Background: Hospital-acquired and ventilator-associated pneumonias (HAP and VAP) are common in critical care and can be life-threatening. Rapid microbiological diagnostics, linked to an algorithm to translate their results into antibiotic choices, could simultaneously improve patient outcomes and antimicrobial stewardship.
Methods: The INHALE Randomised Controlled Trial is a multi-centre, parallel study exploring the potential of the BioFire FilmArray molecular diagnostic to guide antibiotic treatment of HAP/VAP in intensive care units (ICU); it identifies pathogens and key antibiotic resistance in around 90 min.
ACS Pharmacol Transl Sci
June 2020
This is a narrative review on the potential of rapid and point-of-care microbiological testing in pneumonia patients, focusing particularly on hospital-acquired and ventilator-associated pneumonia, which have substantial mortality and diverse microbiology. This work is written from a United Kingdom perspective, but much of it is generalizable internationally. In a world where antimicrobial resistance is a major international threat, the use of rapid molecular diagnostics has great potential to improve both the management of pneumonia patients and the stewardship of antibiotics.
View Article and Find Full Text PDFA 42-year-old woman with a background of psoriatic arthritis presented with a 7-day medical history of fevers of unknown source; she had recently undergone elective shoulder arthroscopy, and her medications included anti-interleukin 17A (anti-IL-17A) drug, secukinumab.She went on to develop sepsis-induced cardiomyopathy, requiring veno-arterial extracorporeal membrane oxygenation (ECMO), from which she was successfully weaned after 12 days. However, she then went on to develop a candidaemia, with new intra-abdominal collections found incidentally on CT; despite appropriate anti-fungal therapy and attempts at drainage, she passed away.
View Article and Find Full Text PDFBackground: In 2016, Zika virus (ZIKV) spread rapidly throughout the Americas and Caribbean in an explosive outbreak. In the UK, testing for ZIKV infection is performed at Public Health England's Rare and Imported Pathogens Laboratory. Here we present the UK's experience of imported ZIKV during the epidemic.
View Article and Find Full Text PDFInvasive aspergillosis is an opportunistic infection for which complex host-pathogen interactions determine infection outcome. In particular, immunosuppressive therapies and other host factors, such as neutropenia, need to be taken into account when modelling the immune response to aspergillosis. Mammalian models have been developed in order to gain a deeper understanding of these biological interactions, which cannot be easily replicated in vitro.
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