection, which are often caused by antibiotic-resistant pathogens. They evaluated a total of 1,832 patients with Gram-negative bacteraemia in the U.S. and Canada. Compared to antibiogram-guided therapy, decision-support models of antibiotic selection incorporating individual patient characteristics and prior culture results have the potential to increase use of narrower-spectrum antibiotics while reducing inadequate therapy. The researchers conclude that multivariable models using readily available epidemiologic factors can be used to predict antimicrobial susceptibility in infecting pathogens with reasonable discriminatory ability. The implementation of sequential predictive models for real-time individualized empiric antibiotic decision-making promise to help optimize adequate coverage for patients while minimizing overuse of broad-spectrum antibiotics.

ESCMID is organizing a postgraduate education course about multidrug-resistant organisms (MDROs) and colistin resistance on 25 and 26 May 2018 in Beijing, China. Clinical microbiologists, infectious disease specialists, public health specialists, or training physicians in infectious diseases may learn about infection control, therapy and rapid diagnosis of MDROs as well as colistin resistance. The registration deadline is 11 May 2018, and you have time until 27 April if you want to apply for an attendance grant.

We are proud to report that 12,949 people from 124 countries attended our annual congress ECCMID 2018 in Madrid last month. The top 10 countries of provenance were the United States, Spain, the United Kingdom, France, Germany, Italy, the Netherlands, Switzerland, Belgium, and China, which for the first time moved into the top 10. Of the 5,500 regular and late-breaking abstracts received from 116 different countries, 3,563 abstracts were presented in oral, eposter and paper poster sessions. The congress featured more than 150 sessions with invited speakers covering the entire field of infectious diseases and clinical microbiology, including eight keynote lectures, over 100 symposia and oral sessions, 22 educational workshops and 22 meet-the-expert sessions. Abstracts, presentations and webcasts from this year’s ECCMID will be freely available on ECCMID Live until the end of August. The material is currently being curated to be included in the ESCMID eLibrary, which also hosts material from other ESCMID events. You may read more about some of the highlights in the press releases on the conference website, and video clips featuring interviews with keynote speakers, session chairs and selected presenters may also be found on the society’s ECCMID 2018 Youtube channel.

ESCMID’s infection control committee EUCIC encourages healthcare and in particular infection prevention and control professionals to participate in this year’s World Health Organization clean hands campaign It’s in your hands – prevent sepsis in health care. WHO calls on health facilities to prevent healthcare-associated sepsis through hand hygiene and infection prevention and control (IPC) action.

Rupprecht et al conducted a review to evaluate the utility of cerebrospinal fluid (CSF) CXCL13 for diagnosis of acute Lyme neuroborreliosis (LNB). They included a total of 18 studies involving 618 patients with acute LNB and 2,326 patients with other neurological disorders. The pooled sensitivity for CSF CXCL13 was 89%, and the pooled specificity was 96%, using the identified optimal cut-off value of 162 pg/mL. There was marked heterogeneity between studies, caused by differences in the designs of the study populations and age distribution. The optimal cut-off in the seven studies with a cross-sectional design was 91 pg/mL and 164 pg/mL in the 11 case-control studies. CSF CXCL13 values above the optimal cut-off level were also detectable in some other CNS disorders, namely neurosyphilis and CNS-lymphoma. The meta-analysis conducted by the researchers in Munich showed that CSF CXCL13 has the potential to become a useful adjunct in the diagnosis of acute LNB.

The ESCMID/ASM conference on drug development to meet the challenge of antimicrobial resistance (AMR) will take place in Lisbon, Portugal, from 4 – 7 September 2018. The registration and the submission of abstracts on original data for poster and platform presentations are open now. The conference focusses on the development of new antimicrobial agents to tackle AMR, which remains a pressing public health problem. The multidisciplinary meeting involves basic scientists, clinical academics, regulatory bodies, funding bodies and the pharmaceutical industry. Its scope stretches from chemistry to clinical development, from neonates to adults, from bacteria to fungi – all with a global perspective. The meeting is practical, interactive with plenty of time for networking. ESCMID will support young investigators and researchers from low and middle-income countries.

Combatting Antimicrobial Resistance in Europe (COMBACTE) is a key project of the European Commissions’ New Drugs For Bad Bugs (ND4BB) programme, which together with the Innovative Medicines Initiative (IMI) is part of the collaborative R&D efforts to tackle antimicrobial resistance. On Monday, 23 April from 19:30 – 22:00 COMBACTE is hosting a networking event for specialists from universities, hospitals, laboratories and the industry, and those interested to learn more about the private-public partnership and the academic milestones the consortium has already reached. You may pick up an invitation for the event at the COMBACTE booth #37.

ESCMID is organizing a postgraduate education course about multidrug-resistant organisms (MDROs) and colistin resistance on 25 and 26 May 2018 in Beijing, China. Clinical microbiologists, infectious disease specialists, public health specialists, or training physicians in infectious diseases may learn about infection control, therapy and rapid diagnosis of MDROs as well as colistin resistance. The registration deadline is 11 May 2018, and you have time until 27 April if you want to apply for an attendance grant.

Places at TAE Day on 21 April at 13:15 are filling up fast so sign up now!

To ensure you can speak to your chosen CM or ID expert, sign up here now. This is a popular session which gives younger professionals the chance to talk to experts in an informal setting. The TAE Award will also be presented during the session and you will hear from the Young Investigator awardees. The deadline for registration is 19 April.

Köck et al reviewed the spread of carbapenem-resistant Enterobacteriaceae (CRE) in livestock, food and companion animals and a potential transmission to humans. They included 68 articles describing CRE among pigs, poultry, cattle, seafood, dogs, cats, horses, pet birds, swallows, wild boars, wild stork, gulls and black kites in Africa, America, Asia, Australia, and Europe between 1980 and 2017. The primary outcome was the occurrence of CRE in samples from these animals; secondary outcomes included the prevalence of CRE, carbapenemase types, CRE genotypes and antimicrobial susceptibilities. They detected the carbapenemases (predominantly affecting Escherichia and Klebsiella): VIM, KPC, NDM, OXA and IMP. Two studies found that 33-67% of exposed humans on poultry farms carried carbapenemase-producing CRE closely related to isolates from the farm environment. 27 studies selectively screened samples for CRE and found a prevalence of <1% among livestock and companion animals in Europe, 2-26% in Africa and 1-15% in Asia. Wildlife (gulls) in Australia and Europe carried CRE in 16-19%. The researchers conclude that the occurrence of CRE in livestock, seafood, wildlife, pets and directly exposed humans poses a risk for public health. Prospective prevalence studies using molecular and cultural microbiological methods are needed to better define the scope and transmission of CRE.

We are seeking qualified applications for the position of the future Programme Director for our annual European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) starting 2020 or 2021 – after at least a one-year transition period as deputy. He or she will then be responsible for identifying the main topics, selecting the speakers and chairpersons and evaluating submitted proposals and abstracts to develop an attractive scientific and educational programme. The programme director will manage and coordinate the ECCMID Programme Committee and liaise with the ESCMID study groups. 

During the one-week course postgraduate and continuing medical education participants may enjoy excellent lectures by renowned experts in the field and network with peers in a relaxed setting. The programme covers a broad range of topics in clinical microbiology and infectious diseases and will interest young medical doctors at the end of their specialty training as well as biologists, pharmacists, PhD students and postdoctoral fellows working in the infection field.

The ESCMID study groups for infections in critically ill patients and bloodstream infections and sepsis published a position paper on sepsis. The researchers summarized the current evidence on precision medicine in sepsis focusing on the interplay between therapies, pathogens and the host and emphasising translation from theory to clinical practice. A secondary objective was to develop recommendations on the management and priorities for further research. They also discuss microbiologic diagnostic approaches including blood cultures (BCs) and rapid diagnostic tests (RDTs) as well as targeted antibiotic treatment. Other topics include the disruption of the host immune system and the use of biomarkers in sepsis management, patient stratification and future clinical trial design. Lastly, personalized antibiotic treatment and stewardship are addressed. The authors provide a road map for recommendations and future perspectives to establish precision medicine in sepsis. RDTs and identifying drug-response phenotypes are two of the main challenges. The next step will be the implementation of precision medicine to sepsis management based on theranostic methodology. This highly individualized approach will be essential for the design of novel clinical trials and improvement of care pathways, the researchers conclude. The lead researchers will present their sepsis paper in an Open Forum discussion on 24 April at noon during ECCMID in Madrid.

To ensure you can speak to your chosen CM or ID expert, sign up here now. This is a popular session which gives younger professionals the chance to talk to experts in an informal setting. The TAE Award will also be presented during the session and you will hear from the Young Investigator awardees. The deadline for registration is 19 April.

Highlights include keynote lectures, educational events and additional new formats. The scientific programme is available now for download. The keynotes on Monday for example include George Daikos’ lecture on extensively-drug resistant (XDR) gram-negative organisms, which cause serious infections associated with increased mortality in many hospitalized patients. Daikos will provide an overview of the experimental data, the accumulated clinical experience and the upcoming new agents with potential activity against these devastating pathogens. Also on Monday Nathalie Questembert-Balaban will discuss phenotypic variability and the evolution of antibiotic tolerance and persistence, which may lead to infection relapse once antibiotic treatment is stopped, and Christian Drosten will discuss SARS, MERS and other coronaviruses to come. He will for example show how the emergence of novel coronaviral diseases has repeatedly involved drastic changes of tissue tropism, involving fundamental changes of disease pattern and transmissibility.

Like in the previous three years, ECCMID will organize a Pipeline Corner where smaller pharmaceutical and diagnostic companies give an overview over the products in development. In addition, there will be a new format, the Open Forum presentations, which feature expert discussions on various topics including sepsis (position paper mentioned below) and antimicrobial resistance.

We are pleased to launch the Parity Tool which is a self-evaluation tool for promoting equality in the clinical microbiology and infectious diseases sectors. Aimed at leaders, HR staff and enlightened CM/ID professionals, the tool is designed to raise awareness; allow for confidential self-assessment of your institute; and provide tools for designing and negotiating measures. We hope you will find this helpful and share it with your colleagues.

You may find the congress app for ECCMID 2018 in the webstore from today. It allows you to navigate through the entire 28th ECCMID programme and you may access all important information on your mobile phone or tablet. You can view sessions by day and category, and access the abstracts being presented. Create your individual scientific schedule and save it to your calendar. Locate all session rooms and your favourite exhibitors on the floor plans. Get in contact with your colleagues via the integrated chat tool and comment on all sessions and presentations. Download the ECCMID 2018 congress app from the iOS or Android app store for your mobile interactive congress experience. You can check the scientific programme on eccmidlive.org.

A group of 15 international experts, led by researchers from the Center for Disease Dynamics, Economics & Policy (CDDEP) in India and the Université de Lorraine in France, has now for the first time defined seven core elements and 29 related checklist items that describe the essential and minimum standards for hospital-based AMS programmes applicable in both high and low-to-middle income countries. The core elements include senior hospital management leadership towards antimicrobial stewardship, accountability and responsibilities, available expertise on infection management, education and practical training. They also include other actions aimed at responsible antimicrobial use, monitoring and surveillance as well as reporting and feedback on a continuous basis. In contrast to existing lists, this new consensus document is more comprehensive and more generic, and can be further modified and used for certification, benchmarking, or performance purposes. Read the press release.

Don't miss this unique opportunity to get close to the experts and to learn about their career paths at TAE Day on 21 April at ECCMID. This is a popular session which gives younger professionals the chance to talk to experts in an informal setting. Participants can sign up for the expert table of their choice to talk about their career and will be able to submit optional questions that the moderator will receive before the session. Places are open to young scientist members and are limited so sign up now!

The study group for antibiotic stewardship contributed to the ebook Antimicrobial Stewardship – from Principles to Practice, which the British Society for Antimicrobial Chemotherapy (BSAC) published last week. This ebook nicely complements ESGAP/ESCMID’s comprehensive book on antimicrobial stewardship that was published last year. You may download the BSAC ebook for free from the internet.

Following the report of a cluster of multidrug-resistant tuberculosis (MDR-TB) among migrants, researchers at the European Centre for Disease Control evaluated if entry screening identified tuberculosis for different categories of migrants in European countries. Their assessment shows that 27 of 36 (75%) patients were screened for tuberculosis. Of these, 13 (50%) were diagnosed through the screening. Most patients were eventually diagnosed with multidrug-resistant tuberculosis within months of entry in the country. The researchers concluded that systematic screening of migrants at entry can identify tuberculosis but only captures active infection at entry. Thus access for migrants to the health system in the host countries should be ensured to allow early detection and treatment of cases and avoid further spread.

In a little more than 30 days we will open the gates at IFEMA for another record-breaking ECCMID. If you have not yet registered, you can still do so online for this scientific highlight. For those of you who have submitted a late-breaker abstract for ECCMID 2018, the notifications were sent out last Friday so please check your inbox. We are also pleased to let you know that our hotel department still has some good hotels in proximity: The AXOR Feria hotel & the Marriott Auditorium. Both are a 10 min. drive from the venue and we have a daily transfer arranged at both hotels. If you want to book or receive more information, please visit our hotel website.

Jolivet et al performed a serial cross-sectional survey in a French university hospital to determine the prevalence and associated factors for carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Overall, 146/844 (17%) patients were digestive carriers of ESBL-PE, with 96 (66%) not previously identified. In these patients, E. coli (62%) and CTX-M type (94%) predominated. Risk factors associated with ESBL-PE carriage included higher age, recent travel abroad, receipt of antibiotic, and prolonged hospitalisation. The authors concluded that given the high prevalence of ESBL-PE, and the high proportion of unknown carriers, reinforcement of standard precautions, rather than contact precautions, for controlling ESBL-PE spread are recommended.

ESCMID jointly with the European Confederation of Medical Mycology and the European Respiratory Society has published a guideline on the diagnosis and management of aspergillosis.

The experts strongly recommend chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA).

For diagnosis they recommend direct microscopy, preferably using optical brighteners, histopathology and culture as well as serum and BAL galactomannan measures as markers. PCR should be considered in conjunction with other diagnostic tests. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates; antifungal susceptibility testing should be performed in patients with invasive disease in regions with resistance found in contemporary surveillance programmes.

Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary IA, whereas liposomal amphotericin B is moderately supported. Combinations of antifungals as primary treatment options are not recommended. Therapeutic drug monitoring is strongly recommended for patients receiving posaconazole suspension or any form of voriconazole for IA treatment, and in refractory disease, where a personalized approach considering reversal of predisposing factors, switching drug class and surgical intervention is also strongly recommended.

Primary prophylaxis with posaconazole is strongly recommended in patients with acute myelogenous leukaemia or myelodysplastic syndrome receiving induction chemotherapy. Secondary prophylaxis is strongly recommended in high-risk patients. The experts strongly recommend treatment duration based on clinical improvement, degree of immunosuppression and response on imaging.

On the 100th anniversary of the 1918 “Spanish” flu, infectious disease evolution specialists Colin A. Russell from the University of Amsterdam will hold a keynote lecture on influenza pandemics. His lecture will cover the history of influenza pandemics, the biological factors that lead to them, the challenges that remain, and the advances required to stop the next “big one”.

Then Nobel Prize winner Rolf M. Zinkernagel will talk about immunology taught by viruses. He will analyse the specificity and the antigen-dependence of protection, the characteristics of protective antibodies and T cells and their kinetics to explain general rules of immunity but also the success and failures of vaccines.

Antimicrobial resistance (AMR) in leprosy cannot be assessed as Mycobacterium leprae does not grow in vitro. A dedicated World Health Organization (WHO) network for the first time studied global data on AMR in leprosy. The researchers led by Emmanuelle Cambau from Paris collected data on molecular detection of resistance genes rpoB, folP1 and gyrA and conducted a prospective open survey of resistance to antileprosy drugs rifampicin, dapsone and ofloxacin in 19 endemic countries. Among 1,932 (1,143 relapse and 789 new) cases studied, 154 (8.0%) M. leprae strains were found with mutations conferring resistance showing 182 resistance traits (74 for rifampicin, 87 for dapsone, and 21 for ofloxacin). Twenty cases showed rifampicin and dapsone resistance, four showed ofloxacin and dapsone resistance, but no cases were resistant to rifampicin and ofloxacin. Rifampicin resistance was observed among relapses (58/1143, 5.1%) and new cases (16/789, 2.0 %) in twelve countries. India, Brazil and Colombia reported more than five rifampicin-resistant cases. Rifampicin resistance emerged stressing the expansion of surveillance programmes. The researcher also urged specialists to be vigilant about the global use of antimicrobial agents as ofloxacin resistance probably developed in relation to the general intake of antibiotics for other infections since it is not part of the multidrug combination to treat leprosy.

ESGLI has published a newsletter with dates of upcoming activities as well as a list of research the study group is undertaking. One of the main activities is the 5th ESGLI meeting from 28 – 30 August 2018 in Lyon, France. The ESGLI 2018 conference will cover a wide range of topics related to Legionella and Legionnaires’ disease from basic microbial genetics and pathogenesis to applied aspects of detection, control and management. The goal of the meeting is to bring together researchers and professionals with more applied issues. The conference will present the latest scientific developments and knowledge about epidemiology and surveillance; clinical aspects and diagnosis; Host - Microbe interactions; Microbe - Environment interactions; outbreaks and case reports; genetics and genomics; prevention and control strategies.

As of 7 March at noon CET, you can click on this link to apply for one of the 50 funded observerships available. The deadline is 18 March so make sure you get your application to us before then. Don´t forget to pay attention to the updated criteria and ensure you have all the necessary documents to send with your application. You may also apply for unfunded observerships via this link.

Any questions, please contact observerships@escmid.org. The next call for funded observerships will be announced in the summer.

Clostridium difficile infection (CDI) is the most important infective cause of healthcare-associated diarrhoea in high income countries and one of the most important healthcare-associated pathogens. Given the ongoing significance of CDI in Europe, the ESCMID study group for C. difficile (ESGCD) updated its guideline, reviewing the literature on interventions to control CDI in adult populations in acute health care settings and deriving specific infection control recommendations. The guidance provides 36 statements on strategies to prevent CDI in acute care settings, including 18 strong recommendations. Strong recommendations were made for a two-stage test to diagnose CDI (focus on prevention of transmission), performance of surveillance with timely feedback, not to screen healthcare workers, the use of personal protective equipment in outbreak settings, implementation of contact precautions, introduction of daily environmental sporicidal disinfection and terminal disinfection of rooms of patients with CDI in outbreak settings, antibiotic stewardship interventions (including restriction of antibiotic agents/classes and reducing duration of antibiotic exposure), as well as for education of healthcare workers, patients and visitors on prevention measures. The highest quality of evidence grading was identified for antibiotic stewardship interventions.

The TAE Day returns to ECCMID on Saturday 21 April 2018. The session, which starts at 13:15 in Hall Y, is made up of round table sessions held with recognized experts in CM and ID, who lead discussions about career development and share their own work-life experiences. The TAE awards for Training Achievement will also be presented during this event and the Young Investigator awardees will share their career experience too.  For more information on the success if last year`s event, click here. Mark the date in your diary and look out for information on how to register coming soon.

ESCMID has received 162 research grant proposals received for research projects dealing with bacterial infections, which received a total of 488 reviews. The ESCMID Executive Committee selected 15 grantees from nine different countries, which corresponds to a very competitive acceptance rate of 9.2%. The society spent EUR 300,000 on the research funding. Congratulations to the grantees. Applications for 2019 research grants will be accepted from July until October 2018. Only projects dealing with fungal/viral/parasitic infections and diseases (incl. diagnostics, pathogenesis, antifungal/antiviral/antiparasitic susceptibility & resistance, stewardship, vaccines) will be accepted.

The ESCMID/ASM conference on drug development to meet the challenge of antimicrobial resistance (AMR) will take place in Lisbon, Portugal, from 4 – 7 September 2018. The registration and the submission of abstracts on original data for poster and platform presentations are open now. The conference focusses on the development of new antimicrobial agents to tackle AMR, which remains a pressing public health problem. The multidisciplinary meeting involves basic scientists, clinical academics, regulatory bodies, funding bodies and the pharmaceutical industry. Its scope stretches from chemistry to clinical development, from neonates to adults, from bacteria to fungi – all with a global perspective. The meeting is practical, interactive with plenty of time for networking. ESCMID will support young investigators and researchers from low and middle-income countries.

You only have a few days left to submit your abstracts with late-breaking research results. The submission is open until Thursday, 1 March 2018 at 23:59 CET. Late-breaking abstracts are accepted if they are of outstanding scientific quality, adding value to the scientific programme and if they contain novel data, which only became available after the end of November.

The two-year training programme started this week with a basic and compulsory module in Groningen. Advanced modules follow in June and October of 2018, and in January, March, May and September of 2019. In addition, trainees will have the opportunity to attend local modules in different countries comprising the topics of the curriculum, follow e-learning modules, and apply for observerships.
With the EUCIC Infection Prevention and Control Certificate, EUCIC aims to provide a unique European perspective on infection prevention and control. It does this by sharing the expertise and competencies within training centres, countries and professions. This collaborative effort will result in the training of a new generation of IPC specialists. The European Centre for Disease Control (ECDC) has agreed to contribute to the training programme in the areas of surveillance, epidemiology and data analysis. A detailed description of the full programme can be found on the website.

CMI’s new website is a useful resource for students, training residents and infectious disease specialists who are teaching or mentoring. They may access collections, materials on emerging infections as well as guidelines and position papers. The new page offers better guidance for authors and has a friendlier look.

EUCAST invites colleagues in both ID and CM to give their view on the Public Consultation on “The EUCAST proposal to modify definitions of susceptibility categories S, I and R and introducing an Area of Technical Uncertainty (ATU)”. EUCAST proposes to retain susceptibility categories “S, I, and R” but to change the definitions to “Susceptible, standard dosing regimen”, “Susceptible, increased exposure”, and “Resistant”.

EUCAST executive urges ESCMID’s members contribute to the public consultation. It is important that members active in the ESCMID network are in favour of keeping the letters S, I and R but adapting the meanings in the current definitions. As methodological uncertainty of antimicrobial susceptibility testing is now the sole responsibility of the laboratory, clinical colleagues should be expected to trust all three of the categories. You may also find previous consultations on the same website. 

The course Antimicrobial Stewardship: Implementing the Change organized by the ESCMID study group for antimicrobial stewardship and the Spanish study group on healthcare-associated infections GEIRAS takes place from 19 – 20 April 2018 in San Lorenzo de El Escorial in Spain – right before ECCMID 2018. The objective of the course is to teach the scientific background of antimicrobial stewardship interventions in various settings: hospital (medicine, surgery, ICU, haematology), primary care, general public, long-term care facilities. Trainees will understand the sociocultural, ethical and behavioural aspects of antimicrobial stewardship and learn about the relevance of the quality management/implementation aspects of antimicrobial stewardship. Experts will point out the barriers to antimicrobial stewardship and how to address them and will outline how to integrate antimicrobial stewardship education in undergraduate and postgraduate curricula of healthcare professionals. The registration deadline is 18 March.

The scientific programme for ECCMID from 21 – 24 April 2018 in Madrid, Spain, is live on the congress website now. You will find the titles of presentations, sessions, content and presenters. Within the preselection you can choose a date to see all scheduled sessions at a glance or browse by session or topic. To get full access, please login with your ESCMID account. As a registered ESCMID user you will be able to create your personal programme for your congress visit and you can also evaluate sessions after they take place to receive CME credits. The abstracts accepted for presentation at ECCMID will become available on 11 April 2018. 

Fabienne Haspot-Degauque, who received an ESCMID research grant from ESCMID in 2010 published the paper Multiplex CRISPR/Cas9 system impairs HCMV replication by excising an essential viral gene in Plos One this month. Human cytomegalovirus (HCMV) primary infection or reactivation can cause severe pathologies in non-immunocompetent individuals. Fabienne hypothesized that disrupting the UL122/123 gene, a key regulator of lytic replication and reactivation from latency, with the fast and highly potent genome-editing tool CRISPR/Cas9 system based on one or three gRNAs would prevent viral replication. The multiplex strategy excised the immediate early (IE) gene in 90% of all viral genomes and thus led to the inhibition of IE protein expression. Consequently, viral genome replication and late protein expression were reduced by 90%. Finally, the production of new viral particles was nearly abrogated. She concluded that the multiplex anti-UL122/123 CRISPR/Cas9 system can target the viral genome efficiently enough to significantly prevent viral replication.

In addition to classical time-consuming identification methods and automated biochemical tests, matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) has revolutionized identification of even unusual and slow growing anaerobic bacteria directly from culture plates. Researchers from the ESCMID study group for anaerobic infections (ESGAI) reviewed anaerobic diagnostics methods available by routine laboratories. The aims of this review were to discuss the presence of anaerobes in commensal microbiota and in infectious processes, and to present optimal methodology for carrying out anaerobic diagnostics of human infections.

The ESCMID study groups for veterinary microbiology (ESGVM) and antimicrobial stewardship (ESGAP) will organize a course on the challenges in veterinary hospital infection control in Birmingham, United Kingdom, on 4 April 2018. The course will be hosted by the annual BSAVA congress (5 – 8 April 2018), one of the largest veterinary conferences worldwide. The objectives are to promote hospital infection control and antimicrobial stewardship in small animal practice and to educate a new generation of veterinary infectious disease specialists to be able to develop and implement infection control programmes and antimicrobial stewardship programmes.

The abstract submission for late-breaking abstracts will be open from 15 February to 1 March 2018. This year we will accept submission for the topics clinical trials, vaccine-preventable diseases and others. As a reminder, to be accepted, late breakers must contain novel data, which only became available after the end of November, when the regular submission deadline closed, be of outstanding scientific quality, fit the topics of the congress, and add value to the scientific programme.

ESCMID Study Group for Infections in Compromised Hosts (ESGICH) and ESCMID Study Group for Infections in Travellers and Migrants (ESGITM) contributed to the Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America. The clinical practice guideline is intended to guide clinicians caring for solid-organ transplant (SOT) donors, candidates and recipients regarding infectious diseases (ID) issues related to this geographical region, mostly located in the tropics. These recommendations are based on both systematic reviews of relevant literature and expert opinion from both transplant ID and travel medicine specialists. The guidelines provide recommendations for risk evaluation and laboratory investigation, as well as management and prevention of infection of the most relevant endemic diseases of Latin America. 

Researchers described the risk of hospital admission for confirmed dengue (VCD) and the risk of clinically severe hospitalised VCD occurring up to four years post first dose in three randomised clinical trials comparing tetravalent dengue vaccine to placebo. Overall, from year 1-4, 233 and 228 participants had ≥1 episode of hospitalised VCD in the vaccinated (N=22,603) and placebo groups (N=11,301), respectively. Among these, 48 and 47 cases, respectively, were classified as clinically severe. In children aged ≥9 years, 88 and 136 participants had ≥1 episode of hospitalised VCD in the vaccinated (N=17,629) and placebo groups (N=8,821), respectively. In vaccinated participants aged <9 years, particularly in those aged 2-5 years, there were more hospitalised VCD cases compared with the control participants in year 3 but not in year 4. The overall relative risks in those aged <9 years for year 1-4 was 0.786 with a higher protective effect in the 6-8-year-olds than in the 2-5-year-olds. The overall benefit-risk remained positive in those aged ≥9 years up to year 4, although the protective effect was lower in years 3 and 4 than in years 1 and 2 (open access).

ESCMID’s European Committee on Infection control (EUCIC) is delighted that the European Centre for Disease Control (ECDC) has agreed to contribute to its training programme in Infection Prevention and Control. ECDC’s contribution is expected in the areas of surveillance, epidemiology and data analysis, and the centre will offer an observership programme covering several of the modules.

Molecular detection of Toxoplasma gondii plays a crucial role in the prenatal and neonatal diagnosis of congenital toxoplasmosis (CT). Sensitivity of this diagnosis is partly related to the efficiency of parasite DNA extraction and amplification. Researchers from France evaluated different DNA extraction methods with automated platforms in combination with adequate PCR amplification assays. They showed variable efficacy among the DNA extraction procedures in isolating ≤5 T. gondii cells/mL in amniotic fluid samples. Moreover, for a given DNA extraction method, variable results were obtained among the two Toxoplasma-PCR assays for detecting ≤5 T. gondii cells/mL: when using TaqMan PCR, all the automated systems yielded more than 60% of positive results. Nevertheless, when testing the DNA extracts in triplicate, four out of six extraction methods allowed a satisfactory detection of low amounts of T. gondii DNA (≥33% of positive results) independently of the PCR assay used. They conclude that despite the influence of the subsequent PCR method used, this study should help microbiologists in the choice of DNA extraction methods for the detection of T. gondii in amniotic fluid. They recommend checking if the extraction method is adequate for the PCR assay used.

Together with the World Health Organization, the European Centre for Disease Prevention and Control and Oman’s Ministry of Health, ESCMID is organizing a postgraduate workshop on migrant health from 8 – 10 March 2018. The course will show how to monitor migrants’ health and how to prevent and control infectious diseases in migrants in Gulf Cooperation Council (GCC) and eastern Mediterranean countries. They will discuss the impact of migrants on the health systems of the hosting countries especially for vaccine preventable diseases, importation of communicable diseases and AMR as well as the role and impact of migrants on the elimination programmes for tuberculosis, malaria, HIV and hepatitis B and C. The grant application deadline for the course is 9 February 2018.

Of the 5,315 abstracts submitted for ECCMID in Madrid, 755 were approved for oral presentation and 2,820 for poster presentation. Over 1,700 were rejected, which corresponds to a rejection rate of 32%. We congratulate all the successful submitters and are looking forward to their presentations at ECCMID from 21 – 24 April 2018.

From 15 February to 1 March 2018 we will accept the submission of late-breaking abstracts for the topics: clinical trials, vaccine-preventable diseases and others. Please look at the abstract guidelines for more information.

Robbert Bentvelsen (pictured right), is a resident in clinical microbiology at Leiden University Centre, the Netherlands. He is a trained physician and as a resident he volunteered to lead the Dutch lab-team in Freetown, Sierra Leone, to help fight the Ebola outbreak. He has won the national prize of the Dutch Hacking Health competition with an infection prevention smartphone app in 2016. Robbert contributes to educate medical students and residents (geriatrics) in the Netherlands and helped in a training programme in Sierra Leone. Currently he is principal investigator in the Participatient project, which aims to reduce urinary tract infections via patient participation through a smartphone app.

Maroun Sfeir (pictured left) is highly involved in teaching medical students and residents at Weill Cornell Medicine during their rotations in the division of infectious disease. He has served as major educator of the microbiology course each autumn for medical students at Cornell University and has received many excellent feedbacks. He was awarded several honours and awards including the ID Week 2016 Trainee Award Grant for Outstanding Case Report. Given his multilingual proficiency, he was granted the Committee of Interns and Residents (CIR) Policy and Education Initiative Scholarship to provide volunteer medical relief in Haiti in 2015 where he spent the summer in Port-au-Prince local hospitals serving the Haitian population and leading workshops for the Haitian physicians.

The awardees will receive their awards during the TAE Day session on Saturday 21 April at ECCMID. 

Researchers from Bologna, Italy investigated the impact of treatment duration on mortality and on relapse in patients with bloodstream infection (BSI) caused by Escherichia coli. Of 856 patients analyzed 426 received short (≤ 10 days) and 430 received long (>10 days) therapy. All-cause mortality at day 90 occurred in 47 patients; at multivariate analysis, short therapy was not associated with higher risk of mortality also after adjusting the model for the propensity score of receiving short therapy. Relapse occurred in 42 patients. Independent risk factors for relapse using death as competing risk were immunosuppression, and end-stage-liver-disease. The propensity-weighted estimation of the average treatment effect for relapse reduction with long therapy was - 1.6% in the total population, and - 7.1% in immunocompromised patients. The researchers concluded that they could not identify shorter treatment duration as a risk factor for mortality and for relapse in patients with E. coli BSI.

Abstract submitters will be informed about acceptance before the early-bird registration deadline runs out on 25 January 2018.

The abstract submission for late-breaking abstracts will be open from 15 February to 1 March 2018. This year we will accept submission for the topics clinical trials, vaccine-preventable diseases and others.

Evgeny (left) from the Institute of Medical Microbiology, University Hospital Münster, Germany, has a strong interest in the translational approach in the diagnostics of infectious diseases with his research focusing on rapid sepsis diagnostics and rapid susceptibility testing. He has developed novel principles of sepsis diagnostics and detection of multidrug-resistant organisms, which have led to patent applications and technology transfer from academia to industry. Some methods are currently in further development funded by the German Ministry of Education and Research, and some have already been introduced into routine diagnostics.

James (right), a National Institute for Health research lecturer from the Brighton and Sussex Medical School, University of Sussex, in Brighton, United Kingdom, is focused on prevention of healthcare-associated infection, including S. aureus and other multidrug-resistant organisms. He combines developing his research interests with completing specialist training in infectious diseases and microbiology. His work utilizes whole-genome sequencing and epidemiological data to evaluate carriage, acquisition and transmission of pathogens in healthcare settings, with the aim of developing interventions to reduce nosocomial infections.  

The awardees will receive their awards during the ESCMID Young Investigator Awards Session at ECCMID. During the session, Evgeny will give his presentation Acceleration of microbiological diagnostics: it’s time to rethink! and James’ talk will be on Unravelling Staphylococcus aureus transmission: a game of catch or hide and seek?

Researchers quantified the impact of antibiotics prescribed in primary care for urinary tract infections (UTIs) on intestinal colonization by ciprofloxacin-resistant (CIP-RE) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Fluoroquinolone treatment caused transient suppression of Enterobacteriaceae and subsequent two-fold increase in CIP-RE prevalence, while nitrofurans had no impact on CIP-RE. ESBL-PE were identified in 5% (107/2058) of samples from 71 (10%) participants, with colonization not associated with antibiotic exposure. Household exposure to CIP-RE or ESBL-PE was associated with increased individual risk of colonization. These findings support avoidance of fluoroquinolones for first-line UTI therapy in primary care, and suggest potential for interventions interrupting household circulation of resistant Enterobacteriaceae, the researchers conclude.

We are excited to announce the launch of the new-look observership programme. To make the programme fairer and more sustainable, some key changes have been made, including:
•    From February, members will be able to apply for non-funded observerships with our Collaborative Centres (ECCs) throughout the year
•    Young Scientist Members can apply for funded observerships during two calls per year. The first will open in the coming weeks, and you can already start preparing by contacting your preferred ECC and agreeing visit dates and objectives with them. You must supply a letter on the ECC´s letter-headed paper with the agreed dates and objectives when you apply. Applicants must also obtain a letter from their supervisor explaining how the visit will benefit the home institution
•    For funded observerships, the observership should take place between April 2018 and March 2019.
For further information about the criteria for both funded and unfunded observerships can be found on the website. The opening of both the funded and unfunded programmes will be announced in upcoming newsletters.

ESCMID extended the grant application deadlines for three postgraduate education courses: For the course Challenges in Veterinary Hospital Infection Control and Antimicrobial Stewardship on 4 April in Birmingham the grant application has been re-opened and extended to 7 February 2018. For the Workshop on Migrants’ Health from 8 – 10 March 2018 in Muscat the deadline is now 9 February 2018, and for the course Adult Immunization: New and Old Challenges from 16 – 17 March  in São Paulo has been extended to 16 February 2018.

The winners of the 2018 Excellence Awards are Claudio Viscoli from the University of Genova in Italy and Dimitrios P. Kontoyiannis from the University of Texas M. D. Anderson Cancer Center in the United States. Kontoyiannis is an international expert in clinical and experimental mycology. His research group is credited for sustained and impactful contributions to medical and translational mycology through advances in antifungal pharmacology, study host defences against fungi, novel diagnostics, clinical trials, dedicated mentoring, organizational service and life-saving patient care. Viscoli is an expert for infectious disease in children and adults with special expertise in infections in compromised host, fungal infections, infections in cancer and neutropenia, infections in liver transplant recipients, opportunistic infections in HIV and HIV vertical transmission. They will receive their awards on Sunday, 22 April 2018 at a dedicated awards session at ECCMID in Madrid.

Clostridium difficile is the leading cause of antibiotic-associated diarrhoea, both in healthcare facilities and the community. The recurrence rate of C. difficile infection (CDI) remains high, up to 20%. Researchers from the Netherlands reviewed novel treatments and approaches for CDI, focusing on new antibiotics, antibiotic inactivators, monoclonal antibodies (mAbs), and gut microbiota modulating therapies. The researchers propose that vancomycin orally will become the first choice instead of metronidazole when antibiotic treatment for CDI is necessary and the severity of the disease difficult to assess. Fidaxomicin is a good alternative, especially in patients at risk of developing a relapse. Vancomycin combined with FMT remains the primary therapy for multiple recurrent CDI. They anticipate that new medication that protects the gut microbiota will be further developed and tested to prevent CDI during antibiotic therapy. ESCMID will publish an update on its 2014 CDI guideline in the coming weeks.

The ESCMID study group for antimicrobial stewardship is organizing the postgraduate education course Antimicrobial Stewardship: Implementing the Change in San Lorenzo de el Escorial, Spain from 19 – 20 April 2018, right before ECCMID opens its doors on 21 April. Participants will learn about the differential aspects of antimicrobial stewardship in various settings, its  scientific background, the sociocultural, ethical and behavioural aspects, the relevance of the quality management/implementation, the barriers, the basic principles of bacterial resistance, and antimicrobial consumption surveillance. Participants have until 2 February 2018 if they want to apply for an attendance grant.

We would like to point out that the main scientific programme of ECCMID 2018 will start on Saturday morning (21 April) already. The ECCMID 2018 Programme Committee has adjusted the order of the sessions to give attendees more options to participate in educational sessions.

This year the two-hour educational workshops will take place throughout the four congress days. The programme on Saturday includes symposia dedicated to regional issues affecting Africa & the Middle East and India & the Far East as well as symposia covering hot topics including multidrug-resistant fungi, antibiotics in chronic infections or the emergence of arboviruses.

ESCMID’s Critically Ill Patients Study Group in cooperation with researchers from Hellenic Society of Chemotherapy and Società Italiana di Terapia Antinfettiva aimed to provide practical suggestions for physicians dealing with the management of infections with Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) in critically ill patients. The researchers from Italy and Greece addressed several key aspects including the prevention of colonization in a patient, the prevention of colonization of his or her contacts and the reduction of mortality in the infected patient by rapidly diagnosing the causative agent and promptly adopting the best therapeutic strategy. The researchers concluded that diagnostic technologies can speed up the diagnosis of KPC-KP infections. Combination treatment should be preferred to monotherapy in cases of severe infections. For non–critically ill patients without severe infections, results from randomized clinical trials are needed for ultimately weighing benefits and costs of using combinations rather than monotherapy. Multifaceted infection control interventions are needed to decrease the rates of colonization and cross-transmission of KPC-KP.

Together with the World Health Organization, the European Centre for Disease Prevention and Control and Oman’s Ministry of Health ESCMID is organizing a postgraduate workshop on migrant health. The course will show how to monitor migrants’ health and how to prevent and control infectious diseases in migrants in Gulf Cooperation Council (GCC) and eastern Mediterranean countries. They will discuss the impact of migrants on the health systems of the hosting countries especially for vaccine preventable diseases, importation of communicable diseases and AMR as well as the role and impact of migrants on the elimination programmes for tuberculosis, malaria, HIV and hepatitis B and C. The grant application deadline for the course is 12 January 2018.