Presentations & Publications



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

ESGCIP and the European Society of Intensive Care Medicine (ESICM) developed a set of recommendations for the management of candidemia and invasive infection due to Candida species in non-immunocompromised critically ill patients. 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 invasive candidiasis.


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

ESGCIP and EFISG work together to develop a standard set of definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Existing guidance for this population of patients is limited and most definitions are aimed at severely immunocompromised patients, but often do not apply to intensive care units patients, who usually show considerable differences in terms of risk factors and performances of various diagnostic procedures. ESGCIP and EFISG will develop a list of potential definitions based on a systematic literature review; the proposed definitions will be evaluated by a panel of 30 experts; selected definitions will be organised in a main consensus document and in an executive summary expected to be published by 2019.

Management of KPC-producing Klebsiella pneumoniae infections

ESGCIP, the Hellenic Society of Chemotherapy (HSC) and the Italian Society of Anti-infective therapy (SITA) provide in this review practical suggestion for physicians dealing with the management of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPCKP) infections in critically ill patients. The panel identified several key aspects to be addressed when dealing with KPCKP in critically ill patients: preventing colonization in the patient, preventing infection in the colonized patient and colonization of his or her contacts, reducing mortality in the infected patient by rapidly diagnosing the causative agent and promptly adopting the best therapeutic strategy. Related suggestions based on the available observational literature and the experience of panel are provided in this review.

Nebulization of Antiinfective Agents in Invasively Mechanically Ventilated Adults

ESGCIP and EPASG co-funded this systematic review and meta-analysis of 1,435 studies performed in adults receiving invasive mechanical ventilation. Two different administration strategies (adjunctive and substitute) were considered clinically relevant. Inclusion was restricted to studies using jet, ultrasonic, and vibrating-mesh nebulizers. Studies involving children, colonized-but-not-infected adults, and cystic fibrosis patients were excluded. The analysis show that data are sparse; however, nebulization may be more effective in cases of resistant organisms and less nephrotoxic (if replacing nephrotoxic systemic agents) but may compromise mechanical ventilation especially in hypoxemic patients.

Assessing predictive accuracy for outcomes of ventilator-associated events in an international cohort: the EUVAE study. Ramírez‑Estrada et al., Intensive Care Med, 2018

The ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) published two papers funded by ESCMID with a Study Group Research Grant of 30’000 euros. In these two papers, authors evaluated the predictive accuracy for outcomes of ventilator-associated events in critically ill children and adults. Peña-López and colleagues focused on a cohort of children and compared outcome-predicting algorithms based on surveillance definitions of the Center for Disease Control and Prevention (2008 and 2013) with a new algorithm (Ped-VAE) developed specifically for children.Ramírez‑Estrada and colleagues studied instead a cohort of 244 adult patients.


The role of infection models and PK/PD modelling for optimising care of critically ill patients with severe infections

ESGCIP and EPASG together with the European Society of Intensive Care Medicine (ESICM) and the International Society of Anti-Infective Pharmacology (ISAP) describe in this review the potential of in vitro and in vivo infection models, clinical pharmacokinetic data and pharmacokinetic /pharmaco-dynamic models to guide the design of more effective antimicrobial dosing regimens for critically ill patients with severe infections. The treatment of infections in critically ill patients is very challenging, as infection paradigms are mostly based on infection models and clinical data that do not specifically account for the antimicrobial pharmacokinetics and severity of illness of these patients. Use of data from preclinical infection models coupled with clinical pharmacokinetic /pharmacodynamic data as well as dosing regimens guided by therapeutic drug monitoring can maximise the utility of antimicrobial regimens. However, clinical outcome and cost-effectiveness studies quantifying the impact of such an intensive intervention are required.

Antimicrobial resistance and antibiotic stewardship programs in the ICU: insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi‑drug resistance

ESCMID, the European Society of Intensive Care Medicine (ESICM) in collaboration with the World Alliance Against Antimicrobial Resistance (WAAAR), organized a round table on MDR. During a full-day meeting, experts from both societies reviewed the challenges of MDR in the intensive care unit (ICU), identified knowledge gaps, and discussed threats and solutions for the future. This report summarizes the discussions, list priorities in the management of infection with multi-drug resistant pathogens, identify areas that urgently require more research, and make recommendations that can be immediately implemented.

Use of nebulized antimicrobials for the treatment of respiratoryinfections in invasively mechanically ventilated adults: a position paper from the European Society of Clinical Microbiology and infectious Diseases

ESGCIP received approval from the ESCMID Executive Committee to develop a Position Paper regarding the nebulization of antibiotics in critically ill invasively mechanically ventilated adult patients, using GRADE methodology to evaluate the available evidence. A Task Force was convened to develop this document, including critical care, respiratory and internal medicine physicians, anaesthesiologists, clinical microbiologists, nurses, pharmacists and medical education specialists. Panel expert participants were suggested by the ESGCIP chai, Prof. Jordi Rello, and approved by the ESCMID Executive Committee, based on their previous clinical experience or on their expertise in clinical trials and publications, ensuring a true multidisciplinary approach. The systematic search of the literature, the meta-analysis and the application of the GRADE methodology were conducted in collaboration with the Iberoamerican Cochrane Centre (Barcelona, Spain).


Sepsis and septic shock in low-income and middle-income countries: need for a different paradigm

Jordi Rello, Hakan Leblebicioglu, on behalf of the members of ESGCIP. Int J Infect Dis. 2016 Jul;48:120-2. doi: 10.1016/j.ijid.2016.04.017. Epub 2016 Apr 25.

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Management of infections in critically ill returning travellers in the intensive care unit-I: considerations on infection control and transmission of resistance

Leblebicioglu H, Rodriguez-Morales AJ, Rossolini GM, López-Vélez R, Zahar JR, Rello J; ESGCIP and ESGITM. Int J Infect Dis. 2016 Jul;48:113-7. doi: 10.1016/j.ijid.2016.04.019. Epub 2016 Apr 28.

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Management of infections in critically ill returning travellers in the intensive care unit-II: clinical syndromes and special considerations in immunocompromised patients

Rello J, Manuel O, Eggimann P, Richards G, Wejse C, Petersen JE, Zacharowski K, Leblebicioglu H; ESGCIP and ESGITM. Int J Infect Dis. 2016 Jul;48:104-12. doi: 10.1016/j.ijid.2016.04.020. Epub 2016 Apr 28.

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Global survey on nebulization of antimicrobial agents in mechanically ventilated patients: a call for international guidelines

Solé-Lleonart C, Roberts JA, Chastre J, Poulakou G, Palmer LB, Blot S, Felton T, Bassetti M, Luyt CE, Pereira JM, Riera J, Welte T, Qiu H, Rouby JJ, Rello J; ESGCIP Investigators. Clin Microbiol Infect. 2016 Apr;22(4):359-64. doi: 10.1016/j.cmi.2015.12.016. Epub 2015 Dec 23.

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