Author: "Elias Iosifidis" - Searchworks@Jio Institute Digital Library Search Results

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117 results on '"Elias Iosifidis"'

1. Randomised multicentre effectiveness trial of rapid syndromic testing by panel assay in children presenting to European emergency departments with acute respiratory infections—trial protocol for the ADEQUATE Paediatric trial

Author: Alexander Ross, Andrew Atkinson, Maarten J Postma, Federica Vanoni, Julia A Bielicki, Fernando Antoñanzas, Herman Goossens, Elias Iosifidis, Emmanuel Roilides, Mark Lyttle, Elia Vitale, Malte Kohns Vasconcelos, Florence Allantaz, Claire Hawksworth, Pablo Rojo, Dalia Dawoud, Surbhi Malhotra-Kumar, Silke Peter, Hanna Renk, Marc Bonten, Manuel Gijon, Maggie Nyirenda Nyang’wa, Thea van Asselt, Anthony Hemeson, Cristina Prat Aymerich, Simon van der Pol, Parthena Savvidou, Sophie Vandepitte, Emma Gardiner, Michelle Clements, Yasmine Yau, Giulio Vecchia, Federica D’Ambrosio, Wietske Bouwman, Marjolein van Esschoten, Frank Leus, David de Pooter, Leen Timbermont, Juan Pablo Rodriguez Ruiz, Benjamin Hommel, Marie Tessonneau, Jean-Louis Tissier, Philippe Cleuziat, Pim van Dorst, Paula Rojas, Marino Gonzales, Harry Heijerman, Henri van Werkhoven, Maria Simitsopoulou, Kalliopi Pantzartzi, Kostas Zarras, Argyro Ftergioti, Maria Kitsou, Aristea Karypiadou, Charis Lampada, Konstantina Charisi, Olga Tsiatsiou, Elsa Chorafa, Elisavet Michailidou, Ann-Kathrin Stiegler, Carmen Junk, Kristina Kiesel, Maren Belschner, Maike Seyfried, Kristina Schmauder, Tobias Walter, Dominic Imort, Fabian Behret, Rahel Berger, Leon Pfeiffer, Emanuela Früh, Elena Robinson, Andrea Marten, Claudia Werner, Rosa Calderón, Fátima Machín, Laura Cabello, Andrea Seoane, Sofía Mesa, Lidia Oviedo, Luisa Barón, Irene Hernández, Lisa Capozzi, Louisa Brock, Cecilia Hultin, Louise F Hill, Alessia Severi Conti, and Gianluca Gualco
Subjects: Medicine
Abstract: Introduction Syndromic panel assays, that is, using one test to simultaneously target multiple pathogens with overlapping signs and symptoms, have been integrated into routine paediatric care over the past decade, mainly for more severely ill and hospitalised patients. Their wider availability and short turnaround times open the possibility to apply them to non-hospitalised patients as well. In this context, it is important to trial how clinicians make use of pathogen detection data and if their early availability influences management decisions, particularly antibiotic use and hospitalisation.Methods and analysis Advanced Diagnostics for Enhanced QUality of Antibiotic prescription in respiratory Tract infections in Emergency rooms is an individually randomised, controlled, open-label effectiveness trial comparing the impact of a respiratory pathogen panel assay (BIOFIRE Respiratory Panel 2.1plus) used as a rapid syndromic test on nasopharyngeal swabs in addition to the standard of care versus standard of care alone. The trial will 1:1 randomise 520 participants under the age of 18 at 7 paediatric emergency departments in 5 European countries. Inclusion criteria for the trial consist of two sets, with the first describing respiratory tract infections in paediatric patients and the second describing the situation of potential management uncertainty in which test results may immediately affect management decisions. Enrolment started in July 2021 and is expected to be completed in early 2024. We will perform a two-sample t-test assuming a pooled variance estimate to compare the log-transformed mean time on antibiotic treatment (in hours) and number of days alive out of the hospital within 14 days after study enrolment between the control and intervention arms.Ethics and dissemination The trial protocol and materials were approved by research ethics committees in all participating countries. The respiratory pathogen panel assay is CE marked (assessed to meet European regulations) and FDA (United States Food and Drug Administration) cleared for diagnostic use. Participants and caregivers provide informed consent prior to study procedures commencing. The trial results will be published in peer-reviewed journals and at national and international conferences. Key messages will also be disseminated via press and social media where appropriate.Trial registration number NCT04781530.
Published: 2024
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2. Untargeted Blood Lipidomics Analysis in Critically Ill Pediatric Patients with Ventilator-Associated Pneumonia: A Pilot Study

Author: Christina Virgiliou, Olga Begou, Argyro Ftergioti, Maria Simitsopoulou, Maria Sdougka, Emmanuel Roilides, Georgios Theodoridis, Helen Gika, and Elias Iosifidis
Subjects: lipidomics, metabolomics, VAP, HRMS, pediatric patient, Microbiology, QR1-502
Abstract: This study aims to explore the diagnostic potential of blood lipid profiles in suspected ventilator-associated pneumonia (VAP). Early detection of VAP remains challenging for clinicians due to subjective clinical criteria and the limited effectiveness of current diagnostic tests. Blood samples from 20 patients, with ages between 6 months and 15 years, were collected at days 1, 3, 6, and 12, and an untargeted lipidomics analysis was performed using a Ultra high Pressure Liquid Chromatography hyphenated with High Resolution Mass Spectrometry UPLC-HRMS (TIMS-TOF/MS) platform. Patients were stratified based on modified pediatric clinical pulmonary index score (mCPIS) into high (mCPIS ≥ 6, n = 12) and low (mCPIS < 6, n = 8) VAP suspicion groups. With the untargeted lipid profiling, we were able to identify 144 lipid species from different lipid groups such as glycerophospholipids, glycerolipids, and sphingolipids, in the blood of children with VAP. Multivariate and univariate statistical analyses revealed a distinct distribution of blood lipid profiles between the studied groups, indicating the potential utility of lipid biomarkers in discriminating VAP presence. Additionally, specific lipids were associated with pharyngeal culture results, notably the presence of Klebsiella pneumoniae and Staphylococcus aureus, underscoring the importance of lipid profiling in identifying the microbial etiology of VAP.
Published: 2024
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3. Targeted Genotyping of MIS-C Patients Reveals a Potential Alternative Pathway Mediated Complement Dysregulation during COVID-19 Infection

Author: Eleni Gavriilaki, Stefanos A. Tsiftsoglou, Tasoula Touloumenidou, Evangelia Farmaki, Paraskevi Panagopoulou, Elissavet Michailidou, Evaggelia-Evdoxia Koravou, Ioulia Mavrikou, Elias Iosifidis, Olga Tsiatsiou, Eleni Papadimitriou, Efimia Papadopoulou-Alataki, Penelope Georgia Papayanni, Christos Varelas, Styliani Kokkoris, Apostolia Papalexandri, Maria Fotoulaki, Assimina Galli-Tsinopoulou, Dimitrios Zafeiriou, Emmanuel Roilides, Ioanna Sakellari, Achilles Anagnostopoulos, and Athanasios Tragiannidis
Subjects: COVID-19, MIS-C, children, complement, SNPs, Biology (General), QH301-705.5
Abstract: Complement dysregulation has been documented in adults with COVID-19 and implicated in relevant pediatric inflammatory responses against SARS-CoV-2. We propose that signatures of complement missense coding SNPs associated with dysregulation could also be identified in children with multisystem inflammatory syndrome (MIS-C). We investigated 71 pediatric patients with RT-PCR validated SARS-CoV-2 hospitalized in pediatric COVID-19 care units (November 2020–March 2021) in three major groups. Seven (7) patients suffered from MIS-C (MIS-C group), 32 suffered from COVID-19 and were hospitalized (admitted group), whereas 32 suffered from COVID-19, but were sent home. All patients survived and were genotyped for variations in the C3, C5, CFB, CFD, CFH, CFHR1, CFI, CD46, CD55, MASP1, MASP2, MBL2, COLEC11, FCN1, and FCN3 genes. Upon evaluation of the missense coding SNP distribution patterns along the three study groups, we noticed similarities, but also considerably increased frequencies of the alternative pathway (AP) associated with SNPs rs12614 CFB, rs1061170, and rs1065489 CFH in the MIS-C patients. Our analysis suggests that the corresponding substitutions potentially reduce the C3b-inactivation efficiency and promote slower and weaker AP C3bBb pre-convertase assembly on virions. Under these circumstances, the complement AP opsonization capacity may be impaired, leading to compromised immune clearance and systemic inflammation in the MIS-C syndrome.
Published: 2022
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4. Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)Research in context

Author: Salvador Pérez-Galera, Jose M. Bravo-Ferrer, María Paniagua, Tomislav Kostyanev, Marlieke E.A. de Kraker, Jan Feifel, Jesús Sojo-Dorado, Joost Schotsman, Rafael Cantón, George L. Daikos, Biljana Carevic, Gorana Dragovac, Lionel K. Tan, Lul Raka, Adriana Hristea, Pierluigi Viale, Murat Akova, Jose María Reguera, Lucía Valiente de Santis, Julián Torre-Cisneros, Ángela Cano, Emmanuel Roilides, Lili Radulovic, Cenk Kirakli, Evelyn Shaw, Matthew E. Falagas, Vicente Pintado, Herman Goossens, Marc J. Bonten, Belén Gutiérrez-Gutiérrez, Jesús Rodriguez-Baño, Almudena de la Serna, Sophie Monteau, Virginia Palomo, Elena Soriano, David Gutierrez, Elisa Moreno, Zaira Palacios, Isabel Morales, Natalia Maldonado, Antonio Plata Ciezar, Juan Diego Ruiz Mesa, Beatriz Sobrino Diaz, Ignacio Marquez Gomez, Ines Perez Camacho, Azahara Frutos-Adame, Julia Guzman-Puche, Irene Gracia-Ahufinger, Elena Perez-Nadales, Julian Torre-Gimenez, Athina Pyrpasopoulou, Elias Iosifidis, Elsa Chorafa, Ivana Radovanovic, Sladjana Petrovic, Slavica Cvetkovi, Srdjan-Sanja Melentijevic, Can Bicmen, Gunes Senol, Fe Tubau, Jordi Camara, Victor Daniel Gumucio, Dimitris Bassoulis, John Deliolanis, Vassiliki Ch. Pitiriga, Nikolaos Triarides, Efstathia Argiti, Nikolaos J. Legakis, Kyriakidou Margarita, Desirée Gijón-Cordero, Patricia Ruiz-Garbajosa, Alessandro Bartoloni, Gian Maria Rossolini, Simin-Aysel Florescu, Maria Nica, Serban Benea, Daniela Talapan, Deana Medić, Sanja Maričić Prijić, Mireia Cantero Caballero, Lina M. Parra Ramírez, Volkan Korten, Hüseyin Bilgin, George N. Dalekos, Aggelos Stefos, Nikolaos Spyridis, Athanasios Michos, Francesco Giuseppe De Rosa, Rossana Cavallo, Nicola Petrosillo, Antonio Dicaro, Maria Paola Landini, Marta Luisa Ciofi degli Atti, Mileva Masanovic, Dusan Matkovic, Sotirios Tsiodras, Francesco Blasi, Marta Di pasquale, Claudio Viscoli, Andrei Vata, Olivia Dorneanu, Perlat Kapisyzi, Adriana Vince, Evdoxia Tsigou, Efstratios Maltezos, Apostolos Komnos, Charalampos Gogos, Fabio Franzetti, Massimo Antonelli, Mihaela Lupse, Dan Corneci, Dana Tomescu, Anca Georgescu, Ljiljana Bukarica, Goran Mitrović, Nataša Lukić Krstić, Arsim Kurti, Beatriz Díaz-Pollán, Julia Origüen Sabater, Patricia Muñoz, Alpay Azap, Banu Sancak, Arife Sahin, and Halis Akalin
Subjects: Antimicrobial resistance, Carbapenem-resistant Enterobacterales, Risk factors, KPC, OXA, Metallo-beta-lactamases, Medicine (General), R5-920
Abstract: Summary: Background: Data on risk factors for carbapenem-resistant Enterobacterales (CRE) with wider applicability are needed to inform preventive measures and efficient design of randomised trials. Methods: An international matched case-control-control study was performed in 50 hospitals with high CRE incidence from March 2016 to November 2018 to investigate different aspects of infections caused by CRE (NCT02709408). Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings: Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-β-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74–15.53;
Published: 2023
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5. Paediatric COVID-19 mortality: a database analysis of the impact of health resource disparity

Author: Nick Daneman, John Marshall, Vinod Kumar, Aasiyah Rashan, Jérôme Dimet, Sylvain Diamantis, John F Fraser, Dominique Deplanque, Anne Conrad, François Lellouche, Heidi Gruner, Detlef Kindgen-Milles, Agnes Meybeck, Maxime Hentzien, Clotilde Allavena, André Cabié, Firouzé Bani-Sadr, Patrick Rossignol, Arjen M Dondorp, Rashan Haniffa, Harald Vonkeman, Lionel Piroth, Mathieu Blot, Yaseen Arabi, Marie-Pierre Debray, François Angoulvant, Marc Leone, Maria Zambon, Florentia Kaguelidou, Marc Lambert, Olivier Lairez, Tom Solomon, Carrol Gamble, Laura Marsh, David Richardson, Christiana Kartsonaki, Philippe Jouvet, Asgar Rishu, Eman Al Qasim, Rachael Parke, Srinivas Murthy, Alistair Nichol, Calum Semple, Colin McArthur, Gail Carson, Jake Dunning, Laura Merson, Peter Horby, David Maslove, Nadia Malik, Stephen R Knight, Annelies Verbon, Oana Sândulescu, Patrick Archambault, Paul McNally, Marlene Murris, Aurore Bousquet, Kenneth A McLean, Hugues Cordel, Marc Fabre, Laurence Bouillet, Melissa Parker, Xavier Duval, Amanda Corley, James Lee, Kusum Menon, Christian Rabaud, Paul Klenerman, Jean-François Timsit, Jennifer Lee, Nicolas Terzi, Saad Nseir, Gwenhaël Colin, Steve Webb, Kalynn Kennon, Caroline Mudara, Diana Hernández, Yazdan Yazdanpanah, Elias Iosifidis, Emmanuel Roilides, Yi Lin Lee, Pieter Depuydt, Jean-François Payen, Ana Martins, Samreen Ijaz, Meera Chand, Wei Shen Lim, Bruno Levy, Eric D'ortenzio, Jean-Charles Preiser, Pierre Delobel, Claudia Figueiredo-Mello, Jaques Sztajnbok, Ana Freitas Ribeiro, Tiphaine Goulenok, Bronner P Gonçalves, Arnaud Scherpereel, Chloe Donohue, Carlo Giaquinto, Karolina Nowicka, Adrien Auvet, Debby Bogaert, Elisabeth Botelho-Nevers, Amandine Gagneux-Brunon, Merce Jourdain, Anne McCarthy, Todd C Lee, António Mesquita, Sue Smith, Jia Wei, Jenny Lennon, Antoine Khalil, Nathalie Pansu, Victor Fomin, Audrey Barrelet, Christophe Fraser, Daniel Munblit, Robert A Fowler, William Greenhalf, François-Xavier Lescure, Nicolas Carlier, Saye Khoo, Riinu Pius, Lisa Norman, Louise Sigfrid, Sophie Halpin, Clare Jackson, Antonia Ho, Andrew Dagens, Thomas Flament, Julie Mankikian, Romain Basmaci, Peter Openshaw, Mary Copland, Brenda Reeve, William Dechert, Patricia Lizotte, Felwa Bin Humaid, Tom Fletcher, Adrien Lemaignen, Pierre Tattevin, Christelle Delmas, Hélène Espérou, Claire Lévy-Marchal, Olivier Picone, Jeanne Sibiude, Cecile Yelnik, Olivia V Swann, Michelle Girvan, Piero L Olliaro, Beatrice Alex, Benjamin Bach, Alexander J Mentzer, Mahdad Noursadeghi, Shona C Moore, Massimo Palmarini, Georgios Pollakis, Vanessa Sancho-Shimizu, Shiranee Sriskandan, David Stuart, Charlotte Summers, Ryan S Thwaites, Hayley Hardwick, Wilna Oosthuyzen, Fiona Griffiths, Jo Dalton, Egle Saviciute, Stephanie Roberts, Janet Harrison, Marie Connor, Gary Leeming, Ross Hendry, Victoria Shaw, Jade Ghosn, Lucille Blumberg, Nicolas Benech, James Scott-Brown, Odile Launay, Todd Karsies, Yoan Lavie-Badie, Minh Le, Elise Artaud-Macari, Mylène Maillet, Huda Alfoudri, Djura Piersma, Didier Laureillard, Graham S. Cooke, Nicholas Sedillot, Anne-Sophie Boureau, Tony Trapani, Laurent Abel, Samuel Hinton, Sally Shrapnel, Heidi Dalton, Guillaume Martin-Blondel, Valérie Garrait, Isabelle Delacroix, Samantha Lissauer, Malte Kohns Vasconcelos, Oleksa Rewa, Erlina Burhan, Sara Machado, Jean-Benoît Arlet, Raphaël Borie, Kévin Bouiller, Vincent Langlois, Mélanie Roriz, Mical Paul, Vincent Dubée, Erwan L'her, Michael Rose, Luis Felipe Reyes, Anna Beltrame, Stéphanie Fry, Andrew Udy, Laurent Plantier, Jean-Christophe Goffard, Denis Malvy, Nina Jamieson, Irfan Khan, François Dubos, Jean-Sébastien Hulot, Paola Rodari, Paul Campbell, Abigail Beane, Cécile Tromeur, Paul Loubet, Marina Esposito-Farèse, France Mentré, Valérie Gaborieau, Anne-Marie Guerguerian, Cécile Goujard, Vincent Thibault, Rodrigo Díaz, Patricia Gordon, Sadie Kelly, Bertrand Dussol, Simon Forsyth, Marion Schneider, Nathalie Gault, Marielle Buisson, Yves Levy, Prasan Kumar Panda, Marjolein Brusse-Keizer, Carine Roy, Walter Picard, Tom Drake, Paul Tierney, Olivier Sanchez, Antoine Kimmoun, David Thomson, Nathan Peiffer-Smadja, Julien Poissy, Lila Bouadma, Bruno Lina, Maude Bouscambert, Alexandre Gaymard, Gilles Peytavin, Jeremie Guedj, Claire Andrejak, Cedric Laouenan, Anissa Chair, Samira Laribi, Marie-Capucine Tellier, Sandrine Couffin-Cadiergues, Soizic Le Mestre, Ventzislava Petrov-Sanchez, Alpha Diallo, NoéMie Mercier, Sarah Tubiana, Marion Noret, Oriane Puechal, Caroline Semaille, Patrick Imbert, Jonathan Remppis, Emmanuelle Mercier, Rui Pereira, Sylvie Van Der Werf, Waasila Jassat, Arsene Kpangon, Dominique Luton, Sophie Mahy, Pierre-Adrien Bolze, Sarah Moore, Adrienne Chan, Raphael Favory, Daniel Mathieu, Andrea Angheben, Andrea Rossanese, Matthew Hall, Johann Auchabie, Mohammed Quraishi, Katharina Weil, Hanna Renk, Hans Martin Bosse, Christophe Rapp, Vincent Peigne, Tae Song, Dewi Guellec, Mark G. Pritchard, Adrian Streinu-Cercel, Christl A Donnelly, François Goehringer, Elodie Curlier, Catherine Chirouze, Stéphane Jaureguiberry, Ary Serpa Neto, Jose Andres Calvache, Laurent Bitker, Hodane Yonis, Neerusha Kaisbain, Coline Jaud-Fischer, Laurent Mandelbrot, Jérémie Pasquier, Juliette Patrier, Gianluigi Li Bassi, Sheryl Ann Abdukahil, Jia Shyi Loy, Filipe Cardoso, Diptesh Aryal, Polina Bugaeva, Evert-Jan Wils, Stephanie Yerkovich, Julie Chas, Thushan de Silva, Ruth Lyons, Murray Wham, Sara Clohisey, Seán Keating, Thibault Chiarabini, Agnes Sommet, Hugues Aumaître, Sylvie LeGac, Sarah E McDonald, Jeanne Truong, Camille Couffignal, Anne-Hélène Boivin, Timo Brandenburger, Diane Descamps, Tala Al-Dabbous, Mark Joseph, Hwa Jin Cho, Desy Rusmawatiningtyas, Muhammad Rayhan, Christel Arnold-Day, Navy Lolong, Ernita Akmal, Menaldi Rasmin, Daniel Marino, Neurinda Permata Kusumastuti, Stéphane Lasry, Amanda Rojek, Sebastien Preau, Jean-Marie Turmel, Nowneet Kumar Bhat, Cynthia Braga, Pavan Kumar Vecham, Benoit Thill, Karine Faure, Denis Garot, Grégory Corvaisier, Elsa Nyamankolly, Joshua Solomon, Emma Clarke, Patricia Fontela, Eva Geraud, Eva Miranda Marwali, Aria Kekalih, Saptadi Yuliarto, Dyah Kanya Wati, Ivy Cerelia Valerie, Maureen Masha, Jolanta Popielska, Anca Streinu-Cercel, Mohan Dass Pathmanathan, Barbara Wanjiru Citarella, Heidi Jean Dalton, Nurul Najmee Abdulkadir, Lara Absil, Subhash Acharya, Diana Adrião, Younes Ait Tamlihat, Kévin Alexandre, Kazali Enagnon Alidjnou, Nathalie Allou, Rita Alves, Joana Alves Cabrita, Maria Amaral, Nur Amira, Phoebe Ampaw, Séverine Ansart, Sivanesen Anthonidass, Carlos Alexandre Brito, Ardiyan Apriyana, Carolline Araujo, Muhammad Ashraf, Jean Baptiste Assie, Amirul Asyraf, Anika Atique, AM Udara Attanyake, Laurène Azemar, Cecile Azoulay, Delphine Bachelet, Claudine Badr, J. Kenneth Baillie, Nazreen Abu Bakar, Mohanaprasanth Balakrishnan, Valeria Balan, Renata Barbalho, Wendy S. Barclay, Saef Umar Barnett, Marie Bartoli, Joaquín Baruch, Muhammad Fadhli Basri, Jules Bauer, Diego Fernando Rincon, Alexandra Bedossa, Ker Hong Bee, Husna Begum, Sylvie Behilill, Albertus Beishuizen, Marine Beluze, Lionel Eric Benjiman, Dehbia Benkerrou, Delphine Bergeaud, José Luis Sobrino, Giulia Bertoli, Simon Bessis, Sybille Bevilcaqua, Karine Bezulier, Krishna Bhavsar, Farah Nadiah Bidin, Mohd Nazlin Kamarudin, François Bissuel, Jonathan Bitton, Laetitia Bodenes, Isabela Bolaños, François Bompart, Diogo Borges, Olivier Bouchaud, Sabelline Bouchez, Dounia Bouhmani, Damien Bouhour, Camile Bouisse, Jason Bouziotis, Bianca Boxma, Marielle Boyer-Besseyre, Fernando Augusto Bozza, Axelle Braconnier, Kathy Brickell, Aidan Burrell, Ingrid G Bustos, Denis Butnaru, Eder Caceres, Cyril Cadoz, Rui Caetano Garcês, Valentine Campana, Pauline Caraux-Paz, Chiara Simona Cardellino, Sofia Cardoso, Filipa Cardoso, Thierry Carmoi, Marie-Christine Carret, François Martin Carrier, Maire-Laure Casanova, Mariana Cascão, José Casimiro, Nidyanara Castanheira, Guylaine Castor-Alexandre, François-Xavier Catherine, Paolo Cattaneo, Roberta Cavalin, Minerva Cervantes-Gonzalez, Catherine Chakveatze, Christelle Chantalat Auger, Jean-Marc Chapplain, Anjellica Chen, Matthew Pellan Cheng, Antoine Cheret, Julian Chica, Suresh Kumar Chidambaram, Leong Chin Tho, Bernard Cholley, Marie-Charlotte Chopin, Ting Soo Chow, Hiu Jian Chua, Jonathan Chua, Alexandra Coelho, Megan Coles, Pamela Combs, Sabine Cornelis, Alexander Daniel Cornet, Arianne Joy Corpuz, Emma Costigan, Roxane Courtois, Stéphanie Cousse, Rachel Cregan, Sabine Croonen, Claudina Cruz, Juan Luis Bermúdez, Jaime Cruz Rojo, Paula Custodio, Ana Silva Filipe, Charlene Da Silveira, Juliana Damas, Corinne Daniel, Emmanuelle A Dankwa, Jorge Dantas, Etienne De Montmollin, Rafael Freitas França, Peter de Vries, Jillian Deacon, Alexa Debard, Nathalie DeCastro, Lauren Deconninck, Romain Decours, Eve Defous, Eric Delaveuve, Karen Delavigne, Corine Delsing, Elisa Demonchy, Emmanuelle Denis, Mathilde Desvallées, Santi Dewayanti, Pathik Dhanger, André Dias, Kévin Didier, Jean-Luc Diehl, Wim Dieperink, Vincent Dinot, Fara Diop, Alphonsine Diouf, Yael Dishon, Félix Djossou, Annemarie B. Docherty, Maria Donnelly, Céline Dorival, James Joshua Douglas, Nathalie Dournon, Murray Dryden, Claudio Duarte Fonseca, Alexandre Ducancelle, Paul Dunand, Sim Choon Ean, Mohammed El Sanharawi, Brigitte Elharrar, Philippine Eloy, Isabelle Enderle, Chan Chee Eng, Ilka Engelmann, Vincent Enouf, Olivier Epaulard, Martina Escher, Catarina Espírito Santo, João Estevão, Manuel Etienne, Nadia Ettalhaoui, Mirjam Evers, Isabelle Fabre, Amna Faheem, Arabella Fahy, Cameron J. Fairfield, Pedro Faria, Ahmed Farooq, Hanan Fateena, Jorge Fernandes, Marília Andreia Fernandes, François-Xavier Ferrand, Eglantine Ferrand Devouge, Joana Ferrão, Mário Ferraz, Bernardo Ferreira, Nicolas Ferriere, Céline Ficko, Clara Flateau, Tatiana Fonseca, Erwan Fourn, Robert A. Fowler, Marcela Vieira Freire, Rostane Gaci, Jean-Charles Gagnard, Yasmin Gani, Noelia García Barrio, Esteban Garcia-Gallo, Louis Gerbaud Morlaes, Nuno Germano, Jess Gibson, Tristan Gigante, Morgane Gilg, Guillermo Giordano, Valérie Gissot, Daniel Glikman, Petr Glybochko, Geraldine Goco, Siri Goepel, Jin Yi Goh, Marie Gominet, Bronner P. Gonçalves, Isabelle Gorenne, Laure Goubert, Pascal Granier, Christopher A. Green, Courtney Greene, Segolène Greffe, Albert Groenendijk, Anja Grosse Lordemann, Yusing Gu, Martin Guego, Daniela Guerreiro, Romain Guery, Anne Guillaumot, Laurent Guilleminault, Thomas Guimard, Marieke Haalboom, Daniel Haber, Hannah Habraken, Ali Hachemi, Nadir Hadri, Fakhir Haidri, Ansley Hamer, Rebecca Hamidfar, Lim Yuen Han, Kok Wei Hao, Ewen M. Harrison, Lars Heggelund, Astarini Hidayah, Rupert Higgins, Hikombo Hitoto, Yi Bin Ho, Alexandre Hoctin, Isabelle Hoffmann, Wei Han Hoh, Ikram Houas, Catherine L. Hough, Jimmy Ming-Yang Hsu, Arfan Ikram, Hajnal-Gabriela Illes, Hugo Inácio, Yun Sii Ing, Sarah Isgett, Tiago Isidoro, Nadiah Ismail, Margaux Isnard, Danielle Jaafar, Salma Jaafoura, Julien Jabot, Pierre Jaquet, Florence Jego, Anilawati Mat Jelani, Ong Yiaw Joe, Cédric Joseph, Swosti Joshi, Dafsah Juzar, Ouifiya Kafif, Thavamany Kaleesvran, Sabina Kali, Muhammad Aisar Kamaluddin, Zul Amali Kamaruddin, Nadiah Kamarudin, Kong Yeow Kang, Pratap Karpayah, Anant Kataria, Kevin Katz, Yvelynne Kelly, Younes Kerroumi, Sharma Keshav, Coralie Khan, Quratul Ain Khan, Sushil Khanal, Abid Khatak, Ryan Khoo, Denisa Khoo, Khor How Kiat, Peter Kiiza, Rob Klont, Gry Kloumann Bekken, Robin Kobbe, Chamira Kodippily, Vinothini Krishnan, Ganesh Kumar, Bharath Kumar Vijayaraghavan, Demetrios Kutsogiannis, Marie Lachatre, Marie Lacoste, Marie Lagrange, Fabrice Laine, Antonio Lalueza, Marie Langelot-Richard, Marina Lanza, Delphine Lariviere, Andy Law, Teresa Lawrence, Clément Le Bihan, Cyril Le Bris, Georges Le Falher, Lucie Le Fevre, Quentin Le Hingrat, Marion Le Maréchal, Gwenaël Le Moal, Vincent Le Moing, Hervé Le Nagard, Paul Le Turnier, Ema Leal, Marta Leal Santos, Heng Gee Lee, Biing Horng Lee, Laurent Lefebvre, Bénédicte Lefebvre, Benjamin Lefèvre, Jean-Daniel Lelievre, Véronique Lemee, Anthony Lemeur, Ha Sha Lene, Quentin Lepiller, Olivier Lesens, Mathieu Lesouhaitier, Geoffrey Liegeon, Kah Chuan Lim, Lim Lina, Guillaume Lingas, Sylvie Lion-Daolio, Marine Livrozet, Leong Chee Loon, Diogo Lopes, Anthony L. Loschner, Bouchra Loufti, Guillame Louis, Lee Lee Low, Marije Lowik, Jean Christophe Lucet, Carlos Lumbreras Bermejo, Liem Luong, Oryane Mabiala, Moïse Machado, Gabriel Macheda, Hashmi Madiha, Guillermo Maestro de la Calle, Rafael Mahieu, Thomas Maitre, Fernando Maltez, Victoria Manda, Jose M. Mandei, Edmund Manning, Aldric Manuel, Ceila Sant'Ana Malaque, Samuel Markowicz, Celina Turchi Martelli, Martin Martinot, Caroline Martins Rego, Marsilla Marzukie, Sabina Mason, Sobia Masood, Basri Mat Nor, Moshe Matan, Mathieu Mattei, Romans Matulevics, Laurence Maulin, Thierry Mazzoni, Cécile Mear-Passard, Ogechukwu Menkiti, Antoine Merckx, Mayka Mergeay-Fabre, Alison M. Meynert, Vanina Meysonnier, Amina Meziane, Mehdi Mezidi, Céline Michelanglei, Isabelle Michelet, Nor Arisah Misnan, Tahira Jamal Mohamed, Nik Nur Mohamed, Asma Moin, Agostinho Monteiro, Claudia Montes, Lina Morales Cely, Lucia Moro, Hugo Mouquet Ben Morton, Clara Mouton Perrot, Julien Moyet, Ng Yong Muh, Dzawani Muhamad, Jimmy Mullaert, Karl Erik Müller, Himed Musaab, Himasha Muvindi, Gugapriyaa Muyandy, Nadège Neant, Nikita Nekliudov, Raul Neto, Anthony Nghi, Duc Nguyen, Nurul Amani Noordin, Nurul Faten Norharizam, Nurnaningsih Nurnaningsih, Annmarie O'Callaghan, Katie O'Hearn, Agnieszka Oldakowska, Piero L. Olliaro, David S.Y. Ong, Jee Yan Ong, Saijad Orakzai, Claudia Milena Orozco-Chamorro, Linda O'Shea, Siti Zubaidah Othman, Nadia Ouamara, Rachida Ouissa, Eric Oziol, Justine Pages Maïder Pagadoy, Lai Hui Pang, Aurélie Papadopoulos, Bruno Pastene, Christelle Paul, Jorge Paulos, William A. Paxton, Kalaiarasu Peariasamy, Miguel Pedrera Jiménez, Florent Peelman, Ithan D. Peltan, Daniel Perez, Thomas Perpoint, Vincent Pestre, Michele Petrovic, Scott Pharand, Carola Pierobon, Carlos Pimentel, Raquel Pinto, Catarina Pires, Isabelle Pironneau, Hon Shen Png, Ryadh Pokeerbux, Maria Pokorska-Spiewak, Diane Ponscarme, Douwe F. Postma, Diana Póvoas, Gamage Dona Priyadarshani, Vilmaris Quinones-Cardona, Víctor Quirós González, Marie Rafiq, Rozanah Abd Rahman, Ahmad Kashfi Rahman, Giri Shan Rajahram, Nagarajan Ramakrishnan, José Ramalho, Ahmad Afiq Ramli, Blandine Rammaert, Grazielle Viana Ramos, Thalha Rashan, Cornelius Rau, Tharmini Ravi, Stanislas Rebaudet, Sarah Redl, Attaur Rehman, Martine Remy, Hongru Ren, Anne-Sophie Resseguier, Matthieu Revest, Laurent Richier, Siti Nurul Ridzuan, Ana L Rios, Patrick Rispal, Karine Risso, David L. Robertson, Olivier Robineau, Pierre-Marie Roger, Juliette Romaru, Manuel Rosa-Calatrava, Bénédicte Rossignol, Stella Rousset, Benoît Roze, Clark D. Russell, Musharaf Sadat, Valla Sahraei, Maximilien Saint-Gilles, Stéphane Sallaberry, Charlotte Salmon Gandonniere, Hélène Salvator, Zulfiqar Sandhu, Pierre-François Sandrine, Shirley Sarfo-Mensah, Benjamine Sarton, Parthena Savvidou, Yen Tsen Saw, Janet T. Scott, Jaganathan Selvanayagam, Mageswari Selvarajoo, Malcolm G. Semple, Rasidah Bt Senian, Eric Senneville, Tânia Sequeira, Pablo Serrano Balazote, Ellen Shadowitz, Syamin Asyraf Shahidan, Mohammad Shamsah, Shaikh Sharjeel, Catherine A. Shaw, Ashraf Sheharyar, Mohiuddin Shiekh, Nassima Si Mohammed, Ng Yong Siang, Benedict Sim Heng, Karisha Sivam, Morgane Snacken, Tze Vee Soh, Rima Song, Azlan Mat Soom, Albert Sotto, B. P Edouard Soum, Sanka Sri Darshana, Sarah Stabler, Ymkje Stienstra, Jacky Y. Suen, Deepashankari Suppiah, Andrey Svistunov, Sarah Syahrin, Shirin Tabrizi, Fabio S. Taccone, Lysa Tagherset, Shahdattul Mawarni Taib, Ewa Talarek, Kim Keat Tan, Yan Chyi Tan, Coralie Tardivon, M Azhari Taufik, Richard S. Tedder, Tze Yuan Tee, João Teixeira, Sze Kye Teoh, François Téoulé, Olivier Terrier, Hubert Tessier-Grenier, Alif Adlan Thabit, Zhang Duan Tham, Suvintheran Thangavelu, Simon-Djamel Thiberville, Jananee Thirumanickam, Emma C. Thomson, Surain Raaj Thurai, Peter S Timashev, Noémie Tissot, Jordan Zhien Toh, Sia Loong Tonnii, Marta Torre, Margarida Torres, Théo Treoux, Tiffany Trouillon, Christelle Tual, Lance C.W. Turtle, PG Ishara Udayanga, Timothy M. Uyeki, Luís Val-Flores, Amélie Valran, Marcel van den Berge, Job van der Palen, Paul van der Valk, Peter Van der Voort, Jarne Van Hattem, Carolien van Netten, Ilonka van Veen, Noémie Vanel, Shoban Raj Vasudayan, Charline Vauchy, Shaminee Veeran, Aurélie Veislinger, James Vickers, José Ernesto Vidal, César Vieira, Benoit Visseaux, Fanny Vuotto, Noor Hidayu Wahab, Suhaila Abdul Wahab, Nadirah Abdul Wahid, Tan Pei Wen, Sanne Wesselius, Nicole White, Paul Henri Wicky, Aurélie Wiedemann, Calvin Wong, Xin Ci Wong, Yew Sing Wong, Teck Fung Wong, Gan Ee Xian, Lim Saio Xian, Kuan Pei Xuan, Siti Rohani Yakop, Nicholas Yee Hing, Chian Hui Yeoh, Obada Yousif, Marion Zabbe, Masliza Zahid, Maram Zahran, Nor Zaila Zaidan, Konrad Zawadka, Nurul Zaynah, Hiba Zayyad, and David Zucman
Subjects: Pediatrics, RJ1-570
Abstract: Background The impact of the COVID-19 pandemic on paediatric populations varied between high-income countries (HICs) versus low-income to middle-income countries (LMICs). We sought to investigate differences in paediatric clinical outcomes and identify factors contributing to disparity between countries.Methods The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) COVID-19 database was queried to include children under 19 years of age admitted to hospital from January 2020 to April 2021 with suspected or confirmed COVID-19 diagnosis. Univariate and multivariable analysis of contributing factors for mortality were assessed by country group (HICs vs LMICs) as defined by the World Bank criteria.Results A total of 12 860 children (3819 from 21 HICs and 9041 from 15 LMICs) participated in this study. Of these, 8961 were laboratory-confirmed and 3899 suspected COVID-19 cases. About 52% of LMICs children were black, and more than 40% were infants and adolescent. Overall in-hospital mortality rate (95% CI) was 3.3% [=(3.0% to 3.6%), higher in LMICs than HICs (4.0% (3.6% to 4.4%) and 1.7% (1.3% to 2.1%), respectively). There were significant differences between country income groups in intervention profile, with higher use of antibiotics, antivirals, corticosteroids, prone positioning, high flow nasal cannula, non-invasive and invasive mechanical ventilation in HICs. Out of the 439 mechanically ventilated children, mortality occurred in 106 (24.1%) subjects, which was higher in LMICs than HICs (89 (43.6%) vs 17 (7.2%) respectively). Pre-existing infectious comorbidities (tuberculosis and HIV) and some complications (bacterial pneumonia, acute respiratory distress syndrome and myocarditis) were significantly higher in LMICs compared with HICs. On multivariable analysis, LMIC as country income group was associated with increased risk of mortality (adjusted HR 4.73 (3.16 to 7.10)).Conclusion Mortality and morbidities were higher in LMICs than HICs, and it may be attributable to differences in patient demographics, complications and access to supportive and treatment modalities.
Published: 2022
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6. Neonatal Bloodstream Infection with Ceftazidime-Avibactam-Resistant blaKPC-2-Producing Klebsiella pneumoniae Carrying blaVEB-25

Author: Charalampos Zarras, Elias Iosifidis, Maria Simitsopoulou, Styliani Pappa, Angeliki Kontou, Emmanuel Roilides, and Anna Papa
Subjects: multidrug resistance, Gram-negative bacteria, Enterobacterales, carbapenemases, blaVEB-25 carbapenemase, neonatal intensive care unit, Therapeutics. Pharmacology, RM1-950
Abstract: Background: Although ceftazidime/avibactam (CAZ/AVI) has become an important option for treating adults and children, no data or recommendations exist for neonates. We report a neonatal sepsis case due to CAZ/AVI-resistant blaKPC-2-harboring Klebsiella pneumoniae carrying blaVEB-25 and the use of a customized active surveillance program in conjunction with enhanced infection control measures. Methods: The index case was an extremely premature neonate hospitalized for 110 days that had been previously treated with multiple antibiotics. Customized molecular surveillance was implemented at hospital level and enhanced infection control measures were taken for early recognition and prevention of outbreak. Detection and identification of blaVEB-25 was performed using next-generation sequencing. Results: This was the first case of a bloodstream infection caused by KPC-producing K. pneumoniae that was resistant to CAZ/AVI without the presence of a metalo-β-lactamase in the multiplex PCR platform in a neonate. All 36 additional patients tested (12 in the same NICU and 24 from other hospital departments) carried wild-type blaVEB-1 but they did not harbor blaVEB-25. Conclusion: The emergence of blaVEB-25 is signal for the horizontal transfer of plasmids at hospital facilities and it is of greatest concern for maintaining a sharp vigilance for the surveillance of novel resistance mechanisms. Molecular diagnostics can guide appropriate antimicrobial therapy and the early implementation of infection control measures against antimicrobial resistance.
Published: 2023
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7. Use of Newer and Repurposed Antibiotics against Gram-Negative Bacteria in Neonates

Author: Angeliki Kontou, Maria Kourti, Elias Iosifidis, Kosmas Sarafidis, and Emmanuel Roilides
Subjects: neonates, ceftazidime–avibactam, ceftolozane/tazobactam, imipenem/cilastatin–relabactam, meropenem–vaborbactam, colistin, Therapeutics. Pharmacology, RM1-950
Abstract: Antimicrobial resistance has become a significant public health problem globally with multidrug resistant Gram negative (MDR-GN) bacteria being the main representatives. The emergence of these pathogens in neonatal settings threatens the well-being of the vulnerable neonatal population given the dearth of safe and effective therapeutic options. Evidence from studies mainly in adults is now available for several novel antimicrobial compounds, such as new β-lactam/β-lactamase inhibitors (e.g., ceftazidime–avibactam, meropenem–vaborbactam, imipenem/cilastatin–relebactam), although old antibiotics such as colistin, tigecycline, and fosfomycin are also encompassed in the fight against MDR-GN infections that remain challenging. Data in the neonatal population are scarce, with few clinical trials enrolling neonates for the evaluation of the efficacy, safety, and dosing of new antibiotics, while the majority of old antibiotics are used off-label. In this article we review data about some novel and old antibiotics that are active against MDR-GN bacteria causing sepsis and are of interest to be used in the neonatal population.
Published: 2023
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8. Genetic Characterization of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates in a Tertiary Hospital in Greece, 2018–2022

Author: Charalampos Zarras, Theodoros Karampatakis, Styliani Pappa, Elias Iosifidis, Eleni Vagdatli, Emmanuel Roilides, and Anna Papa
Subjects: carbapenem-resistant Klebsiella pneumoniae, whole genome sequencing, core genome single-nucleotide polymorphism analysis, molecular epidemiology, Therapeutics. Pharmacology, RM1-950
Abstract: Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a serious public health issue. The study aimed to identify the antimicrobial resistance and accessory genes, the clonal relatedness, and the evolutionary dynamics of selected CRKP isolates recovered in an adult and pediatric intensive care unit of a tertiary hospital in Greece. Methods: Twenty-four CRKP isolates recovered during 2018–2022 were included in the study. Next-generation sequencing was performed using the Ion Torrent PGM Platform. The identification of the plasmid content, MLST, and antimicrobial resistance genes, as well as the comparison of multiple genome alignments and the identification of core genome single-nucleotide polymorphism sites, were performed using various bioinformatics software. Results: The isolates belonged to eight sequence types: 11, 15, 30, 35, 39, 307, 323, and 512. A variety of carbapenemases (KPC, VIM, NDM, and OXA-48) and resistance genes were detected. CRKP strains shared visually common genomic regions with the reference strain (NTUH-K2044). ST15, ST323, ST39, and ST11 CRKP isolates presented on average 17, 6, 16, and 866 recombined SNPs, respectively. All isolates belonging to ST15, ST323, and ST39 were classified into distinct phylogenetic branches, while ST11 isolates were assigned to a two-subclade branch. For large CRKP sets, the phylogeny seems to change approximately every seven SNPs. Conclusions: The current study provides insight into the genetic characterization of CRKP isolates in the ICUs of a tertiary hospital. Our results indicate clonal dispersion of ST15, ST323, and ST39 and highly diverged ST11 isolates.
Published: 2023
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9. Evaluation of Five Host Inflammatory Biomarkers in Early Diagnosis of Ventilator-Associated Pneumonia in Critically Ill Children: A Prospective Single Center Cohort Study

Author: Maria Sdougka, Maria Simitsopoulou, Elena Volakli, Asimina Violaki, Vivian Georgopoulou, Argiro Ftergioti, Emmanuel Roilides, and Elias Iosifidis
Subjects: ventilator-associated pneumonia, critically ill children, biomarkers, Therapeutics. Pharmacology, RM1-950
Abstract: Background: Early diagnosis of ventilator-associated pneumonia (VAP) remains a challenge due to subjective clinical criteria and the low discriminative power of diagnostic tests. We assessed whether rapid molecular diagnostics in combination with Clinically Pulmonary Index Score (CPIS) scoring, microbiological surveillance and biomarker measurements of PTX-3, SP-D, s-TREM, PTX-3, IL-1β and IL-8 in the blood or lung could improve the accuracy of VAP diagnosis and follow-up in critically ill children. Methods: A prospective pragmatic study in a Pediatric Intensive Care Unit (PICU) was conducted on ventilated critically ill children divided into two groups: high and low suspicion of VAP according to modified Clinically Pulmonary Index Score (mCPIS). Blood and bronchial samples were collected on days 1, 3, 6 and 12 after event onset. Rapid diagnostics were used for pathogen identification and ELISA for PTX-3, SP-D, s-TREM, IL-1β and IL-8 measurements. Results: Among 20 enrolled patients, 12 had a high suspicion (mCPIS > 6), and 8 had a low suspicion of VAP (mCPIS < 6); 65% were male; and 35% had chronic disease. IL-1β levels at day 1 correlated significantly with the number of mechanical ventilation days (rs = 0.67, p < 0.001) and the PICU stay (r = 0.66; p < 0.002). No significant differences were found in the levels of the other biomarkers between the two groups. Mortality was recorded in two patients with high VAP suspicion. Conclusions: PTX-3, SP-D, s-TREM, IL-1β and IL-8 biomarkers could not discriminate patients with a high or low suspicion of VAP diagnosis.
Published: 2023
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10. Epidemiology of Mucormycosis in Greece; Results from a Nationwide Prospective Survey and Published Case Reports

Author: Maria Drogari-Apiranthitou, Anna Skiada, Ioannis Panayiotides, Timoleon-Achilleas Vyzantiadis, Aikaterina Poulopoulou, Myrto Christofidou, Anastasia Antoniadou, Emmanuel Roilides, Elias Iosifidis, Vassiliki Mamali, Athina Argyropoulou, Styliani Sympardi, Nikoletta Charalampaki, Nikolaos Antonakos, Paraskevi Mantzana, Zafeiria Mastora, Ourania Nicolatou-Galitis, Maria Orfanidou, Zoi-Dorothea Pana, Ioannis Pavleas, Angelos Pefanis, Vissaria Sakka, Anastasia Spiliopoulou, Maria Stamouli, Polydoros Tofas, Eleni Vagiakou, and George Petrikkos
Subjects: mucormycosis, zygomycosis, Mucorales, epidemiology, Greece, Biology (General), QH301-705.5
Abstract: Mucormycosis has emerged as a group of severe infections mainly in immunocompromised patients. We analysed the epidemiology of mucormycosis in Greece in a multicentre, nationwide prospective survey of patients of all ages, during 2005–2022. A total of 108 cases were recorded. The annual incidence declined after 2009 and appeared stable thereafter, at 0.54 cases/million population. The most common forms were rhinocerebral (51.8%), cutaneous (32.4%), and pulmonary (11.1%). Main underlying conditions were haematologic malignancy/neutropenia (29.9%), haematopoietic stem cell transplantation (4.7%), diabetes mellitus (DM) (15.9%), other immunodeficiencies (23.4%), while 22.4% of cases involved immunocompetent individuals with cutaneous/soft-tissue infections after motor vehicle accident, surgical/iatrogenic trauma, burns, and injuries associated with natural disasters. Additionally, DM or steroid-induced DM was reported as a comorbidity in 21.5% of cases with various main conditions. Rhizopus (mostly R. arrhizus) predominated (67.1%), followed by Lichtheimia (8.5%) and Mucor (6.1%). Antifungal treatment consisted mainly of liposomal amphotericin B (86.3%), median dose 7 mg/kg/day, range 3–10 mg/kg/day, with or without posaconazole. Crude mortality was 62.8% during 2005–2008 but decreased significantly after 2009, at 34.9% (p = 0.02), with four times fewer haematological cases, fewer iatrogenic infections, and fewer cases with advanced rhinocerebral form. The increased DM prevalence should alert clinicians for timely diagnosis of mucormycosis in this patient population.
Published: 2023
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11. Forecasting models of infections due to carbapenem-resistant Gram-negative bacteria in an intensive care unit in an endemic area

Author: Theodoros Karampatakis, Katerina Tsergouli, Elias Iosifidis, Charalampos Antachopoulos, Eleni Mouloudi, Aggeliki Karyoti, Athanassios Tsakris, and Emmanuel Roilides
Subjects: Forecasting model, Carbapenem-resistant Gram-negative bacteria, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Intensive care unit, Microbiology, QR1-502
Abstract: Objectives: The aim of this study was to forecast the monthly incidence rates of infections [infections/1000 bed-days (IBD)] due to carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) and total carbapenem-resistant Gram-negative bacteria (CRGNB) in an endemic intensive care unit (ICU) during the subsequent year (December 2016–December 2017) following the observational period. Methods: A 52-month observational period (August 2012–November 2016) was used. Two forecasting models, including a simple seasonal model for CRGNB, CRKP and CRPA and Winters’ additive model for CRAB infections, were applied. Results: The models predicted the highest infection rates for CRKP, CRAB and CRGNB in January and September 2017 (23.8/23.4, 24.6/28.5 and 46.8/46.7 IBD, respectively) and for CRPA in February and March 2017 (8.3 and 7.9, respectively). The highest observed rates for CRKP, CRAB and CRGNB were indeed in January and September 2017 (25.6/19.0, 34.2/23.8 and 59.8/42.8 IBD, respectively); and for CRPA in February and March of the same year (15.2 and 12.7, respectively). The increased rates may be associated with personnel’s annual work programme and behavioural factors. Conclusion: Forecasting models in endemic ICUs may assist in implementation strategies for infection control measures.
Published: 2020
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12. Aetiology of acute respiratory infection in preschool children requiring hospitalisation in Europe—results from the PED-MERMAIDS multicentre case–control study

Author: Cristina Calvo, Andrew Riordan, Liviana Da Dalt, Federico Martinón-Torres, Peter Horby, Julia A Bielicki, Maria Tsolia, Michael Sharland, Herman Goossens, Marion Koopmans, Despoina Gkentzi, Peter J Openshaw, Menno D de Jong, Elias Iosifidis, Emmanuel Roilides, Carlo Giaquinto, Louise Sigfrid, Margareta Ieven, Malte Kohns Vasconcelos, Pablo Rojo, Cristina Epalza, Sigita Burokiene, Hanna Renk, Samsul Islam, Vana Spoulou, Katherine Loens, Daniele Donà, Veerle Matheeussen, Savvas Papachristou, Manuel Gijon, Chiara Minotti, Jessica Jarvis, Aggeliki Syggelou, Maggie Nyirenda Nyang’wa, Sophie Keers, Anna-Lena Gemmel, Carmen D’Amore, Marta Ciofi degli Atti, Carmen Rodríguez-Tenreiro Sánchez, Tessa Goetghebuer, Markus Hufnagel, and Pieter L A Fraaij
Subjects: Medicine, Diseases of the respiratory system, RC705-779
Abstract: Background Both pathogenic bacteria and viruses are frequently detected in the nasopharynx (NP) of children in the absence of acute respiratory infection (ARI) symptoms. The aim of this study was to estimate the aetiological fractions for ARI hospitalisation in children for respiratory syncytial virus (RSV) and influenza virus and to determine whether detection of specific respiratory pathogens on NP samples was associated with ARI hospitalisation.Methods 349 children up to 5 years of age hospitalised for ARI (following a symptom-based case definition) and 306 hospital controls were prospectively enrolled in 16 centres across seven European Union countries between 2016 and 2019. Admission day NP swabs were analysed by multiplex PCR for 25 targets.Results RSV was the leading single cause of ARI hospitalisations, with an overall population attributable fraction (PAF) of 33.4% and high seasonality as well as preponderance in younger children. Detection of RSV on NP swabs was strongly associated with ARI hospitalisation (OR adjusted for age and season: 20.6, 95% CI: 9.4 to 45.3). Detection of three other viral pathogens showed strong associations with ARI hospitalisation: influenza viruses had an adjusted OR of 6.1 (95% CI: 2.5 to 14.9), parainfluenza viruses (PIVs) an adjusted OR of 4.6 (95% CI: 1.8 to 11.3) and metapneumoviruses an adjusted OR of 4.5 (95% CI: 1.3 to 16.1). Influenza viruses had a PAF of 7.9%, PIVs of 6.5% and metapneumoviruses of 3.0%. In contrast, most other pathogens were found in similar proportions in cases and controls, including Streptococcus pneumoniae, which was weakly associated with case status, and endemic coronaviruses.Conclusion RSV is the predominant cause of ARI hospitalisations in young children in Europe and its detection, as well as detection of influenza virus, PIV or metapneumovirus, on NP swabs can establish aetiology with high probability. PAFs for RSV and influenza virus are highly seasonal and age dependent.
Published: 2021
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13. Meropenem vs standard of care for treatment of neonatal late onset sepsis (NeoMero1): A randomised controlled trial.

Author: Irja Lutsar, Corine Chazallon, Ursula Trafojer, Vincent Meiffredy de Cabre, Cinzia Auriti, Chiara Bertaina, Francesca Ippolita Calo Carducci, Fuat Emre Canpolat, Susanna Esposito, Isabelle Fournier, Maarja Hallik, Paul T Heath, Mari-Liis Ilmoja, Elias Iosifidis, Jelena Kuznetsova, Laurence Meyer, Tuuli Metsvaht, George Mitsiakos, Zoi Dorothea Pana, Fabio Mosca, Lorenza Pugni, Emmanuel Roilides, Paolo Rossi, Kosmas Sarafidis, Laura Sanchez, Michael Sharland, Vytautas Usonis, Adilia Warris, Jean-Pierre Aboulker, Carlo Giaquinto, and NeoMero Consortium
Subjects: Medicine, Science
Abstract: BackgroundThe early use of broad-spectrum antibiotics remains the cornerstone for the treatment of neonatal late onset sepsis (LOS). However, which antibiotics should be used is still debatable, as relevant studies were conducted more than 20 years ago, recruited in single centres or countries, evaluated antibiotics not in clinical use anymore and had variable inclusion/exclusion criteria and outcome measures. Moreover, antibiotic-resistant bacteria have become a major problem in many countries worldwide. We hypothesized that efficacy of meropenem as a broad-spectrum antibiotic is superior to standard of care regimens (SOC) in empiric treatment of LOS and aimed to compare meropenem to SOC in infants aged Methods and findingsNeoMero-1 was a randomized, open-label, phase III superiority trial conducted in 18 neonatal units in 6 countries. Infants with post-menstrual age (PMA) of ≤44 weeks with positive blood culture and one, or those with negative culture and at least with two predefined clinical and laboratory signs suggestive of LOS, or those with PMA >44 weeks meeting the Goldstein criteria of sepsis, were randomized in a 1:1 ratio to receive meropenem or one of the two SOC regimens (ampicillin+gentamicin or cefotaxime+gentamicin) chosen by each site prior to the start of the study for 8-14 days. The primary outcome was treatment success (survival, no modification of allocated therapy, resolution/improvement of clinical and laboratory markers, no need of additional antibiotics and presumed/confirmed eradication of pathogens) at test-of-cure visit (TOC) in full analysis set. Stool samples were tested at baseline and Day 28 for meropenem-resistant Gram-negative organisms (CRGNO). The primary analysis was performed in all randomised patients and in patients with culture confirmed LOS. Proportions of participants with successful outcome were compared by using a logistic regression model adjusted for the stratification factors. From September 3, 2012 to November 30th 2014, total of 136 patients (instead of planned 275) in each arm were randomized; 140 (52%) were culture positive. Successful outcome at TOC was achieved in 44/136 (32%) in the meropenem arm vs. 31/135 (23%) in the SOC arm (p = 0.087). The respective numbers in patients with positive cultures were 17/63 (27%) vs. 10/77 (13%) (p = 0.022). The main reason of failure was modification of allocated therapy. Treatment emergent adverse events occurred in 72% and serious adverse events in 17% of patients, the Day 28 mortality was 6%. Cumulative acquisition of CRGNO by Day 28 occurred in 4% of patients in the meropenem and 12% in the SOC arm (p = 0.052).ConclusionsWithin this study population, we found no evidence that meropenem was superior to SOC in terms of success at TOC, short term hearing disturbances, safety or mortality were similar in both treatment arms but the study was underpowered to detect the planned effect. Meropenem treatment did not select for colonization with CRGNOs. We suggest that meropenem as broad-spectrum antibiotic should be reserved for neonates who are more likely to have Gram-negative LOS, especially in NICUs where microorganisms producing extended spectrum- and AmpC type beta-lactamases are circulating.
Published: 2020
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14. Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey

Author: Ann Versporten, MPH, Peter Zarb, PhD, Isabelle Caniaux, MPharm, Marie-Françoise Gros, MD, Nico Drapier, BAI, Mark Miller, MD, Vincent Jarlier, ProfMD, Dilip Nathwani, ProfMD, Herman Goossens, ProfMD, Andi Koraqi, Iris Hoxha, Silva Tafaj, Denada Lacej, Martin Hojman, Rodolfo Ernesto Quiros, Lilit Ghazaryan, Kelly A Cairns, Allen Cheng, Kylie C Horne, Fiona F Doukas, Thomas Gottlieb, Jameela Alsalman, Koen Magerman, Gounongbe YT Marielle, Amela Dedeic Ljubovic, André Afonso Machado Coelho, Ana Cristina Gales, Emma Keuleyan, Deana Sabuda, Jennifer Lee Boswell, John M Conly, Alvaro Rojas, Camila Carvajal, Jaime Labarca, Antonio Solano, Carlos Ramírez Valverde, Juan M Villalobos-Vindas, Irina Pristas, Vanda Plecko, Niki Paphitou, Erjona Shaqiri, Maija-Liisa Rummukainen, Karaman Pagava, Irma Korinteli, Tobias Brandt, Sabine Messler, Anthony Enimil, Elias Iosifidis, Emmanuel Roilides, Mamadou Saliou Sow, Sharmila Sengupta, Joby V George, Aruna Poojary, Priyanka Patil, Jafar Soltani, Zahra Jafarpour, Hadi Ameen, David Fitzgerald, Yasmin Maor, Michal Chowers, Elizabeth Temkin, Susanna Esposito, Luca Arnoldo, Silvio Brusaferro, Yoshiaki Gu, Feras Darwish El-Hajji, Nam Joong Kim, Baktygul Kambaralieva, Jana Pavare, Lelde Zarakauska, Vytautas Usonis, Sigita Burokiene, Inga Ivaskeviciene, Gordana Mijovic, Natasa Duborija-Kovacevic, Kristen Bondesio, Kenneth Iregbu, Oyinlola Oduyebo, Denis Raka, Lul Raka, Svetlana Rachina, Mushira Abdulaziz Enani, Mohamed Al Shehri, Biljana Carevic, Gorana Dragovac, Dusanka Obradovic, Aleksandra Stojadinovic, Lili Radulovic, Jia EN Wu, Gladys Wei Teng Chung, Hui Hiong Chen, Paul Anantharajah Tambyah, David Lye, Sock Hoon Tan, Tat Ming Ng, Hui Lin Tay, Moi Lin Ling, Maciej Piotr Chlebicki, Andrea L Kwa, Winnie Lee, Bojana Beović, Angela Dramowski, Heather Finlayson, Jantjie Taljaard, Guillermo Ojeda-Burgos, Pilar Retamar, Johan Lucas, Wolter Pot, Cees Verduin, Jan Kluytmans, Michael Scott, Mamoon A Aldeyab, Bernadette McCullagh, Cairine Gormley, David Sharpe, Mark Gilchrist, Laura Whitney, Matthew Laundy, Debbie Lockwood, Simon B Drysdale, Jennifer Boudreaux, Edward J Septimus, Nickie Greer, Gerard Gawrys, Edgar Rios, and Suzanne May
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. Methods: We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates) receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015. Hospitals were classified as primary, secondary, tertiary (including infectious diseases hospitals), and paediatric hospitals. Five main ward types were defined: medical wards, surgical wards, intensive-care units, haematology oncology wards, and medical transplantation (bone marrow or solid transplants) wards. Data recorded included patient characteristics, antimicrobials received, diagnosis, therapeutic indication according to predefined lists, and markers of prescribing quality (eg, whether a stop or review date were recorded, and whether local prescribing guidelines existed and were adhered to). We report findings for adult inpatients. Findings: The Global-PPS for 2015 included adult data from 303 hospitals in 53 countries, including eight lower-middle-income and 17 upper-middle-income countries. 86 776 inpatients were admitted to 3315 adult wards, of whom 29 891 (34·4%) received at least one antimicrobial. 41 213 antimicrobial prescriptions were issued, of which 36 792 (89·3%) were antibacterial agents for systemic use. The top three antibiotics prescribed worldwide were penicillins with β-lactamase inhibitors, third-generation cephalosporins, and fluoroquinolones. Carbapenems were most frequently prescribed in Latin America and west and central Asia. Of patients who received at least one antimicrobial, 5926 (19·8%) received a targeted antibacterial treatment for systemic use, and 1769 (5·9%) received a treatment targeting at least one multidrug-resistant organism. The frequency of health-care-associated infections was highest in Latin America (1518 [11·9%]) and east and south Asia (5363 [10·1%]). Overall, the reason for treatment was recorded in 31 694 (76·9%) of antimicrobial prescriptions, and a stop or review date in 15 778 (38·3%). Local antibiotic guidelines were missing for 7050 (19·2%) of the 36 792 antibiotic prescriptions, and guideline compliance was 77·4%. Interpretation: The Global-PPS showed that worldwide surveillance can be accomplished with voluntary participation. It provided quantifiable measures to assess and compare the quantity and quality of antibiotic prescribing and resistance in hospital patients worldwide. These data will help to improve the quality of antibiotic prescribing through education and practice changes, particularly in low-income and middle-income countries that have no tools to monitor antibiotic prescribing in hospitals. Funding: bioMérieux.
Published: 2018
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15. Child Morbidity and Disease Burden in Refugee Camps in Mainland Greece

Author: Asterios Kampouras, Georgios Tzikos, Eustathios Partsanakis, Konstantinos Roukas, Stefanos Tsiamitros, Dimitrios Deligeorgakis, Elisavet Chorafa, Maria Schoina, and Elias Iosifidis
Subjects: child morbidity, disease burden, refugee crisis, Pediatrics, RJ1-570
Abstract: The crisis conflicts in Syria have forced a lot of people to relocate and live in mainland Greece, where they are hosted in refugee camps. In the present study, our aim was to assess child morbidity and overall disease burden in two camps in northern Greece during a six-month winter period. A primary health care office was founded in each camp. Refugees of all ages with health problems were examined daily by specialty doctors. Cases were classified into two categories: Infectious or non-infectious. In total, 2631 patients were examined during this period (out of the 3760 refugees hosted). Of these patients, 9.8% were infants, 12.7% were toddlers, and 13.4% were children. Most of the visits for children aged less than 12 years old were due to infectious diseases (80.8%). The most common sites of communicable diseases among children were the respiratory tract (66.8%), the skin (23.2%), and the urinary (3.2%) and gastrointestinal tracts (6.2%). Non-communicable diseases were mostly due to gastrointestinal (20.2%), respiratory (18.2%), surgical (13.1%), and allergic (10.3%) disorders. Infants, toddlers, and children suffered more frequently from respiratory infections, while in adolescents and adults, non-infectious diseases were more common. Toddlers and children were more likely to fall ill in comparison to infants. Conclusions: During the winter period, infectious diseases, especially of the respiratory tract, are the main reason for care seeking among refugees in Greek camps, with toddlers suffering more than other age groups. The overall mortality and referral percentage were low, indicating that adequate primary care is provided in this newly established refugee hosting model.
Published: 2019
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16. Invasive Aspergillosis in Pediatric Leukemia Patients: Prevention and Treatment

Author: Savvas Papachristou, Elias Iosifidis, and Emmanuel Roilides
Subjects: Aspergillus, anti-fungal agents, hematological malignancies, Biology (General), QH301-705.5
Abstract: The purpose of this article is to review and update the strategies for prevention and treatment of invasive aspergillosis (IA) in pediatric patients with leukemia and in patients with hematopoietic stem cell transplantation. The major risk factors associated with IA will be described since their recognition constitutes the first step of prevention. The latter is further analyzed into chemoprophylaxis and non-pharmacologic approaches. Triazoles are the mainstay of anti-fungal prophylaxis while the other measures revolve around reducing exposure to mold spores. Three levels of treatment have been identified: (a) empiric, (b) pre-emptive, and (c) targeted treatment. Empiric is initiated in febrile neutropenic patients and uses mainly caspofungin and liposomal amphotericin B (LAMB). Pre-emptive is a diagnostic driven approach attempting to reduce unnecessary use of anti-fungals. Treatment targeted at proven or probable IA is age-dependent, with voriconazole and LAMB being the cornerstones in >2yrs and
Published: 2019
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17. Advances in the Treatment of Mycoses in Pediatric Patients

Author: Elias Iosifidis, Savvas Papachristou, and Emmanuel Roilides
Subjects: invasive fungal infections, neonates, antifungal agents, children, Biology (General), QH301-705.5
Abstract: The main indications for antifungal drug administration in pediatrics are reviewed as well as an update of the data of antifungal agents and antifungal policies performed. Specifically, antifungal therapy in three main areas is updated as follows: (a) Prophylaxis of premature neonates against invasive candidiasis; (b) management of candidemia and meningoencephalitis in neonates; and (c) prophylaxis, empiric therapy, and targeted antifungal therapy in children with primary or secondary immunodeficiencies. Fluconazole remains the most frequent antifungal prophylactic agent given to high-risk neonates and children. However, the emergence of fluconazole resistance, particularly in non-albicans Candida species, should be considered during preventive or empiric therapy. In very-low birth-weight neonates, although fluconazole is used as antifungal prophylaxis in neonatal intensive care units (NICU’s) with relatively high incidence of invasive candidiasis (IC), its role is under continuous debate. Amphotericin B, primarily in its liposomal formulation, remains the mainstay of therapy for treating neonatal and pediatric yeast and mold infections. Voriconazole is indicated for mold infections except for mucormycosis in children >2 years. Newer triazoles-such as posaconazole and isavuconazole-as well as echinocandins, are either licensed or under study for first-line or salvage therapy, whereas combination therapy is kept for refractory cases.
Published: 2018
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18. Recent Advances in the Treatment of Scedosporiosis and Fusariosis

Author: Matthew W. McCarthy, Aspasia Katragkou, Elias Iosifidis, Emmanuel Roilides, and Thomas J. Walsh
Subjects: fusariosis, scedosporiosis, isavuconazole, voriconazole, MALDI-TOF, Biology (General), QH301-705.5
Abstract: Species of Scedosporium and Fusarium are considered emerging opportunistic pathogens, causing invasive fungal diseases in humans that are known as scedosporiosis and fusariosis, respectively. These mold infections typically affect patients with immune impairment; however, cases have been reported in otherwise healthy individuals. Clinical manifestations vary considerably, ranging from isolated superficial infection to deep-seated invasive infection—affecting multiple organs—which is often lethal. While there have been a number of advances in the detection of these infections, including the use of polymerase chain reaction (PCR) and matrix-assisted laser desorption ionization/time-of-flight mass spectrometry (MALDI-TOF MS), diagnosis is often delayed, leading to substantial morbidity and mortality. Although the optimal therapy is controversial, there have also been notable advances in the treatment of these diseases, which often depend on a combination of antifungal therapy, reversal of immunosuppression, and in some cases, surgical resection. In this paper, we review these advances and examine how the management of scedosporiosis and fusariosis may change in the near future.
Published: 2018
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19. Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Author: Kartsonaki, Christiana, Baillie, J Kenneth, Barrio, Noelia García, Baruch, Joaquín, Beane, Abigail, Blumberg, Lucille, Bozza, Fernando, Broadley, Tessa, Burrell, Aidan, Carson, Gail, Citarella, Barbara Wanjiru, Dagens, Andrew, Dankwa, Emmanuelle A, Donnelly, Christl A, Dunning, Jake, Elotmani, Loubna, Escher, Martina, Farshait, Nataly, Goffard, Jean-Christophe, Gonçalves, Bronner P, Hall, Matthew, Hashmi, Madiha, Sim Lim Heng, Benedict, Ho, Antonia, Jassat, Waasila, Pedrera Jiménez, Miguel, Laouenan, Cedric, Lissauer, Samantha, Martin-Loeches, Ignacio, Mentré, France, Merson, Laura, Morton, Ben, Munblit, Daniel, Nekliudov, Nikita A, Nichol, Alistair D, Singh Oinam, Budha Charan, Ong, David, Panda, Prasan Kumar, Petrovic, Michele, Pritchard, Mark G, Ramakrishnan, Nagarajan, Ramos, Grazielle Viana, Roger, Claire, Sandulescu, Oana, Semple, Malcolm G, Sharma, Pratima, Sigfrid, Louise, Somers, Emily C, Streinu-Cercel, Anca, Taccone, Fabio, Vecham, Pavan Kumar, Kumar Tirupakuzhi Vijayaraghavan, Bharath, Wei, Jia, Wils, Evert-Jan, Ci Wong, Xin, Horby, Peter, Rojek, Amanda, Olliaro, Piero L, ISARIC Clinical Characterisation Group: Ali Abbas, Sheryl Ann Abdukahil, Nurul Najmee Abdulkadir, Ryuzo Abe, Laurent Abel, Lara Absil, Subhash Acharya, Andrew Acker, Elisabeth Adam, Diana Adrião, Saleh Al Ageel, Shakeel Ahmed, Kate Ainscough, Eka Airlangga, Tharwat Aisa, Ali Ait Hssain, Younes Ait Tamlihat, Takako Akimoto, Ernita Akmal, Eman Al Qasim, Razi Alalqam, Angela Alberti, Tala Al-Dabbous, Senthilkumar Alegesan, Cynthia Alegre, Marta Alessi, Beatrice Alex, Kévin Alexandre, Abdulrahman Al-Fares, Huda Alfoudri, Imran Ali, Adam Ali, Naseem Ali Shah, Kazali Enagnon Alidjnou, Jeffrey Aliudin, Qabas Alkhafajee, Clotilde Allavena, Nathalie Allou, Aneela Altaf, João Alves, Rita Alves, João Melo Alves, Maria Amaral, Nur Amira, Phoebe Ampaw, Roberto Andini, Claire Andréjak, Andrea Angheben, François Angoulvant, Séverine Ansart, Sivanesen Anthonidass, Massimo Antonelli, Carlos Alexandre Antunes de Brito, Ardiyan Apriyana, Yaseen Arabi, Irene Aragao, Francisco Arancibia, Carolline Araujo, Antonio Arcadipane, Patrick Archambault, Lukas Arenz, Jean-Benoît Arlet, Christel Arnold-Day, Lovkesh Arora, Rakesh Arora, Elise Artaud-Macari, Diptesh Aryal, Angel Asensio, Muhammad Ashraf, Namra Asif, Mohammad Asim, Jean Baptiste Assie, Amirul Asyraf, Anika Atique, A M Udara Lakshan Attanyake, Johann Auchabie, Hugues Aumaitre, Adrien Auvet, Laurène Azemar, Cecile Azoulay, Benjamin Bach, Delphine Bachelet, Claudine Badr, Nadia Baig, J Kevin Baird, Erica Bak, Agamemnon Bakakos, Nazreen Abu Bakar, Andriy Bal, Mohanaprasanth Balakrishnan, Valeria Balan, Firouzé Bani-Sadr, Renata Barbalho, Nicholas Yuri Barbosa, Wendy S Barclay, Saef Umar Barnett, Michaela Barnikel, Helena Barrasa, Audrey Barrelet, Cleide Barrigoto, Marie Bartoli, Mustehan Bashir, Romain Basmaci, Muhammad Fadhli Hassin Basri, Denise Battaglini, Jules Bauer, Diego Fernando Bautista Rincon, Denisse Bazan Dow, Alexandra Bedossa, Ker Hong Bee, Husna Begum, Sylvie Behilill, Albertus Beishuizen, Aleksandr Beljantsev, David Bellemare, Anna Beltrame, Beatriz Amorim Beltrão, Marine Beluze, Nicolas Benech, Lionel Eric Benjiman, Dehbia Benkerrou, Suzanne Bennett, Luís Bento, Jan-Erik Berdal, Delphine Bergeaud, Hazel Bergin, José Luis Bernal Sobrino, Giulia Bertoli, Lorenzo Bertolino, Simon Bessis, Sybille Bevilcaqua, Karine Bezulier, Amar Bhatt, Krishna Bhavsar, Claudia Bianco, Farah Nadiah Bidin, Moirangthem Bikram Singh, Felwa Bin Humaid, Mohd Nazlin Bin Kamarudin, François Bissuel, Patrick Biston, Laurent Bitker, Jonathan Bitton, Pablo Blanco-Schweizer, Catherine Blier, Frank Bloos, Mathieu Blot, Filomena Boccia, Laetitia Bodenes, Alice Bogaarts, Debby Bogaert, Anne-Hélène Boivin, Pierre-Adrien Bolze, François Bompart, Aurelius Bonfasius, Diogo Borges, Raphaël Borie, Hans Martin Bosse, Elisabeth Botelho-Nevers, Lila Bouadma, Olivier Bouchaud, Sabelline Bouchez, Dounia Bouhmani, Damien Bouhour, Kévin Bouiller, Laurence Bouillet, Camile Bouisse, Anne-Sophie Boureau, John Bourke, Maude Bouscambert, Aurore Bousquet, Jason Bouziotis, Bianca Boxma, Marielle Boyer-Besseyre, Maria Boylan, Axelle Braconnier, Cynthia Braga, Timo Brandenburger, Filipa Brás Monteiro, Luca Brazzi, Patrick Breen, Dorothy Breen, Kathy Brickell, Shaunagh Browne, Alex Browne, Nicolas Brozzi, Marjolein Brusse-Keizer, Nina Buchtele, Christian Buesaquillo, Polina Bugaeva, Marielle Buisson, Danilo Buonsenso, Erlina Burhan, Ingrid G Bustos, Denis Butnaru, André Cabie, Susana Cabral, Eder Caceres, Cyril Cadoz, Mia Callahan, Kate Calligy, Jose Andres Calvache, João Camões, Valentine Campana, Paul Campbell, Josie Campisi, Cecilia Canepa, Mireia Cantero, Pauline Caraux-Paz, Sheila Cárcel, Chiara Simona Cardellino, Sofia Cardoso, Filipe Cardoso, Filipa Cardoso, Nelson Cardoso, Simone Carelli, Nicolas Carlier, Thierry Carmoi, Gayle Carney, Inês Carqueja, Marie-Christine Carret, François Martin Carrier, Ida Carroll, Maire-Laure Casanova, Mariana Cascão, Siobhan Casey, José Casimiro, Bailey Cassandra, Silvia Castañeda, Nidyanara Castanheira, Guylaine Castor-Alexandre, Henry Castrillón, Ivo Castro, Ana Catarino, François-Xavier Catherine, Paolo Cattaneo, Roberta Cavalin, Giulio Giovanni Cavalli, Alexandros Cavayas, Adrian Ceccato, Minerva Cervantes-Gonzalez, Anissa Chair, Catherine Chakveatze, Adrienne Chan, Meera Chand, Christelle Chantalat Auger, Jean-Marc Chapplain, Julie Chas, Allegra Chatterjee, Mobin Chaudry, Jonathan Samuel Chávez Iñiguez, Anjellica Chen, Yih-Sharng Chen, Matthew Pellan Cheng, Antoine Cheret, Thibault Chiarabini, Julian Chica, Suresh Kumar Chidambaram, Leong Chin Tho, Catherine Chirouze, Davide Chiumello, Sung-Min Cho, Bernard Cholley, Marie-Charlotte Chopin, Ting Soo Chow, Yock Ping Chow, Hiu Jian Chua, Jonathan Chua, Jose Pedro Cidade, José Miguel Cisneros Herreros, Anna Ciullo, Jennifer Clarke, Emma Clarke, Rolando Claure-Del Granado, Sara Clohisey, Perren J Cobb, Cassidy Codan, Caitriona Cody, Alexandra Coelho, Megan Coles, Gwenhaël Colin, Michael Collins, Sebastiano Maria Colombo, Pamela Combs, Marie Connor, Anne Conrad, Sofía Contreras, Elaine Conway, Graham S Cooke, Mary Copland, Hugues Cordel, Amanda Corley, Sabine Cornelis, Alexander Daniel Cornet, Arianne Joy Corpuz, Andrea Cortegiani, Grégory Corvaisier, Emma Costigan, Camille Couffignal, Sandrine Couffin-Cadiergues, Roxane Courtois, Stéphanie Cousse, Rachel Cregan, Charles Crepy D'Orleans, Cosimo Cristella, Sabine Croonen, Gloria Crowl, Jonathan Crump, Claudina Cruz, Juan Luis Cruz Berm, Jaime Cruz Rojo, Marc Csete, Ailbhe Cullen, Matthew Cummings, Gerard Curley, Elodie Curlier, Colleen Curran, Paula Custodio, Ana da Silva Filipe, Charlene Da Silveira, Al-Awwab Dabaliz, Darren Dahly, Heidi Dalton, Jo Dalton, Seamus Daly, Nick Daneman, Corinne Daniel, Jorge Dantas, Frédérick D'Aragon, Menno de Jong, Gillian de Loughry, Diego de Mendoza, Etienne De Montmollin, Rafael Freitas de Oliveira França, Ana Isabel de Pinho Oliveira, Rosanna De Rosa, Cristina De Rose, Thushan de Silva, Peter de Vries, Jillian Deacon, David Dean, Alexa Debard, Marie-Pierre Debray, Nathalie DeCastro, William Dechert, Lauren Deconninck, Romain Decours, Eve Defous, Isabelle Delacroix, Eric Delaveuve, Karen Delavigne, Nathalie M Delfos, Ionna Deligiannis, Andrea Dell'Amore, Christelle Delmas, Pierre Delobel, Corine Delsing, Elisa Demonchy, Emmanuelle Denis, Dominique Deplanque, Pieter Depuydt, Mehul Desai, Diane Descamps, Mathilde Desvallées, Santi Dewayanti, Pathik Dhanger, Alpha Diallo, Sylvain Diamantis, André Dias, Juan Jose Diaz, Priscila Diaz, Rodrigo Diaz, Kévin Didier, Jean-Luc Diehl, Wim Dieperink, Jérôme Dimet, Vincent Dinot, Fara Diop, Alphonsine Diouf, Yael Dishon, Félix Djossou, Annemarie B Docherty, Helen Doherty, Arjen M Dondorp, Andy Dong, Maria Donnelly, Sean Donohue, Yoann Donohue, Chloe Donohue, Peter Doran, Céline Dorival, Eric D'Ortenzio, James Joshua Douglas, Renee Douma, Nathalie Dournon, Triona Downer, Joanne Downey, Mark Downing, Tom Drake, Aoife Driscoll, Murray Dryden, Claudio Duarte Fonseca, Vincent Dubee, François Dubos, Alexandre Ducancelle, Toni Duculan, Susanne Dudman, Abhijit Duggal, Paul Dunand, Mathilde Duplaix, Emanuele Durante-Mangoni, Lucian Durham, Bertrand Dussol, Juliette Duthoit, Xavier Duval, Anne Margarita Dyrhol-Riise, Sim Choon Ean, Marco Echeverria-Villalobos, Siobhan Egan, Carla Eira, Mohammed El Sanharawi, Subbarao Elapavaluru, Brigitte Elharrar, Jacobien Ellerbroek, Philippine Eloy, Tarek Elshazly, Iqbal Elyazar, Isabelle Enderle, Tomoyuki Endo, Chan Chee Eng, Ilka Engelmann, Vincent Enouf, Olivier Epaulard, Mariano Esperatti, Hélène Esperou, Marina Esposito-Farese, João Estevão, Manuel Etienne, Nadia Ettalhaoui, Anna Greti Everding, Mirjam Evers, Marc Fabre, Isabelle Fabre, Amna Faheem, Arabella Fahy, Cameron J Fairfield, Zul Fakar, Komal Fareed, Pedro Faria, Ahmed Farooq, Hanan Fateena, Arie Zainul Fatoni, Karine Faure, Raphaël Favory, Mohamed Fayed, Niamh Feely, Laura Feeney, Jorge Fernandes, Marília Andreia Fernandes, Susana Fernandes, François-Xavier Ferrand, Eglantine Ferrand Devouge, Joana Ferrão, Mário Ferraz, Sílvia Ferreira, Isabel Ferreira, Benigno Ferreira, Ricard Ferrer-Roca, Nicolas Ferriere, Céline Ficko, Claudia Figueiredo-Mello, William Finlayson, Juan Fiorda, Thomas Flament, Clara Flateau, Tom Fletcher, Letizia Lucia Florio, Deirdre Flynn, Claire Foley, Jean Foley, Victor Fomin, Tatiana Fonseca, Patricia Fontela, Simon Forsyth, Denise Foster, Giuseppe Foti, Erwan Fourn, Robert A Fowler, Marianne Fraher, Diego Franch-Llasat, John F Fraser, Christophe Fraser, Marcela Vieira Freire, Ana Freitas Ribeiro, Caren Friedrich, Ricardo Fritz, Stéphanie Fry, Nora Fuentes, Masahiro Fukuda, G Argin, Valérie Gaborieau, Rostane Gaci, Massimo Gagliardi, Jean-Charles Gagnard, Amandine Gagneux-Brunon, Sérgio Gaião, Linda Gail Skeie, Phil Gallagher, Carrol Gamble, Yasmin Gani, Arthur Garan, Rebekha Garcia, Julia Garcia-Diaz, Esteban Garcia-Gallo, Navya Garimella, Denis Garot, Valérie Garrait, Basanta Gauli, Nathalie Gault, Aisling Gavin, Anatoliy Gavrylov, Alexandre Gaymard, Johannes Gebauer, Eva Geraud, Louis Gerbaud Morlaes, Nuno Germano, Praveen Kumar Ghisulal, Jade Ghosn, Marco Giani, Jess Gibson, Tristan Gigante, Morgane Gilg, Elaine Gilroy, Guillermo Giordano, Michelle Girvan, Valérie Gissot, Daniel Glikman, Petr Glybochko, Eric Gnall, Geraldine Goco, François Goehringer, Siri Goepel, Jin Yi Goh, Jonathan Golob, Rui Gomes, Kyle Gomez, Joan Gómez-Junyent, Marie Gominet, Alicia Gonzalez, Patricia Gordon, Isabelle Gorenne, Laure Goubert, Cécile Goujard, Tiphaine Goulenok, Margarite Grable, Jeronimo Graf, Edward Wilson Grandin, Pascal Granier, Giacomo Grasselli, Christopher A Green, Courtney Greene, William Greenhalf, Segolène Greffe, Domenico Luca Grieco, Matthew Griffee, Fiona Griffiths, Ioana Grigoras, Albert Groenendijk, Anja Grosse Lordemann, Heidi Gruner, Yusing Gu, Jérémie Guedj, Martin Guego, Dewi Guellec, Anne-Marie Guerguerian, Daniela Guerreiro, Romain Guery, Anne Guillaumot, Laurent Guilleminault, Maisa Guimarães de Castro, Thomas Guimard, Marieke Haalboom, Daniel Haber, Hannah Habraken, Ali Hachemi, Amy Hackmann, Nadir Hadri, Fakhir Haidri, Sheeba Hakak, Adam Hall, Sophie Halpin, Jawad Hameed, Ansley Hamer, Raph L Hamers, Rebecca Hamidfar, Terese Hammond, Lim Yuen Han, Rashan Haniffa, Kok Wei Hao, Hayley Hardwick, Ewen M Harrison, Janet Harrison, Samuel Bernard Ekow Harrison, Alan Hartman, Mohd Shahnaz Hasan, Junaid Hashmi, Muhammad Hayat, Ailbhe Hayes, Leanne Hays, Jan Heerman, Lars Heggelund, Ross Hendry, Martina Hennessy, Aquiles Henriquez-Trujillo, Maxime Hentzien, Jaime Hernandez-Montfort, Andrew Hershey, Liv Hesstvedt, Astarini Hidayah, Eibhilin Higgins, Dawn Higgins, Rupert Higgins, Rita Hinchion, Samuel Hinton, Hiroaki Hiraiwa, Haider Hirkani, Hikombo Hitoto, Yi Bin Ho, Alexandre Hoctin, Isabelle Hoffmann, Wei Han Hoh, Oscar Hoiting, Rebecca Holt, Jan Cato Holter, Juan Pablo Horcajada, Koji Hoshino, Ikram Houas, Catherine L Hough, Stuart Houltham, Jimmy Ming-Yang Hsu, Jean-Sébastien Hulot, Stella Huo, Abby Hurd, Iqbal Hussain, Samreen Ijaz, Hajnal-Gabriela Illes, Patrick Imbert, Mohammad Imran, Rana Imran Sikander, Aftab Imtiaz, Hugo Inácio, Carmen Infante Dominguez, Yun Sii Ing, Elias Iosifidis, Mariachiara Ippolito, Sarah Isgett, Tiago Isidoro, Nadiah Ismail, Margaux Isnard, Junji Itai, Daniel Ivulich, Danielle Jaafar, Salma Jaafoura, Julien Jabot, Clare Jackson, Nina Jamieson, Victoria Janes, Pierre Jaquet, Coline Jaud-Fischer, Stéphane Jaureguiberry, Jeffrey Javidfar, Denise Jaworsky, Florence Jego, Anilawati Mat Jelani, Synne Jenum, Ruth Jimbo-Sotomayor, Ong Yiaw Joe, Ruth N Jorge García, Cédric Joseph, Mark Joseph, Swosti Joshi, Mercé Jourdain, Philippe Jouvet, Hanna Jung, Anna Jung, Dafsah Juzar, Ouifiya Kafif, Florentia Kaguelidou, Neerusha Kaisbain, Thavamany Kaleesvran, Sabina Kali, Alina Kalicinska, Smaragdi Kalomoiri, Muhammad Aisar Ayadi Kamaluddin, Zul Amali Che Kamaruddin, Nadiah Kamarudin, Paul Kambiya, Kavita Kamineni, Darshana Hewa Kandamby, Chris Kandel, Kong Yeow Kang, Darakhshan Kanwal, Pratap Karpayah, Todd Karsies, Daisuke Kasugai, Anant Kataria, Kevin Katz, Aasmine Kaur, Christy Kay, Hannah Keane, Seán Keating, Pulak Kedia, Claire Kelly, Yvelynne Kelly, Andrea Kelly, Niamh Kelly, Aoife Kelly, Sadie Kelly, Maeve Kelsey, Ryan Kennedy, Kalynn Kennon, Maeve Kernan, Younes Kerroumi, Sharma Keshav, Imrana Khalid, Osama Khalid, Antoine Khalil, Coralie Khan, Irfan Khan, Quratul Ain Khan, Sushil Khanal, Abid Khatak, Amin Khawaja, Krish Kherajani, Michelle E Kho, Saye Khoo, Ryan Khoo, Denisa Khoo, Nasir Khoso, Khor How Kiat, Yuri Kida, Peter Kiiza, Beathe Kiland Granerud, Anders Benjamin Kildal, Jae Burm Kim, Antoine Kimmoun, Detlef Kindgen-Milles, Alexander King, Nobuya Kitamura, Paul Klenerman, Rob Klont, Gry Kloumann Bekken, Stephen R Knight, Robin Kobbe, Chamira Kodippily, Malte Kohns Vasconcelos, Sabin Koirala, Mamoru Komatsu, Caroline Kosgei, Arsène Kpangon, Karolina Krawczyk, Vinothini Krishnan, Sudhir Krishnan, Oksana Kruglova, Deepali Kumar, Ganesh Kumar, Mukesh Kumar, Dinesh Kuriakose, Ethan Kurtzman, Demetrios Kutsogiannis, Galyna Kutsyna, Konstantinos Kyriakoulis, Marie Lachatre, Marie Lacoste, John G Laffey, Marie Lagrange, Fabrice Laine, Olivier Lairez, Sanjay Lakhey, Antonio Lalueza, Marc Lambert, François Lamontagne, Marie Langelot-Richard, Vincent Langlois, Eka Yudha Lantang, Marina Lanza, Cédric Laouénan, Samira Laribi, Delphine Lariviere, Stéphane Lasry, Sakshi Lath, Naveed Latif, Odile Launay, Didier Laureillard, Yoan Lavie-Badie, Andy Law, Teresa Lawrence, Cassie Lawrence, Minh Le, Clément Le Bihan, Cyril Le Bris, Georges Le Falher, Lucie Le Fevre, Quentin Le Hingrat, Marion Le Maréchal, Soizic Le Mestre, Gwenaël Le Moal, Vincent Le Moing, Hervé Le Nagard, Paul Le Turnier, Ema Leal, Marta Leal Santos, Todd C Lee, James Lee, Jennifer Lee, Heng Gee Lee, Biing Horng Lee, Yi Lin Lee, Su Hwan Lee, Gary Leeming, Laurent Lefebvre, Bénédicte Lefebvre, Benjamin Lefevre, Sylvie LeGac, Jean-Daniel Lelievre, François Lellouche, Adrien Lemaignen, Véronique Lemee, Anthony Lemeur, Gretchen Lemmink, Ha Sha Lene, Jenny Lennon, Rafael León, Marc Leone, Michela Leone, Quentin Lepiller, François-Xavier Lescure, Olivier Lesens, Mathieu Lesouhaitier, Amy Lester-Grant, Bruno Levy, Yves Levy, Claire Levy-Marchal, Katarzyna Lewandowska, Erwan L'Her, Gianluigi Li Bassi, Janet Liang, Ali Liaquat, Geoffrey Liegeon, Wei Shen Lim, Kah Chuan Lim, Chantre Lima, Lim Lina, Bruno Lina, Andreas Lind, Maja Katherine Lingad, Guillaume Lingas, Sylvie Lion-Daolio, Keibun Liu, Marine Livrozet, Patricia Lizotte, Antonio Loforte, Navy Lolong, Leong Chee Loon, Diogo Lopes, Dalia Lopez-Colon, Jose W Lopez-Revilla, Anthony L Loschner, Paul Loubet, Bouchra Loufti, Guillame Louis, Silvia Lourenco, Lara Lovelace-Macon, Lee Lee Low, Marije Lowik, Jia Shyi Loy, Jean Christophe Lucet, Carlos Lumbreras Bermejo, Carlos M Luna, Olguta Lungu, Liem Luong, Nestor Luque, Dominique Luton, Nilar Lwin, Ruth Lyons, Olavi Maasikas, Oryane Mabiala, Moïse Machado, Gabriel Macheda, Hashmi Madiha, Guillermo Maestro de la Calle, Rafael Mahieu, Sophie Mahy, Ana Raquel Maia, Lars S Maier, Mylène Maillet, Thomas Maitre, Maximilian Malfertheiner, Nadia Malik, Paddy Mallon, Fernando Maltez, Denis Malvy, Victoria Manda, Laurent Mandelbrot, Frank Manetta, Julie Mankikian, Edmund Manning, Aldric Manuel, Ceila Maria Sant Ana Malaque, Flávio Marino, Daniel Marino, Samuel Markowicz, Charbel Maroun Eid, Ana Marques, Catherine Marquis, Brian Marsh, Laura Marsh, Megan Marshal, John Marshall, Celina Turchi Martelli, Dori-Ann Martin, Emily Martin, Guillaume Martin-Blondel, Martin Martinot, Alejandro Martin-Quiros, João Martins, Ana Martins, Nuno Martins, Caroline Martins Rego, Gennaro Martucci, Olga Martynenko, Eva Miranda Marwali, Marsilla Marzukie, David Maslove, Sabina Mason, Sobia Masood, Basri Mat Nor, Moshe Matan, Meghena Mathew, Daniel Mathieu, Mathieu Mattei, Romans Matulevics, Laurence Maulin, Michael Maxwell, Javier Maynar, Thierry Mazzoni, Natalie Mc Evoy, Lisa Mc Sweeney, Colin McArthur, Anne McCarthy, Aine McCarthy, Colin McCloskey, Rachael McConnochie, Sherry McDermott, Sarah E McDonald, Aine McElroy, Samuel McElwee, Victoria McEneany, Allison McGeer, Chris McKay, Johnny McKeown, Kenneth A McLean, Paul McNally, Bairbre McNicholas, Elaine McPartlan, Edel Meaney, Cécile Mear-Passard, Maggie Mechlin, Maqsood Meher, Omar Mehkri, Ferruccio Mele, Luis Melo, Kashif Memon, Joao Joao Mendes, Ogechukwu Menkiti, Kusum Menon, Alexander J Mentzer, Emmanuelle Mercier, Noémie Mercier, Antoine Merckx, Mayka Mergeay-Fabre, Blake Mergler, António Mesquita, Roberta Meta, Osama Metwally, Agnès Meybeck, Dan Meyer, Alison M Meynert, Vanina Meysonnier, Amina Meziane, Mehdi Mezidi, Céline Michelanglei, Isabelle Michelet, Efstathia Mihelis, Vladislav Mihnovit, Hugo Miranda-Maldonado, Nor Arisah Misnan, Tahira Jamal Mohamed, Nik Nur Eliza Mohamed, Asma Moin, David Molina, Elena Molinos, Brenda Molloy, Mary Mone, Agostinho Monteiro, Claudia Montes, Giorgia Montrucchio, Shona C Moore, Sarah Moore, Lina Morales Cely, Lucia Moro, Catherine Motherway, Ana Motos, Hugo Mouquet, Clara Mouton Perrot, Julien Moyet, Caroline Mudara, Aisha Kalsoom Mufti, Ng Yong Muh, Dzawani Muhamad, Jimmy Mullaert, Fredrik Müller, Karl Erik Müller, Syed Muneeb, Nadeem Munir, Laveena Munshi, Aisling Murphy, Lorna Murphy, Marlène Murris, Srinivas Murthy, Himed Musaab, Himasha Muvindi, Gugapriyaa Muyandy, Dimitra Melia Myrodia, Farah Nadia Mohd-Hanafiah, Dave Nagpal, Alex Nagrebetsky, Mangala Narasimhan, Nageswaran Narayanan, Rashid Nasim Khan, Alasdair Nazerali-Maitland, Nadège Neant, Holger Neb, Erni Nelwan, Raul Neto, Emily Neumann, Pauline Yeung Ng, Wing Yiu Ng, Anthony Nghi, Duc Nguyen, Orna Ni Choileain, Niamh Ni Leathlobhair, Prompak Nitayavardhana, Stephanie Nonas, Nurul Amani Mohd Noordin, Marion Noret, Nurul Faten Izzati Norharizam, Lisa Norman, Alessandra Notari, Mahdad Noursadeghi, Karolina Nowicka, Adam Nowinski, Saad Nseir, Jose I Nunez, Nurnaningsih Nurnaningsih, Dwi Utomo Nusantara, Elsa Nyamankolly, Fionnuala O Brien, Annmarie O Callaghan, Annmarie O'Callaghan, Giovanna Occhipinti, Derbrenn OConnor, Max O'Donnell, Tawnya Ogston, Takayuki Ogura, Tak-Hyuk Oh, Sophie O'Halloran, Katie O'Hearn, Shinichiro Ohshimo, Agnieszka Oldakowska, João Oliveira, Larissa Oliveira, Jee Yan Ong, Wilna Oosthuyzen, Anne Opavsky, Peter Openshaw, Saijad Orakzai, Claudia Milena Orozco-Chamorro, Jamel Ortoleva, Javier Osatnik, Linda O'Shea, Miriam O'Sullivan, Siti Zubaidah Othman, Nadia Ouamara, Rachida Ouissa, Eric Oziol, Maïder Pagadoy, Justine Pages, Mario Palacios, Amanda Palacios, Massimo Palmarini, Giovanna Panarello, Hem Paneru, Lai Hui Pang, Mauro Panigada, Nathalie Pansu, Aurélie Papadopoulos, Rachael Parke, Melissa Parker, Briseida Parra, Taha Pasha, Jérémie Pasquier, Bruno Pastene, Fabian Patauner, Drashti Patel, Mohan Dass Pathmanathan, Luís Patrão, Patricia Patricio, Juliette Patrier, Lisa Patterson, Rajyabardhan Pattnaik, Mical Paul, Christelle Paul, Jorge Paulos, William A Paxton, Jean-François Payen, Kalaiarasu Peariasamy, Giles J Peek, Florent Peelman, Nathan Peiffer-Smadja, Vincent Peigne, Mare Pejkovska, Paolo Pelosi, Ithan D Peltan, Rui Pereira, Daniel Perez, Luis Periel, Thomas Perpoint, Antonio Pesenti, Vincent Pestre, Lenka Petrou, Ventzislava Petrov-Sanchez, Frank Olav Pettersen, Gilles Peytavin, Scott Pharand, Michael Piagnerelli, Walter Picard, Olivier Picone, Maria de Piero, Carola Pierobon, Djura Piersma, Carlos Pimentel, Raquel Pinto, Catarina Pires, Isabelle Pironneau, Lionel Piroth, Ayodhia Pitaloka, Riinu Pius, Laurent Plantier, Hon Shen Png, Julien Poissy, Ryadh Pokeerbux, Maria Pokorska-Spiewak, Sergio Poli, Georgios Pollakis, Diane Ponscarme, Jolanta Popielska, Diego Bastos Porto, Andra-Maris Post, Douwe F Postma, Pedro Povoa, Diana Póvoas, Jeff Powis, Sofia Prapa, Sébastien Preau, Christian Prebensen, Jean-Charles Preiser, Anton Prinssen, Gamage Dona Dilanthi Priyadarshani, Lucia Proença, Sravya Pudota, Oriane Puéchal, Bambang Pujo Semedi, Mathew Pulicken, Gregory Purcell, Luisa Quesada, Vilmaris Quinones-Cardona, Víctor Quirós González, Else Quist-Paulsen, Mohammed Quraishi, Maia Rabaa, Christian Rabaud, Ebenezer Rabindrarajan, Aldo Rafael, Marie Rafiq, Gabrielle Ragazzo, Mutia Rahardjani, Rozanah Abd Rahman, Ahmad Kashfi Haji Ab Rahman, Arsalan Rahutullah, Fernando Rainieri, Giri Shan Rajahram, Pratheema Ramachandran, Ahmad Afiq Ramli, Blandine Rammaert, Asim Rana, Rajavardhan Rangappa, Ritika Ranjan, Christophe Rapp, Aasiyah Rashan, Thalha Rashan, Ghulam Rasheed, Menaldi Rasmin, Indrek Rätsep, Cornelius Rau, Tharmini Ravi, Ali Raza, Andre Real, Stanislas Rebaudet, Sarah Redl, Brenda Reeve, Attaur Rehman, Liadain Reid, Dag Henrik Reikvam, Renato Reis, Jordi Rello, Jonathan Remppis, Martine Remy, Hongru Ren, Hanna Renk, Anne-Sophie Resseguier, Matthieu Revest, Oleksa Rewa, Luis Felipe Reyes, Tiago Reyes, Maria Ines Ribeiro, Antonia Ricchiuto, David Richardson, Denise Richardson, Laurent Richier, Siti Nurul Atikah Ahmad Ridzuan, Jordi Riera, Ana L Rios, Asgar Rishu, Patrick Rispal, Karine Risso, Maria Angelica Rivera Nuñez, Nicholas Rizer, Chiara Robba, André Roberto, Stephanie Roberts, David L Robertson, Olivier Robineau, Ferran Roche-Campo, Paola Rodari, Simão Rodeia, Bernhard Roessler, Pierre-Marie Roger, Emmanuel Roilides, Juliette Romaru, Roberto Roncon-Albuquerque, Mélanie Roriz, Manuel Rosa-Calatrava, Michael Rose, Dorothea Rosenberger, Nurul Hidayah Mohammad Roslan, Andrea Rossanese, Matteo Rossetti, Bénédicte Rossignol, Patrick Rossignol, Stella Rousset, Carine Roy, Benoît Roze, Desy Rusmawatiningtyas, Clark D Russell, Maria Ryan, Maeve Ryan, Steffi Ryckaert, Aleksander Rygh Holten, Isabela Saba, Sairah Sadaf, Musharaf Sadat, Valla Sahraei, Maximilien Saint-Gilles, Pranya Sakiyalak, Nawal Salahuddin, Leonardo Salazar, Jodat Saleem, Gabriele Sales, Stéphane Sallaberry, Charlotte Salmon Gandonniere, Hélène Salvator, Olivier Sanchez, Angel Sanchez-Miralles, Vanessa Sancho-Shimizu, Gyan Sandhu, Zulfiqar Sandhu, Pierre-François Sandrine, Marlene Santos, Shirley Sarfo-Mensah, Bruno Sarmento Banheiro, Iam Claire E Sarmiento, Benjamine Sarton, Ankana Satya, Sree Satyapriya, Rumaisah Satyawati, Egle Saviciute, Parthena Savvidou, Yen Tsen Saw, Justin Schaffer, Tjard Schermer, Arnaud Scherpereel, Marion Schneider, Stephan Schroll, Michael Schwameis, Gary Schwartz, Brendan Scicluna, Janet T Scott, James Scott-Brown, Nicholas Sedillot, Tamara Seitz, Jaganathan Selvanayagam, Mageswari Selvarajoo, Caroline Semaille, Rasidah Bt Senian, Eric Senneville, Claudia Sepulveda, Filipa Sequeira, Tânia Sequeira, Ary Serpa Neto, Pablo Serrano Balazote, Ellen Shadowitz, Syamin Asyraf Shahidan, Mohammad Shamsah, Anuraj Shankar, Shaikh Sharjeel, Catherine A Shaw, Victoria Shaw, Ashraf Sheharyar, Rohan Shetty, Rajesh Mohan Shetty, Haixia Shi, Nisreen Shiban, Mohiuddin Shiekh, Nobuaki Shime, Hiroaki Shimizu, Keiki Shimizu, Sally Shrapnel, Pramesh Sundar Shrestha, Shubha Kalyan Shrestha, Hoi Ping Shum, Nassima Si Mohammed, Ng Yong Siang, Jeanne Sibiude, Atif Siddiqui, Piret Sillaots, Catarina Silva, Rogério Silva, Maria Joao Silva, Wai Ching Sin, Dario Sinatti, Punam Singh, Budha Charan Singh, Pompini Agustina Sitompul, Karisha Sivam, Vegard Skogen, Sue Smith, Benjamin Smood, Coilin Smyth, Michelle Smyth, Morgane Snacken, Dominic So, Tze Vee Soh, Joshua Solomon, Tom Solomon, Agnès Sommet, Rima Song, Tae Song, Jack Song Chia, Michael Sonntagbauer, Azlan Mat Soom, Alberto Sotto, Edouard Soum, Marta Sousa, Ana Chora Sousa, Maria Sousa Uva, Vicente Souza-Dantas, Alexandra Sperry, Elisabetta Spinuzza, B P Sanka Ruwan Sri Darshana, Shiranee Sriskandan, Sarah Stabler, Thomas Staudinger, Stephanie-Susanne Stecher, Trude Steinsvik, Ymkje Stienstra, Birgitte Stiksrud, Eva Stolz, Amy Stone, Adrian Streinu-Cercel, David Stuart, Ami Stuart, Decy Subekti, Gabriel Suen, Jacky Y Suen, Asfia Sultana, Charlotte Summers, Dubravka Supic, Deepashankari Suppiah, Magdalena Surovcová, Suwarti Suwarti, Andrey Svistunov, Sarah Syahrin, Konstantinos Syrigos, Jaques Sztajnbok, Konstanty Szuldrzynski, Shirin Tabrizi, Lysa Tagherset, Shahdattul Mawarni Taib, Ewa Talarek, Sara Taleb, Jelmer Talsma, Renaud Tamisier, Maria Lawrensia Tampubolon, Kim Keat Tan, Yan Chyi Tan, Taku Tanaka, Hiroyuki Tanaka, Hayato Taniguchi, Huda Taqdees, Arshad Taqi, Coralie Tardivon, Pierre Tattevin, M Azhari Taufik, Hassan Tawfik, Richard S Tedder, Tze Yuan Tee, João Teixeira, Sofia Tejada, Marie-Capucine Tellier, Sze Kye Teoh, Vanessa Teotonio, François Téoulé, Pleun Terpstra, Olivier Terrier, Nicolas Terzi, Hubert Tessier-Grenier, Adrian Tey, Alif Adlan Mohd Thabit, Anand Thakur, Zhang Duan Tham, Suvintheran Thangavelu, Vincent Thibault, Simon-Djamel Thiberville, Benoît Thill, Jananee Thirumanickam, Shaun Thompson, Emma C Thomson, David Thomson, Surain Raaj Thanga Thurai, Ryan S Thwaites, Paul Tierney, Vadim Tieroshyn, Peter S Timashev, Jean-François Timsit, Noémie Tissot, Jordan Zhien Yang Toh, Maria Toki, Kristian Tonby, Sia Loong Tonnii, Margarida Torres, Antoni Torres, Rosario Maria Torres Santos-Olmo, Hernando Torres-Zevallos, Michael Towers, Tony Trapani, Théo Treoux, Cécile Tromeur, Ioannis Trontzas, Tiffany Trouillon, Jeanne Truong, Christelle Tual, Sarah Tubiana, Helen Tuite, Jean-Marie Turmel, Lance C W Turtle, Anders Tveita, Pawel Twardowski, Makoto Uchiyama, P G Ishara Udayanga, Andrew Udy, Roman Ullrich, Alberto Uribe, Asad Usman, Timothy M Uyeki, Cristinava Vajdovics, Piero Valentini, Luís Val-Flores, Amélie Valran, Stijn Van de Velde, Marcel van den Berge, Machteld Van der Feltz, Job van der Palen, Paul van der Valk, Nicky Van Der Vekens, Peter Van der Voort, Sylvie Van Der Werf, Laura van Gulik, Jarne Van Hattem, Carolien van Netten, Frank van Someren Greve, Ilonka van Veen, Hugo Van Willigen, Noémie Vanel, Henk Vanoverschelde, Pooja Varghese, Michael Varrone, Shoban Raj Vasudayan, Charline Vauchy, Shaminee Veeran, Aurélie Veislinger, Sebastian Vencken, Sara Ventura, Annelies Verbon, James Vickers, José Ernesto Vidal, César Vieira, Deepak Vijayan, Joy Ann Villanueva, Judit Villar, Pierre-Marc Villeneuve, Andrea Villoldo, Gayatri Vishwanathan, Benoit Visseaux, Hannah Visser, Chiara Vitiello, Harald Vonkeman, Fanny Vuotto, Suhaila Abdul Wahab, Noor Hidayu Wahab, Nadirah Abdul Wahid, Marina Wainstein, Wan Fadzlina Wan Muhd Shukeri, Chih-Hsien Wang, Steve Webb, Katharina Weil, Tan Pei Wen, Sanne Wesselius, T Eoin West, Murray Wham, Bryan Whelan, Nicole White, Paul Henri Wicky, Aurélie Wiedemann, Surya Otto Wijaya, Keith Wille, Suzette Willems, Virginie Williams, Calvin Wong, Yew Sing Wong, Teck Fung Wong, Natalie Wright, Gan Ee Xian, Lim Saio Xian, Kuan Pei Xuan, Ioannis Xynogalas, Siti Rohani Binti Mohd Yakop, Masaki Yamazaki, Yazdan Yazdanpanah, Nicholas Yee Liang Hing, Cécile Yelnik, Chian Hui Yeoh, Stephanie Yerkovich, Toshiki Yokoyama, Hodane Yonis, Obada Yousif, Saptadi Yuliarto, Akram Zaaqoq, Marion Zabbe, Kai Zacharowski, Masliza Zahid, Maram Zahran, Nor Zaila Binti Zaidan, Maria Zambon, Miguel Zambrano, Alberto Zanella, Konrad Zawadka, Nurul Zaynah, Hiba Zayyad, Alexander Zoufaly, David Zucman, Kartsonaki, Christiana, Baillie, J Kenneth, Barrio, Noelia García, Baruch, Joaquín, Beane, Abigail, Blumberg, Lucille, Bozza, Fernando, Broadley, Tessa, Burrell, Aidan, Carson, Gail, Citarella, Barbara Wanjiru, Dagens, Andrew, Dankwa, Emmanuelle A, Donnelly, Christl A, Dunning, Jake, Elotmani, Loubna, Escher, Martina, Farshait, Nataly, Goffard, Jean-Christophe, Gonçalves, Bronner P, Hall, Matthew, Hashmi, Madiha, Sim Lim Heng, Benedict, Ho, Antonia, Jassat, Waasila, Pedrera Jiménez, Miguel, Laouenan, Cedric, Lissauer, Samantha, Martin-Loeches, Ignacio, Mentré, France, Merson, Laura, Morton, Ben, Munblit, Daniel, Nekliudov, Nikita A, Nichol, Alistair D, Singh Oinam, Budha Charan, Ong, David, Panda, Prasan Kumar, Petrovic, Michele, Pritchard, Mark G, Ramakrishnan, Nagarajan, Ramos, Grazielle Viana, Roger, Claire, Sandulescu, Oana, Semple, Malcolm G, Sharma, Pratima, Sigfrid, Louise, Somers, Emily C, Streinu-Cercel, Anca, Taccone, Fabio, Vecham, Pavan Kumar, Kumar Tirupakuzhi Vijayaraghavan, Bharath, Wei, Jia, Wils, Evert-Jan, Ci Wong, Xin, Horby, Peter, Rojek, Amanda, Olliaro, Piero L, ISARIC Clinical Characterisation Group: Ali Abbas, Sheryl Ann Abdukahil, Nurul Najmee Abdulkadir, Ryuzo Abe, Laurent Abel, Lara Absil, Subhash Acharya, Andrew Acker, Elisabeth Adam, Diana Adrião, Saleh Al Ageel, Shakeel Ahmed, Kate Ainscough, Eka Airlangga, Tharwat Aisa, Ali Ait Hssain, Younes Ait Tamlihat, Takako Akimoto, Ernita Akmal, Eman Al Qasim, Razi Alalqam, Angela Alberti, Tala Al-Dabbous, Senthilkumar Alegesan, Cynthia Alegre, Marta Alessi, Beatrice Alex, Kévin Alexandre, Abdulrahman Al-Fares, Huda Alfoudri, Imran Ali, Adam Ali, Naseem Ali Shah, Kazali Enagnon Alidjnou, Jeffrey Aliudin, Qabas Alkhafajee, Clotilde Allavena, Nathalie Allou, Aneela Altaf, João Alves, Rita Alves, João Melo Alves, Maria Amaral, Nur Amira, Phoebe Ampaw, Roberto Andini, Claire Andréjak, Andrea Angheben, François Angoulvant, Séverine Ansart, Sivanesen Anthonidass, Massimo Antonelli, Carlos Alexandre Antunes de Brito, Ardiyan Apriyana, Yaseen Arabi, Irene Aragao, Francisco Arancibia, Carolline Araujo, Antonio Arcadipane, Patrick Archambault, Lukas Arenz, Jean-Benoît Arlet, Christel Arnold-Day, Lovkesh Arora, Rakesh Arora, Elise Artaud-Macari, Diptesh Aryal, Angel Asensio, Muhammad Ashraf, Namra Asif, Mohammad Asim, Jean Baptiste Assie, Amirul Asyraf, Anika Atique, A M Udara Lakshan Attanyake, Johann Auchabie, Hugues Aumaitre, Adrien Auvet, Laurène Azemar, Cecile Azoulay, Benjamin Bach, Delphine Bachelet, Claudine Badr, Nadia Baig, J Kevin Baird, Erica Bak, Agamemnon Bakakos, Nazreen Abu Bakar, Andriy Bal, Mohanaprasanth Balakrishnan, Valeria Balan, Firouzé Bani-Sadr, Renata Barbalho, Nicholas Yuri Barbosa, Wendy S Barclay, Saef Umar Barnett, Michaela Barnikel, Helena Barrasa, Audrey Barrelet, Cleide Barrigoto, Marie Bartoli, Mustehan Bashir, Romain Basmaci, Muhammad Fadhli Hassin Basri, Denise Battaglini, Jules Bauer, Diego Fernando Bautista Rincon, Denisse Bazan Dow, Alexandra Bedossa, Ker Hong Bee, Husna Begum, Sylvie Behilill, Albertus Beishuizen, Aleksandr Beljantsev, David Bellemare, Anna Beltrame, Beatriz Amorim Beltrão, Marine Beluze, Nicolas Benech, Lionel Eric Benjiman, Dehbia Benkerrou, Suzanne Bennett, Luís Bento, Jan-Erik Berdal, Delphine Bergeaud, Hazel Bergin, José Luis Bernal Sobrino, Giulia Bertoli, Lorenzo Bertolino, Simon Bessis, Sybille Bevilcaqua, Karine Bezulier, Amar Bhatt, Krishna Bhavsar, Claudia Bianco, Farah Nadiah Bidin, Moirangthem Bikram Singh, Felwa Bin Humaid, Mohd Nazlin Bin Kamarudin, François Bissuel, Patrick Biston, Laurent Bitker, Jonathan Bitton, Pablo Blanco-Schweizer, Catherine Blier, Frank Bloos, Mathieu Blot, Filomena Boccia, Laetitia Bodenes, Alice Bogaarts, Debby Bogaert, Anne-Hélène Boivin, Pierre-Adrien Bolze, François Bompart, Aurelius Bonfasius, Diogo Borges, Raphaël Borie, Hans Martin Bosse, Elisabeth Botelho-Nevers, Lila Bouadma, Olivier Bouchaud, Sabelline Bouchez, Dounia Bouhmani, Damien Bouhour, Kévin Bouiller, Laurence Bouillet, Camile Bouisse, Anne-Sophie Boureau, John Bourke, Maude Bouscambert, Aurore Bousquet, Jason Bouziotis, Bianca Boxma, Marielle Boyer-Besseyre, Maria Boylan, Axelle Braconnier, Cynthia Braga, Timo Brandenburger, Filipa Brás Monteiro, Luca Brazzi, Patrick Breen, Dorothy Breen, Patrick Breen, Kathy Brickell, Shaunagh Browne, Alex Browne, Nicolas Brozzi, Marjolein Brusse-Keizer, Nina Buchtele, Christian Buesaquillo, Polina Bugaeva, Marielle Buisson, Danilo Buonsenso, Erlina Burhan, Ingrid G Bustos, Denis Butnaru, André Cabie, Susana Cabral, Eder Caceres, Cyril Cadoz, Mia Callahan, Kate Calligy, Jose Andres Calvache, João Camões, Valentine Campana, Paul Campbell, Josie Campisi, Cecilia Canepa, Mireia Cantero, Pauline Caraux-Paz, Sheila Cárcel, Chiara Simona Cardellino, Sofia Cardoso, Filipe Cardoso, Filipa Cardoso, Nelson Cardoso, Simone Carelli, Nicolas Carlier, Thierry Carmoi, Gayle Carney, Inês Carqueja, Marie-Christine Carret, François Martin Carrier, Ida Carroll, Maire-Laure Casanova, Mariana Cascão, Siobhan Casey, José Casimiro, Bailey Cassandra, Silvia Castañeda, Nidyanara Castanheira, Guylaine Castor-Alexandre, Henry Castrillón, Ivo Castro, Ana Catarino, François-Xavier Catherine, Paolo Cattaneo, Roberta Cavalin, Giulio Giovanni Cavalli, Alexandros Cavayas, Adrian Ceccato, Minerva Cervantes-Gonzalez, Anissa Chair, Catherine Chakveatze, Adrienne Chan, Meera Chand, Christelle Chantalat Auger, Jean-Marc Chapplain, Julie Chas, Allegra Chatterjee, Mobin Chaudry, Jonathan Samuel Chávez Iñiguez, Anjellica Chen, Yih-Sharng Chen, Matthew Pellan Cheng, Antoine Cheret, Thibault Chiarabini, Julian Chica, Suresh Kumar Chidambaram, Leong Chin Tho, Catherine Chirouze, Davide Chiumello, Sung-Min Cho, Bernard Cholley, Marie-Charlotte Chopin, Ting Soo Chow, Yock Ping Chow, Hiu Jian Chua, Jonathan Chua, Jose Pedro Cidade, José Miguel Cisneros Herreros, Anna Ciullo, Jennifer Clarke, Emma Clarke, Rolando Claure-Del Granado, Sara Clohisey, Perren J Cobb, Cassidy Codan, Caitriona Cody, Alexandra Coelho, Megan Coles, Gwenhaël Colin, Michael Collins, Sebastiano Maria Colombo, Pamela Combs, Marie Connor, Anne Conrad, Sofía Contreras, Elaine Conway, Graham S Cooke, Mary Copland, Hugues Cordel, Amanda Corley, Sabine Cornelis, Alexander Daniel Cornet, Arianne Joy Corpuz, Andrea Cortegiani, Grégory Corvaisier, Emma Costigan, Camille Couffignal, Sandrine Couffin-Cadiergues, Roxane Courtois, Stéphanie Cousse, Rachel Cregan, Charles Crepy D'Orleans, Cosimo Cristella, Sabine Croonen, Gloria Crowl, Jonathan Crump, Claudina Cruz, Juan Luis Cruz Berm, Jaime 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Tanaka, Hiroyuki Tanaka, Hayato Taniguchi, Huda Taqdees, Arshad Taqi, Coralie Tardivon, Pierre Tattevin, M Azhari Taufik, Hassan Tawfik, Richard S Tedder, Tze Yuan Tee, João Teixeira, Sofia Tejada, Marie-Capucine Tellier, Sze Kye Teoh, Vanessa Teotonio, François Téoulé, Pleun Terpstra, Olivier Terrier, Nicolas Terzi, Hubert Tessier-Grenier, Adrian Tey, Alif Adlan Mohd Thabit, Anand Thakur, Zhang Duan Tham, Suvintheran Thangavelu, Vincent Thibault, Simon-Djamel Thiberville, Benoît Thill, Jananee Thirumanickam, Shaun Thompson, Emma C Thomson, David Thomson, Surain Raaj Thanga Thurai, Ryan S Thwaites, Paul Tierney, Vadim Tieroshyn, Peter S Timashev, Jean-François Timsit, Noémie Tissot, Jordan Zhien Yang Toh, Maria Toki, Kristian Tonby, Sia Loong Tonnii, Margarida Torres, Antoni Torres, Rosario Maria Torres Santos-Olmo, Hernando Torres-Zevallos, Michael Towers, Tony Trapani, Théo Treoux, Cécile Tromeur, Ioannis Trontzas, Tiffany Trouillon, Jeanne Truong, Christelle Tual, Sarah Tubiana, Helen Tuite, Jean-Marie Turmel, Lance C W Turtle, Anders Tveita, Pawel Twardowski, Makoto Uchiyama, P G Ishara Udayanga, Andrew Udy, Roman Ullrich, Alberto Uribe, Asad Usman, Timothy M Uyeki, Cristinava Vajdovics, Piero Valentini, Luís Val-Flores, Amélie Valran, Stijn Van de Velde, Marcel van den Berge, Machteld Van der Feltz, Job van der Palen, Paul van der Valk, Nicky Van Der Vekens, Peter Van der Voort, Sylvie Van Der Werf, Laura van Gulik, Jarne Van Hattem, Carolien van Netten, Frank van Someren Greve, Ilonka van Veen, Hugo Van Willigen, Noémie Vanel, Henk Vanoverschelde, Pooja Varghese, Michael Varrone, Shoban Raj Vasudayan, Charline Vauchy, Shaminee Veeran, Aurélie Veislinger, Sebastian Vencken, Sara Ventura, Annelies Verbon, James Vickers, José Ernesto Vidal, César Vieira, Deepak Vijayan, Joy Ann Villanueva, Judit Villar, Pierre-Marc Villeneuve, Andrea Villoldo, Gayatri Vishwanathan, Benoit Visseaux, Hannah Visser, Chiara Vitiello, Harald Vonkeman, Fanny Vuotto, Suhaila Abdul Wahab, Noor Hidayu Wahab, Nadirah Abdul Wahid, Marina Wainstein, Wan Fadzlina Wan Muhd Shukeri, Chih-Hsien Wang, Steve Webb, Katharina Weil, Tan Pei Wen, Sanne Wesselius, T Eoin West, Murray Wham, Bryan Whelan, Nicole White, Paul Henri Wicky, Aurélie Wiedemann, Surya Otto Wijaya, Keith Wille, Suzette Willems, Virginie Williams, Calvin Wong, Yew Sing Wong, Teck Fung Wong, Natalie Wright, Gan Ee Xian, Lim Saio Xian, Kuan Pei Xuan, Ioannis Xynogalas, Siti Rohani Binti Mohd Yakop, Masaki Yamazaki, Yazdan Yazdanpanah, Nicholas Yee Liang Hing, Cécile Yelnik, Chian Hui Yeoh, Stephanie Yerkovich, Toshiki Yokoyama, Hodane Yonis, Obada Yousif, Saptadi Yuliarto, Akram Zaaqoq, Marion Zabbe, Kai Zacharowski, Masliza Zahid, Maram Zahran, Nor Zaila Binti Zaidan, Maria Zambon, Miguel Zambrano, Alberto Zanella, Konrad Zawadka, Nurul Zaynah, Hiba Zayyad, Alexander Zoufaly, David Zucman, University of Oxford, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), This work was made possible by the UK Foreign, Commonwealth and Development Office, Wellcome (215091/Z/18/Z, 205228/Z/16/Z, 220757/Z/20/Z), Bill & Melinda Gates Foundation (OPP1209135), UK Medical Research Council Clinical Research Training Fellowship (MR/V001671/1), the philanthropic support of the donors to the University of Oxford’s COVID-19 Research Response Fund, CIHR Coronavirus Rapid Research Funding Opportunity (OV2170359) and the co-ordination in Canada by Sunnybrook Research Institute, endorsement of the Irish Critical Care—Clinical Trials Group, co-ordination in Ireland by the Irish Critical Care—Clinical Trials Network at University College Dublin and funding by the Health Research Board of Ireland (CTN-2014–12), the Rapid European COVID-19 Emergency Response research (RECOVER) (H2020 project 101003589) and European Clinical Research Alliance on Infectious Diseases (ECRAID) (965313), the COVID clinical management team, AIIMS, Rishikesh, India, the COVID-19 Clinical Management team, Manipal Hospital Whitefield, Bengaluru, India, Cambridge NIHR Biomedical Research Centre, the dedication and hard work of the Groote Schuur Hospital Covid ICU Team, support by the Groote Schuur nursing and University of Cape Town registrar bodies co-ordinated by the Division of Critical Care at the University of Cape Town, the Liverpool School of Tropical Medicine and the University of Oxford, the dedication and hard work of the Norwegian SARS-CoV-2 study team, the Research Council of Norway (grant no. 312780) and a philanthropic donation from Vivaldi Invest A/S owned by Jon Stephenson von Tetzchner, Imperial NIHR Biomedical Research Centre, the Comprehensive Local Research Networks of which PJMO is an NIHR Senior Investigator (NIHR201385), Innovative Medicines Initiative Joint Undertaking under Grant Agreement No. 115523 COMBACTE, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007– 2013) and EFPIA companies, in-kind contribution, the French COVID cohort (NCT04262921) is sponsored by INSERM and is funded by the REACTing (REsearch & ACtion emergING infectious diseases) consortium and by a grant of the French Ministry of Health (PHRC n 20–0424), Stiftungsfonds zur Förderung der Bekämpfung der Tuberkulose und anderer Lungenkrankheiten of the City of Vienna (project no. APCOV22BGM), Italian Ministry of Health ‘Fondi Ricerca corrente–L1P6’ to IRCCS Ospedale Sacro Cuore–Don Calabria, Australian Department of Health grant (3273191), Gender Equity Strategic Fund at University of Queensland, Artificial Intelligence for Pandemics (A14PAN) at University of Queensland, the Australian Research Council Centre of Excellence for Engineered Quantum Systems (EQUS, CE170100009), the Prince Charles Hospital Foundation, Australia, grants from Instituto de Salud Carlos III, Ministerio de Ciencia, Spain, Brazil, National Council for Scientific and Technological Development (scholarship no. 303953/2018–7), the Firland Foundation, Shoreline, Washington, USA, a grant from foundation Bevordering Onderzoek Franciscus, the South Eastern Norway Health Authority and the Research Council of Norway, and preparedness work conducted by the Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection. Data and Material provision was supported by grants from the National Institute for Health Research (NIHR, award CO-CIN-01), the Medical Research Council (MRC, and grant MC_PC_19059) and by the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with PHE (award no. 200907), NIHR HPRU in Respiratory Infections at Imperial College London with PHE (award no. 200927), Liverpool Experimental Cancer Medicine Centre (grant no. C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (award no. IS-BRC-1215–20013) and NIHR Clinical Research Network providing infrastructure support.
Subjects: Male, Epidemiology, MESH: Hospitalization, MESH: Proportional Hazards Models, MESH: Risk Factors, Risk Factors, MESH: Child, cohort study, MESH: COVID-19, Humans, MESH: SARS-CoV-2, Child, Proportional Hazards Models, MESH: Humans, MESH: Middle Aged, SARS-CoV-2, COVID-19, risk of death, General Medicine, Middle Aged, co-morbidities, symptoms, treatments, MESH: Male, Hospitalization, Intensive Care Units, MESH: Intensive Care Units, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, COVID-19/therapy
Abstract: Background We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.
Published: 2023

20. Antimicrobial Stewardship Programs in PICU Settings: A Systematic Review

Author: Elisavet Chorafa, Vasiliki Komatsiouli, Elias Iosifidis, Maria Kourti, Maria Sdougka, and Emmanuel Roilides
Subjects: Pediatrics, Perinatology and Child Health, Critical Care and Intensive Care Medicine
Abstract: Development of antimicrobial stewardship programs (ASPs) is strategy for prevention and management of emergence of antimicrobial-resistant organisms. In this study, we systematically reviewed the literature on antimicrobial stewardship interventions in PICUs and analyzed approaches, structure, implementation, and outcomes of the ASPs.PubMed and Scopus databases were systematically searched for studies published from January 1, 2007, to December 31, 2020, reporting interventions on judicious use of antimicrobials in PICUs (last search performed February 28, 2021).Studies that evaluated an intervention in a PICU setting or both in PICU and other settings and reported separate results for PICU were eligible for full-text review. Studies that had implemented stewardship in the entire hospital, including the PICU, but without presenting dedicated PICU data were excluded from the analysis.The strategy of intervention, structure of ASP team, implementation, and outcomes were assessed with a checklist tool for all studies included in the analysis. Risk of bias was assessed with the Cochrane Risk-of-Bias in Nonrandomized studies of Interventions tool.Thirteen articles were found: 11 that applied ASP in PICUs, and two at hospital level. All PICU-dedicated ASPs applied a multimodal intervention combining strategies simultaneously; audit with feedback (6/11) and facility-specific clinical practice guidelines (7/11) were the most common strategies. A multidisciplinary team was formulated in all ASPs except for three biomarker-based interventions. Six of 11 studies included techniques to enhance behavior change and one implemented a behavior-based intervention. Antibiotic consumption was evaluated in all ASPs, cost in three of 11, antibiotic resistance in one of 11, length of hospitalization in six of 11, and mortality in eight of 11. All hospital-wide ASPs used audit with feedback in addition to facility-specific clinical practice guidelines and assessed antimicrobial consumption, expenditures, length of stay, and mortality.The prevalence of ASPs in PICUs is limited, and few programs follow all of the currently available recommendations.
Published: 2022

21. Antifungal Stewardship Programs in Children: Challenges and Opportunities

Author: Maria Kourti, Elisavet Chorafa, Emmanuel Roilides, and Elias Iosifidis
Subjects: Microbiology (medical), Infectious Diseases, Pediatrics, Perinatology and Child Health
Published: 2023

22. Epidemiology and outcomes of ventilator-associated events in critically ill children: Evaluation of three different definitions

Author: Dimitra Papakyritsi, Elias Iosifidis, Serafia Kalamitsou, Elisavet Chorafa, Eleni Volakli, Yolanda Peña-López, Maria Sdougka, and Emmanuel Roilides
Subjects: Microbiology (medical), Infectious Diseases, Epidemiology
Abstract: Objective:Ventilator-associated pneumonia (VAP) is one of the most common healthcare-associated infections in pediatric intensive care units (PICUs), but its definite diagnosis remains controversial. The CDC Ventilator-Associated Event (VAE) module (validated in adults) constitutes a new approach for VAP surveillance.Design:We described epidemiological characteristics of PICU VAE cases, investigated possible risk factors, and evaluated 3 different sets of diagnostic VAE criteria.Setting:This study was conducted in a PICU in a tertiary-care general hospital in northern Greece during 2017–2019.Patients:The study included patients aged 35 days–16 years who received mechanical ventilation.Methods:From medical records, we retrieved epidemiological data, clinical data, and laboratory characteristics as well as ventilator settings for our analysis. We assessed “oxygen deterioration” for the tier 1 CDC VAE module using 3 sets of diagnostic criteria: (1) CDC adult VAE criteria [increase of daily minimum fraction of inspired oxygen (FiO2) ≥ 0.2 or positive end expiratory pressure (PEEP) ≥ 3 cmH2O for 2 days], (2) the US pediatric VAE criteria [increase of FiO2 ≥ 0.25 or mean airway pressure (MAP) ≥ 4 cmH2O for 2 days], and (3) the European pediatric VAE criteria (increase of FiO2 ≥ 0.2 or PEEP ≥ 2 cmH2O for 1 day or increase of FiO2 ≥ 0.15 and PEEP ≥ 1 cm H2O for 1 day).Results:Among 326 children admitted to the PICU, 301 received mechanical ventilation. The incidence rate according to the CDC adult VAE criteria was 4.7 per 1,000 ventilator days. For the US pediatric VAE criteria the incidence rate was 6 per 1,000 ventilator days. For the European pediatric VAE criteria the incidence rate was 9.7 per 1,000 ventilator days. These results revealed statistically significant correlation of all 3 algorithms with adverse outcomes, including mortality.Conclusions:All VAE algorithms were associated with higher mortality rates. Our findings highlight the need for a unified pediatric VAE definition to improve preventive strategies.
Published: 2022

23. Early initiation of the respiratory syncytial virus season in 2021–2022, Greece

Author: Styliani Pappa, Katerina Haidopoulou, Charalampos Zarras, Eleni Theodorakou, Eleni Papadimitriou, Elias Iosifidis, Ioanna Gkeka, Konstantina Stoikou, Eleni Vagdatli, Lemonia Skoura, and Anna Papa
Subjects: Genotype, Greece, COVID-19, Infant, Respiratory Syncytial Virus Infections, Infectious Diseases, Child, Preschool, Respiratory Syncytial Virus, Human, Virology, Humans, Seasons, Child, Pandemics, Phylogeny
Abstract: Respiratory syncytial virus (RSV) is the most common viral pathogen causing respiratory disease in the pediatric population. An unexpected sudden upsurge of RSV infections among children was observed in September 2021 in Greece. Forty-one rhinopharyngeal samples from children under the age of 2 years with confirmed RSV bronchiolitis were tested to identify the genotype(s) of the RSV strain(s). The children were hospitalized during September-November 2021 in three tertiary hospitals in northern Greece. A one-step RT-PCR which amplifies a fragment of the second hypervariable region of the G protein gene was applied. PCR products were sequenced, and phylogenetic analysis was performed. Most (80.5%) RSV cases were typed as RSV-A, with RSV-B accounting for 19.5% of cases. RSV-A and RSV-B sequences clustered within the ON1 and BA genotypes, respectively. As the same genotypes were detected in cases observed during 2016-2018 in northern Greece, it was suggested that the early upsurge of infections was not related to the emergence of novel strain(s), but it was the result of the absence of immunity among children and their mothers due to the restriction measures taken during the COVID-19 pandemic in the previous RSV season. Awareness is needed to diagnose even the out-of-season RSV infections, while molecular epidemiology plays a key role in monitoring the efficacy of currently available therapeutics and for those under development.
Published: 2022

24. 1824. Combination therapy of daptomycin/colistin for extreme drug resistant Acinetobacter baumannii bacteremia

Author: Charis Lampada, Maria Kourti, Konstantina Charisi, Elias Iosifidis, Charalambos Zarras, Emmanuel Roilides, and Charalambos Antachopoulos
Subjects: Infectious Diseases, Oncology
Abstract: Background There are experimental data demonstrating synergistic in-vitro activity of colistin and daptomycin against extremely drug-resistant (XDR) strains of Acinetobacter baumannii.Aim of this study is the description of a case-series of patients with confirmed XDR A. baumannii bloodstream infection (BSI) receiving an antimicrobial regimen including colistin and daptomycin. Methods Prospective study of patients with BSI caused by XDR A. baumannii from May 2021 to February 2022 in a tertiary level hospital. Demographic, clinical and laboratory data were recorded and evaluated from all patients. BacT Alert system (BiomerieuxR) was used for blood cultures and bacterial identification and susceptibility testing was performed using VITEK® 2. Colistin susceptibility testing (dilution method) were interpreted in accordance to Clinical and Laboratory Standards Institute (CLSI) criteria. Results A total of 16 episodes of XDR A. baumannii were recorded in 16 patients (14 males). Median age was 60 (range 38-85) years. Ten patients (56.2%) were hospitalized in medical wards, and 43.8% in surgery wards. One-third of patients had previously been admitted to the Intensive Care Unit, while all patients had an indwelling central vascular catheter. Fourteen of the 16 XDR strains of A. baumannii were also resistant to colistin. Also, 2 of the 16 strains had a MIC of 2μg/ml for tigecycline, while in the remaining 14 the MIC was > 2μg/ml. All isolates had meropenem MIC >16μg/ml. All patients received a combination of colistin -daptomycin -meropenem -tigecycline. Clinical and laboratory improvement was noted in 15 of the 16 patients within the 14 days of treatment. Fifteen out of the 16 patients showed a microbiological response: the mean duration between the start of treatment and the first negative blood culture was 12 days.Finally, no patient experienced a marked increase in CPK due to daptomycin use. Conclusion The outcome of this case series of patients receiving colistin-daptomycin combination as part of a broader synergistic antimicrobial regimen to treat XDR A. baumannii was satisfactory, with no significant adverse reactions. This potential clinical benefit of the colistin/daptomycin combination should be further evaluated in a larger comparative study. Disclosures All Authors: No reported disclosures.
Published: 2022

25. Author response for 'Symptom‐based case definitions for COVID‐19: Time and geographical variations for detection at hospital admission among 260,000 patients'

Author: null Joaquin Baruch, null Amanda Rojek, null Christiana Kartsonaki, null Bharath K. T. Vijayaraghavan, null Bronner P. Gonçalves, null Mark G. Pritchard, null Laura Merson, null Jake Dunning, null Matthew Hall, null Louise Sigfrid, null Barbara W. Citarella, null Srinivas Murthy, null Trokon O. Yeabah, null Piero Olliaro, null Ali Abbas, null Sheryl Ann Abdukahil, null Nurul Najmee Abdulkadir, null Ryuzo Abe, null Laurent Abel, null Lara Absil, null Subhash Acharya, null Andrew Acker, null Elisabeth Adam, null Diana Adrião, null Saleh Al Ageel, null Shakeel Ahmed, null Kate Ainscough, null Eka Airlangga, null Tharwat Aisa, null Ali Ait Hssain, null Younes Ait Tamlihat, null Takako Akimoto, null Ernita Akmal, null Eman Al Qasim, null Razi Alalqam, null Angela Alberti, null Tala Al‐dabbous, null Senthilkumar Alegesan, null Cynthia Alegre, null Marta Alessi, null Beatrice Alex, null Kévin Alexandre, null Abdulrahman Al‐Fares, null Huda Alfoudri, null Imran Ali, null Adam Ali, null Naseem Ali Shah, null Kazali Enagnon Alidjnou, null Jeffrey Aliudin, null Qabas Alkhafajee, null Clotilde Allavena, null Nathalie Allou, null Aneela Altaf, null João Alves, null Rita Alves, null João Melo Alves, null Maria Amaral, null Nur Amira, null Phoebe Ampaw, null Roberto Andini, null Claire Andréjak, null Andrea Angheben, null François Angoulvant, null Séverine Ansart, null Sivanesen Anthonidass, null Massimo Antonelli, null Carlos Alexandre Antunes de Brito, null Ardiyan Apriyana, null Yaseen Arabi, null Irene Aragao, null Carolline Araujo, null Antonio Arcadipane, null Patrick Archambault, null Lukas Arenz, null Jean‐Benoît Arlet, null Lovkesh Arora, null Rakesh Arora, null Elise Artaud‐Macari, null Diptesh Aryal, null Angel Asensio, null Muhammad Ashraf, null Namra Asif, null Mohammad Asim, null Jean Baptiste Assie, null Amirul Asyraf, null Anika Atique, null A. M. Udara Lakshan Attanyake, null Johann Auchabie, null Hugues Aumaitre, null Adrien Auvet, null Eyvind W. Axelsen, null Laurène Azemar, null Cecile Azoulay, null Benjamin Bach, null Delphine Bachelet, null Claudine Badr, null Roar Bævre‐Jensen, null Nadia Baig, null J. Kenneth Baillie, null J. Kevin Baird, null Erica Bak, null Agamemnon Bakakos, null Nazreen Abu Bakar, null Andriy Bal, null Mohanaprasanth Balakrishnan, null Valeria Balan, null Firouzé Bani‐Sadr, null Renata Barbalho, null Nicholas Yuri Barbosa, null Wendy S. Barclay, null Saef Umar Barnett, null Michaela Barnikel, null Helena Barrasa, null Audrey Barrelet, null Cleide Barrigoto, null Marie Bartoli, null Joaquín Baruch, null Mustehan Bashir, null Romain Basmaci, null Muhammad Fadhli Hassin Basri, null Denise Battaglini, null Jules Bauer, null Diego Fernando Bautista Rincon, null Denisse Bazan Dow, null Abigail Beane, null Alexandra Bedossa, null Ker Hong Bee, null Husna Begum, null Sylvie Behilill, null Albertus Beishuizen, null Aleksandr Beljantsev, null David Bellemare, null Anna Beltrame, null Beatriz Amorim Beltrão, null Marine Beluze, null Nicolas Benech, null Lionel Eric Benjiman, null Dehbia Benkerrou, null Suzanne Bennett, null Luís Bento, null Jan‐Erik Berdal, null Delphine Bergeaud, null Hazel Bergin, null José Luis Bernal Sobrino, null Giulia Bertoli, null Lorenzo Bertolino, null Simon Bessis, null Sybille Bevilcaqua, null Karine Bezulier, null Amar Bhatt, null Krishna Bhavsar, null Claudia Bianco, null Farah Nadiah Bidin, null Moirangthem Bikram Singh, null Felwa Bin Humaid, null Mohd Nazlin Bin Kamarudin, null François Bissuel, null Laurent Bitker, null Jonathan Bitton, null Pablo Blanco‐Schweizer, null Catherine Blier, null Frank Bloos, null Mathieu Blot, null Filomena Boccia, null Laetitia Bodenes, null Alice Bogaarts, null Debby Bogaert, null Anne‐Hélène Boivin, null Pierre‐Adrien Bolze, null François Bompart, null Aurelius Bonfasius, null Diogo Borges, null Raphaël Borie, null Hans Martin Bosse, null Elisabeth Botelho‐Nevers, null Lila Bouadma, null Olivier Bouchaud, null Sabelline Bouchez, null Dounia Bouhmani, null Damien Bouhour, null Kévin Bouiller, null Laurence Bouillet, null Camile Bouisse, null Anne‐Sophie Boureau, null John Bourke, null Maude Bouscambert, null Aurore Bousquet, null Jason Bouziotis, null Bianca Boxma, null Marielle Boyer‐Besseyre, null Maria Boylan, null Fernando Augusto Bozza, null Axelle Braconnier, null Cynthia Braga, null Timo Brandenburger, null Filipa Brás Monteiro, null Luca Brazzi, null Patrick Breen, null Dorothy Breen, null Kathy Brickell, null Shaunagh Browne, null Alex Browne, null Nicolas Brozzi, null Sonja Hjellegjerde Brunvoll, null Marjolein Brusse‐Keizer, null Nina Buchtele, null Christian Buesaquillo, null Polina Bugaeva, null Marielle Buisson, null Danilo Buonsenso, null Erlina Burhan, null Aidan Burrell, null Ingrid G. Bustos, null Denis Butnaru, null André Cabie, null Susana Cabral, null Eder Caceres, null Cyril Cadoz, null Kate Calligy, null Jose Andres Calvache, null João Camões, null Valentine Campana, null Paul Campbell, null Josie Campisi, null Cecilia Canepa, null Mireia Cantero, null Pauline Caraux‐Paz, null Sheila Cárcel, null Chiara Simona Cardellino, null Sofia Cardoso, null Filipe Cardoso, null Filipa Cardoso, null Nelson Cardoso, null Simone Carelli, null Nicolas Carlier, null Thierry Carmoi, null Gayle Carney, null Inês Carqueja, null Marie‐Christine Carret, null François Martin Carrier, null Ida Carroll, null Gail Carson, null Maire‐Laure Casanova, null Mariana Cascão, null Siobhan Casey, null José Casimiro, null Bailey Cassandra, null Silvia Castañeda, null Nidyanara Castanheira, null Guylaine Castor‐Alexandre, null Henry Castrillón, null Ivo Castro, null Ana Catarino, null François‐Xavier Catherine, null Paolo Cattaneo, null Roberta Cavalin, null Giulio Giovanni Cavalli, null Alexandros Cavayas, null Adrian Ceccato, null Minerva Cervantes‐Gonzalez, null Anissa Chair, null Catherine Chakveatze, null Adrienne Chan, null Meera Chand, null Christelle Chantalat Auger, null Jean‐Marc Chapplain, null Julie Chas, null Allegra Chatterjee, null Mobin Chaudry, null Jonathan Samuel Chávez Iñiguez, null Anjellica Chen, null Yih‐Sharng Chen, null Matthew Pellan Cheng, null Antoine Cheret, null Thibault Chiarabini, null Julian Chica, null Suresh Kumar Chidambaram, null Leong Chin Tho, null Catherine Chirouze, null Davide Chiumello, null Sung‐Min Cho, null Bernard Cholley, null Marie‐Charlotte Chopin, null Ting Soo Chow, null Yock Ping Chow, null Jonathan Chua, null Hiu Jian Chua, null Jose Pedro Cidade, null José Miguel Cisneros Herreros, null Barbara Wanjiru Citarella, null Anna Ciullo, null Jennifer Clarke, null Emma Clarke, null Rolando Claure‐Del Granado, null Sara Clohisey, null Perren J. Cobb, null Cassidy Codan, null Caitriona Cody, null Alexandra Coelho, null Megan Coles, null Gwenhaël Colin, null Michael Collins, null Sebastiano Maria Colombo, null Pamela Combs, null Marie Connor, null Anne Conrad, null Sofía Contreras, null Elaine Conway, null Graham S. Cooke, null Mary Copland, null Hugues Cordel, null Amanda Corley, null Sabine Cornelis, null Alexander Daniel Cornet, null Arianne Joy Corpuz, null Andrea Cortegiani, null Grégory Corvaisier, null Emma Costigan, null Camille Couffignal, null Sandrine Couffin‐Cadiergues, null Roxane Courtois, null Stéphanie Cousse, null Rachel Cregan, null Sabine Croonen, null Gloria Crowl, null Jonathan Crump, null Claudina Cruz, null Juan Luis Cruz Bermúdez, null Jaime Cruz Rojo, null Marc Csete, null Ailbhe Cullen, null Matthew Cummings, null Gerard Curley, null Elodie Curlier, null Colleen Curran, null Paula Custodio, null Ana da Silva Filipe, null Charlene Da Silveira, null Al‐Awwab Dabaliz, null Andrew Dagens, null John Arne Dahl, null Darren Dahly, null Heidi Dalton, null Jo Dalton, null Seamus Daly, null Nick Daneman, null Corinne Daniel, null Emmanuelle A. Dankwa, null Jorge Dantas, null Frédérick D'Aragon, null Gillian de Loughry, null Diego de Mendoza, null Etienne De Montmollin, null Rafael Freitas de Oliveira França, null Ana Isabel de Pinho Oliveira, null Rosanna De Rosa, null Cristina De Rose, null Thushan de Silva, null Peter de Vries, null Jillian Deacon, null David Dean, null Alexa Debard, null Marie‐Pierre Debray, null Nathalie DeCastro, null William Dechert, null Lauren Deconninck, null Romain Decours, null Eve Defous, null Isabelle Delacroix, null Eric Delaveuve, null Karen Delavigne, null Nathalie M. Delfos, null Ionna Deligiannis, null Andrea Dell'Amore, null Christelle Delmas, null Pierre Delobel, null Corine Delsing, null Elisa Demonchy, null Emmanuelle Denis, null Dominique Deplanque, null Pieter Depuydt, null Mehul Desai, null Diane Descamps, null Mathilde Desvallées, null Santi Dewayanti, null Pathik Dhanger, null Alpha Diallo, null Sylvain Diamantis, null André Dias, null Juan Jose Diaz, null Priscila Diaz, null Rodrigo Diaz, null Kévin Didier, null Jean‐Luc Diehl, null Wim Dieperink, null Jérôme Dimet, null Vincent Dinot, null Fara Diop, null Alphonsine Diouf, null Yael Dishon, null Félix Djossou, null Annemarie B. Docherty, null Helen Doherty, null Arjen M. Dondorp, null Maria Donnelly, null Christl A. Donnelly, null Sean Donohue, null Yoann Donohue, null Chloe Donohue, null Peter Doran, null Céline Dorival, null Eric D'Ortenzio, null James Joshua Douglas, null Renee Douma, null Nathalie Dournon, null Triona Downer, null Joanne Downey, null Mark Downing, null Tom Drake, null Aoife Driscoll, null Murray Dryden, null Claudio Duarte Fonseca, null Vincent Dubee, null François Dubos, null Alexandre Ducancelle, null Toni Duculan, null Susanne Dudman, null Abhijit Duggal, null Paul Dunand, null Mathilde Duplaix, null Emanuele Durante‐Mangoni, null Lucian Durham, null Bertrand Dussol, null Juliette Duthoit, null Xavier Duval, null Anne Margarita Dyrhol‐Riise, null Sim Choon Ean, null Marco Echeverria‐Villalobos, null Siobhan Egan, null Linn Margrete Eggesbø, null Carla Eira, null Mohammed El Sanharawi, null Subbarao Elapavaluru, null Brigitte Elharrar, null Jacobien Ellerbroek, null Merete Ellingjord‐Dale, null Philippine Eloy, null Tarek Elshazly, null Iqbal Elyazar, null Isabelle Enderle, null Tomoyuki Endo, null Chan Chee Eng, null Ilka Engelmann, null Vincent Enouf, null Olivier Epaulard, null Martina Escher, null Mariano Esperatti, null Hélène Esperou, null Marina Esposito‐Farese, null João Estevão, null Manuel Etienne, null Nadia Ettalhaoui, null Anna Greti Everding, null Mirjam Evers, null Marc Fabre, null Isabelle Fabre, null Amna Faheem, null Arabella Fahy, null Cameron J. Fairfield, null Zul Fakar, null Komal Fareed, null Pedro Faria, null Ahmed Farooq, null Hanan Fateena, null Arie Zainul Fatoni, null Karine Faure, null Raphaël Favory, null Mohamed Fayed, null Niamh Feely, null Laura Feeney, null Jorge Fernandes, null Marília Andreia Fernandes, null Susana Fernandes, null François‐Xavier Ferrand, null Eglantine Ferrand Devouge, null Joana Ferrão, null Mário Ferraz, null Sílvia Ferreira, null Isabel Ferreira, null Benigno Ferreira, null Ricard Ferrer‐Roca, null Nicolas Ferriere, null Céline Ficko, null Claudia Figueiredo‐Mello, null William Finlayson, null Juan Fiorda, null Thomas Flament, null Clara Flateau, null Tom Fletcher, null Letizia Lucia Florio, null Deirdre Flynn, null Claire Foley, null Jean Foley, null Victor Fomin, null Tatiana Fonseca, null Patricia Fontela, null Simon Forsyth, null Denise Foster, null Giuseppe Foti, null Erwan Fourn, null Robert A. Fowler, null Marianne Fraher, null Diego Franch‐Llasat, null John F. Fraser, null Christophe Fraser, null Marcela Vieira Freire, null Ana Freitas Ribeiro, null Caren Friedrich, null Stéphanie Fry, null Nora Fuentes, null Masahiro Fukuda, null G. Argin, null Valérie Gaborieau, null Rostane Gaci, null Massimo Gagliardi, null Jean‐Charles Gagnard, null Amandine Gagneux‐Brunon, null Sérgio Gaião, null Linda Gail Skeie, null Phil Gallagher, null Carrol Gamble, null Yasmin Gani, null Arthur Garan, null Rebekha Garcia, null Noelia García Barrio, null Julia Garcia‐Diaz, null Esteban Garcia‐Gallo, null Navya Garimella, null Denis Garot, null Valérie Garrait, null Basanta Gauli, null Nathalie Gault, null Aisling Gavin, null Anatoliy Gavrylov, null Alexandre Gaymard, null Johannes Gebauer, null Eva Geraud, null Louis Gerbaud Morlaes, null Nuno Germano, null Praveen Kumar Ghisulal, null Jade Ghosn, null Marco Giani, null Jess Gibson, null Tristan Gigante, null Morgane Gilg, null Elaine Gilroy, null Guillermo Giordano, null Michelle Girvan, null Valérie Gissot, null Daniel Glikman, null Petr Glybochko, null Eric Gnall, null Geraldine Goco, null François Goehringer, null Siri Goepel, null Jean‐Christophe Goffard, null Jin Yi Goh, null Jonathan Golob, null Kyle Gomez, null Joan Gómez‐Junyent, null Marie Gominet, null Alicia Gonzalez, null Patricia Gordon, null Isabelle Gorenne, null Laure Goubert, null Cécile Goujard, null Tiphaine Goulenok, null Margarite Grable, null Jeronimo Graf, null Edward Wilson Grandin, null Pascal Granier, null Giacomo Grasselli, null Christopher A. Green, null Courtney Greene, null William Greenhalf, null Segolène Greffe, null Domenico Luca Grieco, null Matthew Griffee, null Fiona Griffiths, null Ioana Grigoras, null Albert Groenendijk, null Anja Grosse Lordemann, null Heidi Gruner, null Yusing Gu, null Jérémie Guedj, null Martin Guego, null Dewi Guellec, null Anne‐Marie Guerguerian, null Daniela Guerreiro, null Romain Guery, null Anne Guillaumot, null Laurent Guilleminault, null Maisa Guimarães de Castro, null Thomas Guimard, null Marieke Haalboom, null Daniel Haber, null Hannah Habraken, null Ali Hachemi, null Amy Hackmann, null Nadir Hadri, null Fakhir Haidri, null Sheeba Hakak, null Adam Hall, null Sophie Halpin, null Jawad Hameed, null Ansley Hamer, null Raph L. Hamers, null Rebecca Hamidfar, null Bato Hammarström, null Terese Hammond, null Lim Yuen Han, null Rashan Haniffa, null Kok Wei Hao, null Hayley Hardwick, null Ewen M. Harrison, null Janet Harrison, null Samuel Bernard Ekow Harrison, null Alan Hartman, null Mohd Shahnaz Hasan, null Junaid Hashmi, null Muhammad Hayat, null Ailbhe Hayes, null Leanne Hays, null Jan Heerman, null Lars Heggelund, null Ross Hendry, null Martina Hennessy, null Aquiles Henriquez‐Trujillo, null Maxime Hentzien, null Jaime Hernandez‐Montfort, null Andrew Hershey, null Liv Hesstvedt, null Astarini Hidayah, null Eibhilin Higgins, null Dawn Higgins, null Rupert Higgins, null Rita Hinchion, null Samuel Hinton, null Hiroaki Hiraiwa, null Haider Hirkani, null Hikombo Hitoto, null Yi Bin Ho, null Antonia Ho, null Alexandre Hoctin, null Isabelle Hoffmann, null Wei Han Hoh, null Oscar Hoiting, null Rebecca Holt, null Jan Cato Holter, null Peter Horby, null Juan Pablo Horcajada, null Koji Hoshino, null Ikram Houas, null Catherine L. Hough, null Stuart Houltham, null Jimmy Ming‐Yang Hsu, null Jean‐Sébastien Hulot, null Stella Huo, null Abby Hurd, null Iqbal Hussain, null Samreen Ijaz, null Hajnal‐Gabriela Illes, null Patrick Imbert, null Mohammad Imran, null Rana Imran Sikander, null Aftab Imtiaz, null Hugo Inácio, null Carmen Infante Dominguez, null Yun Sii Ing, null Elias Iosifidis, null Mariachiara Ippolito, null Sarah Isgett, null Tiago Isidoro, null Nadiah Ismail, null Margaux Isnard, null Mette Stausland Istre, null Junji Itai, null Daniel Ivulich, null Danielle Jaafar, null Salma Jaafoura, null Julien Jabot, null Clare Jackson, null Nina Jamieson, null Pierre Jaquet, null Coline Jaud‐Fischer, null Stéphane Jaureguiberry, null Denise Jaworsky, null Florence Jego, null Anilawati Mat Jelani, null Synne Jenum, null Ruth Jimbo‐Sotomayor, null Ong Yiaw Joe, null Ruth N. Jorge García, null Silje Bakken Jørgensen, null Cédric Joseph, null Mark Joseph, null Swosti Joshi, null Mercé Jourdain, null Philippe Jouvet, null Hanna Jung, null Anna Jung, null Dafsah Juzar, null Ouifiya Kafif, null Florentia Kaguelidou, null Neerusha Kaisbain, null Thavamany Kaleesvran, null Sabina Kali, null Alina Kalicinska, null Karl Trygve Kalleberg, null Smaragdi Kalomoiri, null Muhammad Aisar Ayadi Kamaluddin, null Zul Amali Che Kamaruddin, null Nadiah Kamarudin, null Kavita Kamineni, null Darshana Hewa Kandamby, null Chris Kandel, null Kong Yeow Kang, null Darakhshan Kanwal, null Pratap Karpayah, null Daisuke Kasugai, null Anant Kataria, null Kevin Katz, null Aasmine Kaur, null Christy Kay, null Hannah Keane, null Seán Keating, null Pulak Kedia, null Claire Kelly, null Yvelynne Kelly, null Andrea Kelly, null Niamh Kelly, null Aoife Kelly, null Sadie Kelly, null Maeve Kelsey, null Ryan Kennedy, null Kalynn Kennon, null Maeve Kernan, null Younes Kerroumi, null Sharma Keshav, null Imrana Khalid, null Osama Khalid, null Antoine Khalil, null Coralie Khan, null Irfan Khan, null Quratul Ain Khan, null Sushil Khanal, null Abid Khatak, null Amin Khawaja, null Krish Kherajani, null Michelle E. Kho, null Ryan Khoo, null Denisa Khoo, null Saye Khoo, null Nasir Khoso, null Khor How Kiat, null Yuri Kida, null Peter Kiiza, null Beathe Kiland Granerud, null Anders Benjamin Kildal, null Jae Burm Kim, null Antoine Kimmoun, null Detlef Kindgen‐Milles, null Alexander King, null Nobuya Kitamura, null Eyrun Floerecke Kjetland Kjetland, null Paul Klenerman, null Rob Klont, null Gry Kloumann Bekken, null Stephen R. Knight, null Robin Kobbe, null Chamira Kodippily, null Malte Kohns Vasconcelos, null Sabin Koirala, null Mamoru Komatsu, null Caroline Kosgei, null Arsène Kpangon, null Karolina Krawczyk, null Vinothini Krishnan, null Sudhir Krishnan, null Oksana Kruglova, null Ganesh Kumar, null Deepali Kumar, null Mukesh Kumar, null Pavan Kumar Vecham, null Dinesh Kuriakose, null Ethan Kurtzman, null Demetrios Kutsogiannis, null Galyna Kutsyna, null Konstantinos Kyriakoulis, null Marie Lachatre, null Marie Lacoste, null John G. Laffey, null Marie Lagrange, null Fabrice Laine, null Olivier Lairez, null Sanjay Lakhey, null Antonio Lalueza, null Marc Lambert, null François Lamontagne, null Marie Langelot‐Richard, null Vincent Langlois, null Eka Yudha Lantang, null Marina Lanza, null Cédric Laouénan, null Samira Laribi, null Delphine Lariviere, null Stéphane Lasry, null Sakshi Lath, null Naveed Latif, null Odile Launay, null Didier Laureillard, null Yoan Lavie‐Badie, null Andy Law, null Teresa Lawrence, null Cassie Lawrence, null Minh Le, null Clément Le Bihan, null Cyril Le Bris, null Georges Le Falher, null Lucie Le Fevre, null Quentin Le Hingrat, null Marion Le Maréchal, null Soizic Le Mestre, null Gwenaël Le Moal, null Vincent Le Moing, null Hervé Le Nagard, null Paul Le Turnier, null Ema Leal, null Marta Leal Santos, null Heng Gee Lee, null Biing Horng Lee, null Yi Lin Lee, null Todd C. Lee, null James Lee, null Jennifer Lee, null Su Hwan Lee, null Gary Leeming, null Laurent Lefebvre, null Bénédicte Lefebvre, null Benjamin Lefèvre, null Sylvie LeGac, null Jean‐Daniel Lelievre, null François Lellouche, null Adrien Lemaignen, null Véronique Lemee, null Anthony Lemeur, null Gretchen Lemmink, null Ha Sha Lene, null Jenny Lennon, null Rafael León, null Marc Leone, null Michela Leone, null Quentin Lepiller, null François‐Xavier Lescure, null Olivier Lesens, null Mathieu Lesouhaitier, null Amy Lester‐Grant, null Yves Levy, null Bruno Levy, null Claire Levy‐Marchal, null Katarzyna Lewandowska, null Erwan L'Her, null Gianluigi Li Bassi, null Janet Liang, null Ali Liaquat, null Geoffrey Liegeon, null Kah Chuan Lim, null Wei Shen Lim, null Chantre Lima, null Lim Lina, null Bruno Lina, null Andreas Lind, null Maja Katherine Lingad, null Guillaume Lingas, null Sylvie Lion‐Daolio, null Samantha Lissauer, null Keibun Liu, null Marine Livrozet, null Patricia Lizotte, null Antonio Loforte, null Navy Lolong, null Leong Chee Loon, null Diogo Lopes, null Dalia Lopez‐Colon, null Jose W. Lopez‐Revilla, null Anthony L. Loschner, null Paul Loubet, null Bouchra Loufti, null Guillame Louis, null Silvia Lourenco, null Lara Lovelace‐Macon, null Lee Lee Low, null Marije Lowik, null Jia Shyi Loy, null Jean Christophe Lucet, null Carlos Lumbreras Bermejo, null Carlos M. Luna, null Olguta Lungu, null Liem Luong, null Nestor Luque, null Dominique Luton, null Nilar Lwin, null Ruth Lyons, null Olavi Maasikas, null Oryane Mabiala, null Moïse Machado, null Gabriel Macheda, null Hashmi Madiha, null Guillermo Maestro de la Calle, null Rafael Mahieu, null Sophie Mahy, null Ana Raquel Maia, null Lars S. Maier, null Mylène Maillet, null Thomas Maitre, null Maximilian Malfertheiner, null Nadia Malik, null Paddy Mallon, null Fernando Maltez, null Denis Malvy, null Victoria Manda, null Laurent Mandelbrot, null Frank Manetta, null Julie Mankikian, null Edmund Manning, null Aldric Manuel, null Ceila Maria Sant'Ana Malaque, null Flávio Marino, null Daniel Marino, null Samuel Markowicz, null Charbel Maroun Eid, null Ana Marques, null Catherine Marquis, null Brian Marsh, null Laura Marsh, null Megan Marshal, null John Marshall, null Celina Turchi Martelli, null Dori‐Ann Martin, null Emily Martin, null Guillaume Martin‐Blondel, null Ignacio Martin‐Loeches, null Martin Martinot, null Alejandro Martin‐Quiros, null João Martins, null Ana Martins, null Nuno Martins, null Caroline Martins Rego, null Gennaro Martucci, null Olga Martynenko, null Eva Miranda Marwali, null Marsilla Marzukie, null David Maslove, null Sabina Mason, null Sobia Masood, null Basri Mat Nor, null Moshe Matan, null Meghena Mathew, null Daniel Mathieu, null Mathieu Mattei, null Romans Matulevics, null Laurence Maulin, null Michael Maxwell, null Javier Maynar, null Thierry Mazzoni, null Natalie Mc Evoy, null Lisa Mc Sweeney, null Colin McArthur, null Anne McCarthy, null Aine McCarthy, null Colin McCloskey, null Rachael McConnochie, null Sherry McDermott, null Sarah E. McDonald, null Aine McElroy, null Samuel McElwee, null Victoria McEneany, null Allison McGeer, null Chris McKay, null Johnny McKeown, null Kenneth A. McLean, null Paul McNally, null Bairbre McNicholas, null Elaine McPartlan, null Edel Meaney, null Cécile Mear‐Passard, null Maggie Mechlin, null Maqsood Meher, null Omar Mehkri, null Ferruccio Mele, null Luis Melo, null Kashif Memon, null Joao Joao Mendes, null Ogechukwu Menkiti, null Kusum Menon, null France Mentré, null Alexander J. Mentzer, null Noémie Mercier, null Emmanuelle Mercier, null Antoine Merckx, null Mayka Mergeay‐Fabre, null Blake Mergler, null António Mesquita, null Roberta Meta, null Osama Metwally, null Agnès Meybeck, null Dan Meyer, null Alison M. Meynert, null Vanina Meysonnier, null Amina Meziane, null Mehdi Mezidi, null Céline Michelanglei, null Isabelle Michelet, null Efstathia Mihelis, null Vladislav Mihnovit, null Hugo Miranda‐Maldonado, null Nor Arisah Misnan, null Tahira Jamal Mohamed, null Nik Nur Eliza Mohamed, null Asma Moin, null David Molina, null Elena Molinos, null Brenda Molloy, null Mary Mone, null Agostinho Monteiro, null Claudia Montes, null Giorgia Montrucchio, null Shona C. Moore, null Sarah Moore, null Lina Morales Cely, null Lucia Moro, null Ben Morton, null Catherine Motherway, null Ana Motos, null Hugo Mouquet, null Clara Mouton Perrot, null Julien Moyet, null Caroline Mudara, null Aisha Kalsoom Mufti, null Ng Yong Muh, null Dzawani Muhamad, null Jimmy Mullaert, null Fredrik Müller, null Karl Erik Müller, null Daniel Munblit, null Syed Muneeb, null Nadeem Munir, null Laveena Munshi, null Aisling Murphy, null Lorna Murphy, null Marlène Murris, null Himed Musaab, null Himasha Muvindi, null Gugapriyaa Muyandy, null Dimitra Melia Myrodia, null Farah Nadia Mohd‐Hanafiah, null Dave Nagpal, null Alex Nagrebetsky, null Mangala Narasimhan, null Nageswaran Narayanan, null Rashid Nasim Khan, null Alasdair Nazerali‐Maitland, null Nadège Neant, null Holger Neb, null Nikita Nekliudov, null Erni Nelwan, null Raul Neto, null Emily Neumann, null Pauline Yeung Ng, null Wing Yiu Ng, null Anthony Nghi, null Duc Nguyen, null Orna Ni Choileain, null Niamh Ni Leathlobhair, null Alistair Nichol, null Prompak Nitayavardhana, null Stephanie Nonas, null Nurul Amani Mohd Noordin, null Marion Noret, null Nurul Faten Izzati Norharizam, null Lisa Norman, null Alessandra Notari, null Mahdad Noursadeghi, null Karolina Nowicka, null Adam Nowinski, null Saad Nseir, null Jose I. Nunez, null Nurnaningsih Nurnaningsih, null Dwi Utomo Nusantara, null Elsa Nyamankolly, null Anders Benteson Nygaard, null Fionnuala O. Brien, null Annmarie O. Callaghan, null Annmarie O'Callaghan, null Giovanna Occhipinti, null Derbrenn OConnor, null Max O'Donnell, null Tawnya Ogston, null Takayuki Ogura, null Tak‐Hyuk Oh, null Sophie O'Halloran, null Katie O'Hearn, null Shinichiro Ohshimo, null Agnieszka Oldakowska, null João Oliveira, null Larissa Oliveira, null Piero L. Olliaro, null Jee Yan Ong, null David S. Y. Ong, null Wilna Oosthuyzen, null Anne Opavsky, null Peter Openshaw, null Saijad Orakzai, null Claudia Milena Orozco‐Chamorro, null Jamel Ortoleva, null Javier Osatnik, null Linda O'Shea, null Miriam O'Sullivan, null Siti Zubaidah Othman, null Nadia Ouamara, null Rachida Ouissa, null Eric Oziol, null Maïder Pagadoy, null Justine Pages, null Mario Palacios, null Amanda Palacios, null Massimo Palmarini, null Giovanna Panarello, null Prasan Kumar Panda, null Hem Paneru, null Lai Hui Pang, null Mauro Panigada, null Nathalie Pansu, null Aurélie Papadopoulos, null Rachael Parke, null Melissa Parker, null Briseida Parra, null Taha Pasha, null Jérémie Pasquier, null Bruno Pastene, null Fabian Patauner, null Drashti Patel, null Mohan Dass Pathmanathan, null Luís Patrão, null Patricia Patricio, null Juliette Patrier, null Lisa Patterson, null Rajyabardhan Pattnaik, null Mical Paul, null Christelle Paul, null Jorge Paulos, null William A. Paxton, null Jean‐François Payen, null Kalaiarasu Peariasamy, null Miguel Pedrera Jiménez, null Giles J. Peek, null Florent Peelman, null Nathan Peiffer‐Smadja, null Vincent Peigne, null Mare Pejkovska, null Paolo Pelosi, null Ithan D. Peltan, null Rui Pereira, null Daniel Perez, null Luis Periel, null Thomas Perpoint, null Antonio Pesenti, null Vincent Pestre, null Lenka Petrou, null Michele Petrovic, null Ventzislava Petrov‐Sanchez, null Frank Olav Pettersen, null Gilles Peytavin, null Scott Pharand, null Walter Picard, null Olivier Picone, null Maria de Piero, null Carola Pierobon, null Djura Piersma, null Carlos Pimentel, null Raquel Pinto, null Catarina Pires, null Isabelle Pironneau, null Lionel Piroth, null Ayodhia Pitaloka, null Riinu Pius, null Laurent Plantier, null Hon Shen Png, null Julien Poissy, null Ryadh Pokeerbux, null Maria Pokorska‐Spiewak, null Sergio Poli, null Georgios Pollakis, null Diane Ponscarme, null Jolanta Popielska, null Diego Bastos Porto, null Andra‐Maris Post, null Douwe F. Postma, null Pedro Povoa, null Diana Póvoas, null Jeff Powis, null Sofia Prapa, null Sébastien Preau, null Christian Prebensen, null Jean‐Charles Preiser, null Anton Prinssen, null Gamage Dona Dilanthi Priyadarshani, null Lucia Proença, null Sravya Pudota, null Oriane Puéchal, null Bambang Pujo Semedi, null Mathew Pulicken, null Gregory Purcell, null Luisa Quesada, null Vilmaris Quinones‐Cardona, null Víctor Quirós González, null Else Quist‐Paulsen, null Mohammed Quraishi, null Maia Rabaa, null Christian Rabaud, null Ebenezer Rabindrarajan, null Aldo Rafael, null Marie Rafiq, null Mutia Rahardjani, null Rozanah Abd Rahman, null Ahmad Kashfi Haji Ab Rahman, null Arsalan Rahutullah, null Fernando Rainieri, null Giri Shan Rajahram, null Pratheema Ramachandran, null Nagarajan Ramakrishnan, null Ahmad Afiq Ramli, null Blandine Rammaert, null Grazielle Viana Ramos, null Asim Rana, null Rajavardhan Rangappa, null Ritika Ranjan, null Christophe Rapp, null Aasiyah Rashan, null Thalha Rashan, null Ghulam Rasheed, null Menaldi Rasmin, null Indrek Rätsep, null Cornelius Rau, null Tharmini Ravi, null Ali Raza, null Andre Real, null Stanislas Rebaudet, null Sarah Redl, null Brenda Reeve, null Attaur Rehman, null Liadain Reid, null Dag Henrik Reikvam, null Renato Reis, null Jordi Rello, null Jonathan Remppis, null Martine Remy, null Hongru Ren, null Hanna Renk, null Anne‐Sophie Resseguier, null Matthieu Revest, null Oleksa Rewa, null Luis Felipe Reyes, null Tiago Reyes, null Maria Ines Ribeiro, null Antonia Ricchiuto, null David Richardson, null Denise Richardson, null Laurent Richier, null Siti Nurul Atikah Ahmad Ridzuan, null Jordi Riera, null Ana L. Rios, null Asgar Rishu, null Patrick Rispal, null Karine Risso, null Maria Angelica Rivera Nuñez, null Nicholas Rizer, null Chiara Robba, null André Roberto, null Stephanie Roberts, null David L. Robertson, null Olivier Robineau, null Ferran Roche‐Campo, null Paola Rodari, null Simão Rodeia, null Julia Rodriguez Abreu, null Bernhard Roessler, null Pierre‐Marie Roger, null Claire Roger, null Emmanuel Roilides, null Juliette Romaru, null Roberto Roncon‐Albuquerque, null Mélanie Roriz, null Manuel Rosa‐Calatrava, null Michael Rose, null Dorothea Rosenberger, null Nurul Hidayah Mohammad Roslan, null Andrea Rossanese, null Matteo Rossetti, null Bénédicte Rossignol, null Patrick Rossignol, null Stella Rousset, null Carine Roy, null Benoît Roze, null Desy Rusmawatiningtyas, null Clark D. Russell, null Maria Ryan, null Maeve Ryan, null Steffi Ryckaert, null Aleksander Rygh Holten, null Isabela Saba, null Sairah Sadaf, null Musharaf Sadat, null Valla Sahraei, null Maximilien Saint‐Gilles, null Pranya Sakiyalak, null Nawal Salahuddin, null Leonardo Salazar, null Jodat Saleem, null Gabriele Sales, null Stéphane Sallaberry, null Charlotte Salmon Gandonniere, null Hélène Salvator, null Olivier Sanchez, null Angel Sanchez‐Miralles, null Vanessa Sancho‐Shimizu, null Gyan Sandhu, null Zulfiqar Sandhu, null Pierre‐François Sandrine, null Oana Sandulescu, null Marlene Santos, null Shirley Sarfo‐Mensah, null Bruno Sarmento Banheiro, null Iam Claire E. Sarmiento, null Benjamine Sarton, null Ankana Satya, null Sree Satyapriya, null Rumaisah Satyawati, null Egle Saviciute, null Parthena Savvidou, null Yen Tsen Saw, null Justin Schaffer, null Tjard Schermer, null Arnaud Scherpereel, null Marion Schneider, null Stephan Schroll, null Michael Schwameis, null Gary Schwartz, null Janet T. Scott, null James Scott‐Brown, null Nicholas Sedillot, null Tamara Seitz, null Jaganathan Selvanayagam, null Mageswari Selvarajoo, null Caroline Semaille, null Malcolm G. Semple, null Rasidah Bt Senian, null Eric Senneville, null Filipa Sequeira, null Tânia Sequeira, null Ary Serpa Neto, null Pablo Serrano Balazote, null Ellen Shadowitz, null Syamin Asyraf Shahidan, null Mohammad Shamsah, null Anuraj Shankar, null Shaikh Sharjeel, null Pratima Sharma, null Catherine A. Shaw, null Victoria Shaw, null Ashraf Sheharyar, null Rohan Shetty, null Rajesh Mohan Shetty, null Haixia Shi, null Mohiuddin Shiekh, null Nobuaki Shime, null Keiki Shimizu, null Sally Shrapnel, null Pramesh Sundar Shrestha, null Shubha Kalyan Shrestha, null Hoi Ping Shum, null Nassima Si Mohammed, null Ng Yong Siang, null Jeanne Sibiude, null Atif Siddiqui, null Piret Sillaots, null Catarina Silva, null Rogério Silva, null Maria Joao Silva, null Benedict Sim Lim Heng, null Wai Ching Sin, null Dario Sinatti, null Punam Singh, null Budha Charan Singh, null Pompini Agustina Sitompul, null Karisha Sivam, null Vegard Skogen, null Sue Smith, null Benjamin Smood, null Coilin Smyth, null Michelle Smyth, null Morgane Snacken, null Dominic So, null Tze Vee Soh, null Lene Bergendal Solberg, null Joshua Solomon, null Tom Solomon, null Emily Somers, null Agnès Sommet, null Rima Song, null Myung Jin Song, null Tae Song, null Jack Song Chia, null Michael Sonntagbauer, null Azlan Mat Soom, null Arne Søraas, null Camilla Lund Søraas, null Alberto Sotto, null Edouard Soum, null Marta Sousa, null Ana Chora Sousa, null Maria Sousa Uva, null Vicente Souza‐Dantas, null Alexandra Sperry, null Elisabetta Spinuzza, null B. P. Sanka Ruwan Sri Darshana, null Shiranee Sriskandan, null Sarah Stabler, null Thomas Staudinger, null Stephanie‐Susanne Stecher, null Trude Steinsvik, null Ymkje Stienstra, null Birgitte Stiksrud, null Eva Stolz, null Amy Stone, null Adrian Streinu‐Cercel, null Anca Streinu‐Cercel, null David Stuart, null Ami Stuart, null Decy Subekti, null Gabriel Suen, null Jacky Y. Suen, null Asfia Sultana, null Charlotte Summers, null Dubravka Supic, null Deepashankari Suppiah, null Magdalena Surovcová, null Suwarti Suwarti, null Andrey Svistunov, null Sarah Syahrin, null Konstantinos Syrigos, null Jaques Sztajnbok, null Konstanty Szuldrzynski, null Shirin Tabrizi, null Fabio S. Taccone, null Lysa Tagherset, null Shahdattul Mawarni Taib, null Ewa Talarek, null Sara Taleb, null Jelmer Talsma, null Renaud Tamisier, null Maria Lawrensia Tampubolon, null Kim Keat Tan, null Yan Chyi Tan, null Taku Tanaka, null Hiroyuki Tanaka, null Hayato Taniguchi, null Huda Taqdees, null Arshad Taqi, null Coralie Tardivon, null Pierre Tattevin, null M. Azhari Taufik, null Hassan Tawfik, null Richard S. Tedder, null Tze Yuan Tee, null João Teixeira, null Sofia Tejada, null Marie‐Capucine Tellier, null Sze Kye Teoh, null Vanessa Teotonio, null François Téoulé, null Pleun Terpstra, null Olivier Terrier, null Nicolas Terzi, null Hubert Tessier‐Grenier, null Adrian Tey, null Alif Adlan Mohd Thabit, null Anand Thakur, null Zhang Duan Tham, null Suvintheran Thangavelu, null Vincent Thibault, null Simon‐Djamel Thiberville, null Benoît Thill, null Jananee Thirumanickam, null Shaun Thompson, null Emma C. Thomson, null Surain Raaj Thanga Thurai, null Ryan S. Thwaites, null Paul Tierney, null Vadim Tieroshyn, null Peter S. Timashev, null Jean‐François Timsit, null Bharath Kumar Tirupakuzhi Vijayaraghavan, null Noémie Tissot, null Jordan Zhien Yang Toh, null Maria Toki, null Kristian Tonby, null Sia Loong Tonnii, null Margarida Torres, null Antoni Torres, null Rosario Maria Torres Santos‐Olmo, null Hernando Torres‐Zevallos, null Michael Towers, null Tony Trapani, null Théo Treoux, null Cécile Tromeur, null Ioannis Trontzas, null Tiffany Trouillon, null Jeanne Truong, null Christelle Tual, null Sarah Tubiana, null Helen Tuite, null Jean‐Marie Turmel, null Lance C. W. Turtle, null Anders Tveita, null Pawel Twardowski, null Makoto Uchiyama, null P. G. Ishara Udayanga, null Andrew Udy, null Roman Ullrich, null Alberto Uribe, null Asad Usman, null Timothy M. Uyeki, null Cristinava Vajdovics, null Piero Valentini, null Luís Val‐Flores, null Amélie Valran, null Stijn Van de Velde, null Marcel van den Berge, null Machteld Van der Feltz, null Job van der Palen, null Paul van der Valk, null Nicky Van Der Vekens, null Peter Van der Voort, null Sylvie Van Der Werf, null Laura van Gulik, null Jarne Van Hattem, null Carolien van Netten, null Ilonka van Veen, null Noémie Vanel, null Henk Vanoverschelde, null Pooja Varghese, null Michael Varrone, null Shoban Raj Vasudayan, null Charline Vauchy, null Shaminee Veeran, null Aurélie Veislinger, null Sebastian Vencken, null Sara Ventura, null Annelies Verbon, null James Vickers, null José Ernesto Vidal, null César Vieira, null Deepak Vijayan, null Joy Ann Villanueva, null Judit Villar, null Pierre‐Marc Villeneuve, null Andrea Villoldo, null Gayatri Vishwanathan, null Benoit Visseaux, null Hannah Visser, null Chiara Vitiello, null Harald Vonkeman, null Fanny Vuotto, null Noor Hidayu Wahab, null Suhaila Abdul Wahab, null Nadirah Abdul Wahid, null Marina Wainstein, null Wan Fadzlina Wan Muhd Shukeri, null Chih‐Hsien Wang, null Steve Webb, null Jia Wei, null Katharina Weil, null Tan Pei Wen, null Sanne Wesselius, null T. Eoin West, null Murray Wham, null Bryan Whelan, null Nicole White, null Paul Henri Wicky, null Aurélie Wiedemann, null Surya Otto Wijaya, null Keith Wille, null Suzette Willems, null Virginie Williams, null Evert‐Jan Wils, null Xin Ci Wong, null Calvin Wong, null Yew Sing Wong, null Teck Fung Wong, null Natalie Wright, null Gan Ee Xian, null Lim Saio Xian, null Kuan Pei Xuan, null Ioannis Xynogalas, null Siti Rohani Binti Mohd Yakop, null Masaki Yamazaki, null Yazdan Yazdanpanah, null Nicholas Yee Liang Hing, null Cécile Yelnik, null Chian Hui Yeoh, null Stephanie Yerkovich, null Toshiki Yokoyama, null Hodane Yonis, null Obada Yousif, null Saptadi Yuliarto, null Akram Zaaqoq, null Marion Zabbe, null Kai Zacharowski, null Masliza Zahid, null Maram Zahran, null Nor Zaila Binti Zaidan, null Maria Zambon, null Alberto Zanella, null Konrad Zawadka, null Nurul Zaynah, null Hiba Zayyad, null Alexander Zoufaly, null David Zucman, and null ISARIC Clinical Characterisation Group
Published: 2022

26. A Longitudinal Study of Spontaneous Gut Decolonization of Carbapenem-resistant Gram-negative Bacteria in Neonatal and Pediatric Patients

Author: Violetta-Magdalini Darda, Elias Iosifidis, Charalampos Antachopoulos, Fotis Kirvasilis, Charalampos Zarras, Maria Simitsopoulou, Eugenia Papakonstantinou, Eleni Agakidou, Maria Sdougka, and Emmanuel Roilides
Subjects: Microbiology (medical), Infant, Newborn, Infant, Bacterial Infections, Anti-Bacterial Agents, Infectious Diseases, Carbapenems, Pediatrics, Perinatology and Child Health, Gram-Negative Bacteria, Humans, Longitudinal Studies, Child, Gram-Negative Bacterial Infections, Retrospective Studies
Abstract: Antibiotic exposure may convert gut microbiome to reservoir of resistant organisms, including carbapenem-resistant Gram-negative bacteria (CRGNB). Little is known about natural history of spontaneous CRGNB decolonization of neonates/children and their risk to develop CRGNB infections.Patients hospitalized in a tertiary care hospital (1 days to 16 years) found to be CRGNB colonized in weekly surveillance cultures during hospitalization (January 2018 to December 2019) were prospectively followed after discharge with monthly rectal cultures for 12 months after colonization until decolonization (3 consecutive negative rectal cultures, ≥1 week apart). Patient demographics, clinical characteristics and CRGNB infections were recorded. Polymerase chain reaction for carbapenemases was performed in patients colonized, after 3 negative cultures, at the day of the last negative and the day of the first new positive culture.One-hundred thirty patients (median age, 1.3 months; lower-upper quartile values, 0.8-6.9 months) were studied including 66 neonates (median age, 12.6 days; Q1-Q3, 5-18.5 days). Among patients30 days old, 51.6% achieved decolonization within 6 months, and among neonates, 91% achieved decolonization within 6 months. By 12th month, 89% of30 days and 100% of neonates were decolonized. Forty-four (33.9%) patients (59%30 days and 9% neonates) developed CRGNB infection(s), mainly pneumonia (25%) and bloodstream infection (20.5%). Prolonged colonization (odds ratio [OR], 7.75; 95% confidence interval [CI], 2.10-28.58), duration of broad-spectrum antibiotic use (OR, 1.22; 95% CI, 1.11-1.34) and parenteral nutrition (OR, 4.53; 95% CI, 1.14-17.94) were associated with the development of CRGNB infection. Two patients (1.5%) were found by polymerase chain reaction colonized after 3 negative cultures.Spontaneous decolonization occurs in most CRGNB colonized30 days and all neonates within 12 months. One-third of colonized patients develop CRGNB infection(s). These findings may help optimize duration of contact precautions and empirical antimicrobial therapy for CRGNB colonized pediatric patients.
Published: 2022

27. Management of osteoarticular fungal infections in the setting of immunodeficiency

Author: Savvas Papachristou, Nikolaos V. Sipsas, Thomas J. Walsh, Elias Iosifidis, Maria N. Gamaletsou, and Emmanuel Roilides
Subjects: 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Antifungal Agents, medicine.medical_treatment, 030106 microbiology, Antifungal drug, Arthritis, Microbiology, Immunocompromised Host, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Virology, Osteoarthritis, Epidemiology, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Immunodeficiency, Arthritis, Infectious, Surgical approach, business.industry, Osteomyelitis, Immunotherapy, medicine.disease, Infectious Diseases, Mycoses, business, Immunosuppressive Agents, Dimorphic fungus
Abstract: Introduction: Osteoarticular fungal infections (OAFIs) complicate the clinical course of high-risk patients, including immunosuppressed individuals. Their management, however, despite being intricate, is governed by evidence arising from sub-optimal quality research, such as case series. Guidelines are scarce and when present result in recommendations based on low quality evidence. Furthermore, the differences between the management of immunocompromised and immunocompetent patients are not distinct. This is a narrative review after a literature search in PubMed, up to November 2019.Areas covered: The major fungal groups causing osteomyelitis and/or arthritis are Candida spp., Aspergillus spp., non-Aspergillus filamentous fungi, non-Candida yeasts and endemic dimorphic fungi. Their epidemiology is briefly analyzed with emphasis on immunodeficiency and other risk factors. Management of OAFIs includes appropriate antifungal drug therapy (liposomal amphotericin B, triazoles or echinocandins), local surgery and immunotherapy for primary immunodeficiencies. Cessation of immunosuppressive drugs is also mandated.Expert opinion: Management of OAFIs includes affordable and available options and approaches. However, research on therapeutic practices is urgently required to be further improved, due to the rarity of affected patients. Evolution is expected to translate into novel antifungal drugs, less invasive and precise surgical approaches and targeted enhancement of immunoregulatory pathways in defense of challenging fungal pathogens.
Published: 2020

28. Forecasting models of infections due to carbapenem-resistant Gram-negative bacteria in an intensive care unit in an endemic area

Author: Emmanuel Roilides, Elias Iosifidis, Katerina Tsergouli, Aggeliki Karyoti, Theodoros Karampatakis, E. Mouloudi, Charalampos Antachopoulos, and Athanassios Tsakris
Subjects: Acinetobacter baumannii, Male, 0301 basic medicine, Veterinary medicine, Klebsiella pneumoniae, medicine.disease_cause, law.invention, 0302 clinical medicine, law, Immunology and Allergy, Medicine, Infection control, 030212 general & internal medicine, Aged, 80 and over, biology, Endemic area, Middle Aged, Intensive care unit, QR1-502, Intensive Care Units, Pseudomonas aeruginosa, Female, Seasons, Adult, Microbiology (medical), Adolescent, 030106 microbiology, Immunology, Microbial Sensitivity Tests, Microbiology, Observational period, Young Adult, 03 medical and health sciences, Drug Resistance, Bacterial, Humans, Forecasting model, Aged, Retrospective Studies, Carbapenem resistant, business.industry, Bayes Theorem, Length of Stay, Models, Theoretical, biology.organism_classification, Carbapenems, Carbapenem-resistant Gram-negative bacteria, Gram-Negative Bacterial Infections, business
Abstract: Objectives The aim of this study was to forecast the monthly incidence rates of infections [infections/1000 bed-days (IBD)] due to carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) and total carbapenem-resistant Gram-negative bacteria (CRGNB) in an endemic intensive care unit (ICU) during the subsequent year (December 2016–December 2017) following the observational period. Methods A 52-month observational period (August 2012–November 2016) was used. Two forecasting models, including a simple seasonal model for CRGNB, CRKP and CRPA and Winters’ additive model for CRAB infections, were applied. Results The models predicted the highest infection rates for CRKP, CRAB and CRGNB in January and September 2017 (23.8/23.4, 24.6/28.5 and 46.8/46.7 IBD, respectively) and for CRPA in February and March 2017 (8.3 and 7.9, respectively). The highest observed rates for CRKP, CRAB and CRGNB were indeed in January and September 2017 (25.6/19.0, 34.2/23.8 and 59.8/42.8 IBD, respectively); and for CRPA in February and March of the same year (15.2 and 12.7, respectively). The increased rates may be associated with personnel’s annual work programme and behavioural factors. Conclusion Forecasting models in endemic ICUs may assist in implementation strategies for infection control measures.
Published: 2020

29. Changes in molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in the intensive care units of a Greek hospital, 2018-2021

Author: Charalampos Zarras, Styliani Pappa, Konstantinos Zarras, Theodoros Karampatakis, Eleni Vagdatli, Eleni Mouloudi, Elias Iosifidis, Emmanuel Roilides, and Anna Papa
Subjects: General Immunology and Microbiology, General Medicine, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses
Abstract: The spread of multi-drug resistant (MDR) Gram-negative bacteria, including Klebsiella pneumoniae, constitutes a global threat. The most frequent mechanism of acquired carbapenem resistance is the production of carbapenemases, especially KPC, NDM, VIM, IMP and OXA-48. We analyzed the epidemiological trend of carbapenem resistance genes of carbapenem-resistant K. pneumoniae (CRKP) strains isolated from critically ill patients in a Greek tertiary hospital. The study included 150 CRKP isolates collected from 116 (77.4%) patients hospitalized in the adult ICU and 17 (11.3%) each in the pediatric and the two neonatal ICUs between March 2018 and March 2021. Identification and antimicrobial susceptibility testing were performed using VITEK-2. A multiplex lateral flow immunoassay was used for the detection of carbapenemases, while the detection of bla VIM, bla KPC, bla NDM, bla IMP and bla OXA-48-like genes was achieved by multiplex PCR. The bla NDM was mainly detected in adults (54/116, 46.9%), while in children the most often detected gene was bla KPC (24/34, 70.6%). The predominant carbapenem resistance gene during 2018–2019 was bla KPC alone or in combination with bla VIM, reaching 44.4% in 2019, while during 2020–2021 the detection of bla NDM prevailed significantly, reaching 45.5 and 60.7% for 2020 and 2021, respectively. A shift in the molecular epidemiology of CRKP was seen during 2018–2021, which is probably associated with the recent excessive empiric use of newer antimicrobials. Surveillance studies and proper and strict implementation of infection control measures are highly needed to decrease the spread of MDR bacteria, including CRKP.
Published: 2022

30. Emergence of ST39 carbapenem-resistant Klebsiella pneumoniae producing VIM-1 and KPC-2

Author: Theodoros Karampatakis, Charalampos Zarras, Styliani Pappa, Eleni Vagdatli, Elias Iosifidis, Emmanuel Roilides, and Anna Papa
Subjects: 0303 health sciences, 030306 microbiology, Microbial Sensitivity Tests, Microbiology, beta-Lactamases, Anti-Bacterial Agents, Klebsiella Infections, Klebsiella pneumoniae, 03 medical and health sciences, Carbapenem-Resistant Enterobacteriaceae, Infectious Diseases, Bacterial Proteins, Carbapenems, Humans, Phylogeny, 030304 developmental biology
Abstract: Carbapenem-resistant Klebsiella pneumoniae (CRKP) causes life-threatening hospital-acquired infections. KPC and VIM carbapenemase production is the main molecular mechanism for carbapenem resistance. The aim of the current study was the genetic characterization of four ST39 CRKP isolates simultaneously producing VIM-1 and KPC-2, obtained in a Greek tertiary hospital.Identification and antimicrobial susceptibility testing were performed through VITEK 2. Multiplex PCR, multiplex lateral flow immunoassay, phenotypic tests and next generation sequencing were applied. The sequence reads were de novo assembled and annotated, while antimicrobial resistance genes and plasmids were identified using bioinformatics software. Genomic comparison and core genome single-nucleotide polymorphism-based phylogenetic analysis were also performed.Three isolates were pandrug-resistant, and one was extensively drug-resistant; they all carried blaTo our knowledge this is the first report on detection of CRKP ST39 isolates simultaneously producing VIM-1 and KPC-2 in addition to colistin resistance. The knowledge of the clonal relatedness of the isolates can lead to the implementation of strict infection control measures absolutely needed to eliminate their spread.
Published: 2022
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31. Optimised versus standard dosing of vancomycin in infants with Gram-positive sepsis (NeoVanc): a multicentre, randomised, open-label, phase 2b, non-inferiority trial

Author: Louise F Hill, Michelle N Clements, Mark A Turner, Daniele Donà, Irja Lutsar, Evelyne Jacqz-Aigrain, Paul T Heath, Emmanuel Roilides, Louise Rawcliffe, Clara Alonso-Diaz, Eugenio Baraldi, Andrea Dotta, Mari-Liis Ilmoja, Ajit Mahaveer, Tuuli Metsvaht, George Mitsiakos, Vassiliki Papaevangelou, Kosmas Sarafidis, A Sarah Walker, Michael Sharland, Michelle Clements, Basma Bafadal, Ana Alarcon Allen, Fani Anatolitou, Antonio Del Vecchio, Mario Giuffrè, Korina Karachristou, Paolo Manzoni, Stefano Martinelli, Paul Moriarty, Angeliki Nika, Vana Papaevangelou, Charles Roehr, Laura Sanchez Alcobendas, Tania Siahanidou, Chryssoula Tzialla, Luca Bonadies, Nicola Booth, Paola Catalina Morales-Betancourt, Malaika Cordeiro, Concha de Alba Romero, Javier de la Cruz, Maia De Luca, Daniele Farina, Caterina Franco, Dimitra Gialamprinou, Maarja Hallik, Laura Ilardi, Vincenzo Insinga, Elias Iosifidis, Riste Kalamees, Angeliki Kontou, Zoltan Molnar, Eirini Nikaina, Chryssoula Petropoulou, Mar Reyné, Kassandra Tataropoulou, Pinelopi Triantafyllidou, Adamantios Vontzalidis, Mike Sharland, Hill L.F., Clements M.N., Turner M.A., Dona D., Lutsar I., Jacqz-Aigrain E., Heath P.T., Roilides E., Rawcliffe L., Alonso-Diaz C., Baraldi E., Dotta A., Ilmoja M.-L., Mahaveer A., Metsvaht T., Mitsiakos G., Papaevangelou V., Sarafidis K., Walker A.S., Sharland M., Clements M., Bafadal B., Alarcon Allen A., Anatolitou F., Del Vecchio A., Giuffre M., Karachristou K., Manzoni P., Martinelli S., Moriarty P., Nika A., Roehr C., Sanchez Alcobendas L., Siahanidou T., Tzialla C., Bonadies L., Booth N., Catalina Morales-Betancourt P., Cordeiro M., de Alba Romero C., de la Cruz J., De Luca M., Farina D., Franco C., Gialamprinou D., Hallik M., Ilardi L., Insinga V., Iosifidis E., Kalamees R., Kontou A., Molnar Z., Nikaina E., Petropoulou C., Reyne M., Tataropoulou K., Triantafyllidou P., and Vontzalidis A.
Subjects: medicine.medical_specialty, Time Factors, Population, Equivalence Trials as Topic, Loading dose, Article, law.invention, Gram-positive, Randomized controlled trial, law, Vancomycin, Intensive care, Internal medicine, Intensive Care Units, Neonatal, Sepsis, Developmental and Educational Psychology, Clinical endpoint, Medicine, Humans, Dosing, education, Infusions, Intravenous, education.field_of_study, business.industry, Infant, Newborn, Infant, dosing, United Kingdom, Anti-Bacterial Agents, Europe, Regimen, Treatment Outcome, Spain, Relative risk, Pediatrics, Perinatology and Child Health, sepsi, business
Abstract: Summary Background Vancomycin is the most widely used antibiotic for neonatal Gram-positive sepsis, but clinical outcome data of dosing strategies are scarce. The NeoVanc programme comprised extensive preclinical studies to inform a randomised controlled trial to assess optimised vancomycin dosing. We compared the efficacy of an optimised regimen to a standard regimen in infants with late onset sepsis that was known or suspected to be caused by Gram-positive microorganisms. Methods NeoVanc was an open-label, multicentre, phase 2b, parallel-group, randomised, non-inferiority trial comparing the efficacy and toxicity of an optimised regimen of vancomycin to a standard regimen in infants aged 90 days or younger. Infants with at least three clinical or laboratory sepsis criteria or confirmed Gram-positive sepsis with at least one clinical or laboratory criterion were enrolled from 22 neonatal intensive care units in Greece, Italy, Estonia, Spain, and the UK. Infants were randomly assigned (1:1) to either the optimised regimen (25 mg/kg loading dose, followed by 15 mg/kg every 12 h or 8 h dependent on postmenstrual age, for 5 ± 1 days) or the standard regimen (no loading dose; 15 mg/kg every 24 h, 12 h, or 8 h dependent on postmenstrual age for 10 ± 2 days). Vancomycin was administered intravenously via 60 min infusion. Group allocation was not masked to local investigators or parents. The primary endpoint was success at the test of cure visit (10 ± 1 days after the end of actual vancomycin therapy) in the per-protocol population, where success was defined as the participant being alive at the test of cure visit, having a successful outcome at the end of actual vancomycin therapy, and not having a clinically or microbiologically significant relapse or new infection requiring antistaphylococcal antibiotics for more than 24 h within 10 days of the end of actual vancomycin therapy. The non-inferiority margin was −10%. Safety was assessed in the intention-to-treat population. This trial is registered at ClinicalTrials.gov ( NCT02790996 ). Findings Between March 3, 2017, and July 29, 2019, 242 infants were randomly assigned to the standard regimen group (n=122) or the optimised regimen group (n=120). Primary outcome data in the per-protocol population were available for 90 infants in the optimised group and 92 in the standard group. 64 (71%) of 90 infants in the optimised group and 73 (79%) of 92 in the standard group had success at test of cure visit; non-inferiority was not confirmed (adjusted risk difference −7% [95% CI −15 to 2]). Incomplete resolution of clinical or laboratory signs after 5 ± 1 days of vancomycin therapy was the main factor contributing to clinical failure in the optimised group. Abnormal hearing test results were recorded in 25 (30%) of 84 infants in the optimised group and 12 (15%) of 79 in the standard group (adjusted risk ratio 1·96 [95% CI 1·07 to 3·59], p=0·030). There were six vancomycin-related adverse events in the optimised group (one serious adverse event) and four in the standard group (two serious adverse events). 11 infants in the intention-to-treat population died (six [6%] of 102 infants in the optimised group and five [5%] of 98 in the standard group). Interpretation In the largest neonatal vancomycin efficacy trial yet conducted, no clear clinical impact of a shorter duration of treatment with a loading dose was demonstrated. The use of the optimised regimen cannot be recommended because a potential hearing safety signal was identified; long-term follow-up is being done. These results emphasise the importance of robust clinical safety assessments of novel antibiotic dosing regimens in infants. Funding EU Seventh Framework Programme for research, technological development and demonstration.
Published: 2021

32. Characteristics and outcomes of an international cohort of 400,000 hospitalised patients with Covid-19

Author: Charlotte Summers, Hikombo HITOTO, Anne Sophie Boureau, Pawel Twardowski, Fernando Augusto Bozza, Mark Pritchard, Elias Iosifidis, Jamel Ortoleva, Emanuele Durante-Mangoni, Andreas Lind, Lance Turtle, Paul Le Turnier, Thushan De Silva, Malcolm Gracie Semple, Tom Fletcher, Fakhir Haidri, Sarah Cormican, Ali AIT HSSAIN, Giorgia Montrucchio, Alexandre Gaymard, Gianluigi Li Bassi, Martina Hennessy, Hernando Torres-Zevallos, Waasila Jassat, Oksana Kruglova, Pablo Serrano Balazote, Juan Pablo Horcajada, Christophe Fraser, Mary Catherine Mone, Louise Sigfrid, Patrick Archambault, Jeffrey Javidfar, Francois Lamontagne, Aidan Burrell, Srinivas Murthy, Mauro Panigada, Kevin Bouiller, Helena Barrasa, Hoi Ping Shum, Guillaume Martin-Blondel, Dominique Deplanque, Miguel Pedrera-Jiménez, Clarice Tanaka, William Paxton, Alberto Cucino, Sophie Yacoub, Emmanuelle Denis, Abigail Beane, and Devachandran Jayakumar
Subjects: medicine.medical_specialty, Proportional hazards model, business.industry, Hazard ratio, Respiratory infection, Context (language use), Intensive care unit, law.invention, law, Cohort, Case fatality rate, Emergency medicine, Global health, medicine, business
Abstract: BackgroundPolicymakers need robust data to respond to the COVID-19 pandemic. We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, the world’s largest international, standardised cohort of hospitalised patients.MethodsThe dataset analysed includes COVID-19 patients hospitalised between January 2020 and May 2021. We investigated how symptoms on admission, comorbidities, risk factors, and treatments varied by age, sex, and other characteristics. We used Cox proportional hazards models to investigate associations between demographics, symptoms, comorbidities, and other factors with risk of death, admission to intensive care unit (ICU), and invasive mechanical ventilation (IMV).Findings439,922 patients with laboratory-confirmed (91.7%) or clinically-diagnosed (8.3%) SARS-CoV-2 infection from 49 countries were enrolled. Age (adjusted hazard ratio [HR] per 10 years 1.49 [95% CI 1.49-1.50]) and male sex (1.26 [1.24-1.28]) were associated with a higher risk of death. Rates of admission to ICU and use of IMV increased with age up to age 60, then dropped. Symptoms, comorbidities, and treatments varied by age and had varied associations with clinical outcomes. Tuberculosis was associated with an 86% higher risk of death, and HIV with an 87% higher risk of death. Case fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients.InterpretationThe size of our international database and the standardized data collection method makes this study a reliable and comprehensive international description of COVID-19 clinical features. This is a viable model to be applied to future epidemics.FundingUK Foreign, Commonwealth and Development Office, the Bill & Melinda Gates Foundation and Wellcome. See acknowledgements section for funders of sites that contributed data.Research in contextEvidence before this studyTo identify large, international analyses of hospitalised COVID-19 patients that used standardised data collection, we conducted a systematic review of the literature from 1 Jan 2020 to 28 Apr 2020. We identified 78 studies, with data from 77,443 people (1) predominantly from China. We could not find any studies including data from low and middle-income countries. We repeated our search on 18 Aug 2021 but could not identify any further studies that met our inclusion criteria.Added value of this studyOur study uses standardised clinical data collection to collect data from a vast number of patients across the world, including patients from low-, middle-, and high-income countries. The size of our database gives us great confidence in the accuracy of our descriptions of the global impact of COVID-19. We can confirm findings reported by smaller, country-specific studies and compare clinical data between countries. We have demonstrated that it is possible to collect large volumes of standardised clinical data during a pandemic of a novel acute respiratory infection. The results provide a valuable resource for present policymakers and future global health researchers.Implications of all the available evidencePresenting symptoms of SARS-CoV-2 infection in patients requiring hospitalisation are now well-described globally, with the most common being fever, cough, and shortness of breath. Other symptoms also commonly occur, including altered consciousness in older adults and gastrointestinal symptoms in younger patients, and age can influence the likelihood of a patient having symptoms that match one or more case definitions. There are geographic and temporal variations in the case fatality rate (CFR), but overall, CFR was 20.6% in this large international cohort of hospitalised patients with a median age of 60 years (IQR: 45 to 74 years).
Published: 2021

33. Aetiology of acute respiratory infection in preschool children requiring hospitalisation in Europe-results from the PED-MERMAIDS multicentre case-control study

Author: Menno D. de Jong, Markus Hufnagel, Katherine Loens, Cristina Epalza, Peter J. M. Openshaw, Vana Spoulou, Federico Martinón-Torres, Emmanuel Roilides, Maggie Nyirenda Nyang'wa, Elias Iosifidis, Mike Sharland, Hanna Renk, Cristina Calvo, Marta Ciofi Degli Atti, Carlo Giaquinto, Marion Koopmans, Manuel Gijon, Sigita Burokienė, Veerle Matheeussen, Pablo Rojo, Chiara Minotti, Tessa Goetghebuer, Carmen D'Amore, Savvas Papachristou, Herman Goossens, Liviana Da Dalt, Malte Kohns Vasconcelos, Julia Bielicki, Sophie Keers, Samsul Islam, Maria Tsolia, Jessica Jarvis, Carmen Rodriguez-Tenreiro Sánchez, Despoina Gkentzi, Louise Sigfrid, Peter Horby, Pieter L. A. Fraaij, Anna-Lena Gemmel, Andrew Riordan, Daniele Donà, Aggeliki Syggelou, Margareta Ieven, Virology, Pediatrics, National Institute for Health Research, Asthma UK, and Imperial College Healthcare NHS Trust- BRC Funding
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, viruses, Population, Respiratory Epidemiology, Respiratory Syncytial Virus Infections, medicine.disease_cause, Virus, 03 medical and health sciences, Diseases of the respiratory system, 0302 clinical medicine, respiratory infection, 030225 pediatrics, Internal medicine, Streptococcus pneumoniae, medicine, Humans, media_common.cataloged_instance, pneumonia, 030212 general & internal medicine, European union, education, Respiratory Tract Infections, media_common, clinical epidemiology, paediatric lung disaese, viral infection, education.field_of_study, RC705-779, business.industry, Respiratory infection, medicine.disease, 3. Good health, respiratory tract diseases, Hospitalization, Pneumonia, Case-Control Studies, Child, Preschool, Respiratory Syncytial Virus, Human, Attributable risk, Etiology, Medicine, Human medicine, business
Abstract: BackgroundBoth pathogenic bacteria and viruses are frequently detected in the nasopharynx (NP) of children in the absence of acute respiratory infection (ARI) symptoms. The aim of this study was to estimate the aetiological fractions for ARI hospitalisation in children for respiratory syncytial virus (RSV) and influenza virus and to determine whether detection of specific respiratory pathogens on NP samples was associated with ARI hospitalisation.Methods349 children up to 5 years of age hospitalised for ARI (following a symptom-based case definition) and 306 hospital controls were prospectively enrolled in 16 centres across seven European Union countries between 2016 and 2019. Admission day NP swabs were analysed by multiplex PCR for 25 targets.ResultsRSV was the leading single cause of ARI hospitalisations, with an overall population attributable fraction (PAF) of 33.4% and high seasonality as well as preponderance in younger children. Detection of RSV on NP swabs was strongly associated with ARI hospitalisation (OR adjusted for age and season: 20.6, 95% CI: 9.4 to 45.3). Detection of three other viral pathogens showed strong associations with ARI hospitalisation: influenza viruses had an adjusted OR of 6.1 (95% CI: 2.5 to 14.9), parainfluenza viruses (PIVs) an adjusted OR of 4.6 (95% CI: 1.8 to 11.3) and metapneumoviruses an adjusted OR of 4.5 (95% CI: 1.3 to 16.1). Influenza viruses had a PAF of 7.9%, PIVs of 6.5% and metapneumoviruses of 3.0%. In contrast, most other pathogens were found in similar proportions in cases and controls, including Streptococcus pneumoniae, which was weakly associated with case status, and endemic coronaviruses.ConclusionRSV is the predominant cause of ARI hospitalisations in young children in Europe and its detection, as well as detection of influenza virus, PIV or metapneumovirus, on NP swabs can establish aetiology with high probability. PAFs for RSV and influenza virus are highly seasonal and age dependent.
Published: 2021

34. Ventilator-associated Events in Children

Author: Elias Iosifidis and Susan E. Coffin
Subjects: Microbiology (medical), medicine.medical_specialty, Biomedical Research, business.industry, Critical Illness, Healthcare-Associated Pneumonia, Infant, Newborn, MEDLINE, Pneumonia, Ventilator-Associated, Research needs, Pneumonia ventilator associated, Home Care Services, Quality Improvement, Infectious Diseases, Practice Guidelines as Topic, Pediatrics, Perinatology and Child Health, medicine, Humans, Child, Intensive care medicine, business
Published: 2020

35. Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network

Author: Yogesha K N, Sithembiso Velaphi, Sanjeev Singh, Philippa Musoke, Sushma Nangia, Harish Chellani, Pra-ornsuda Sukrakanchana, Paul T. Heath, Tim R. Cressey, Angela Dramowski, Pongsatorn Paopongsawan, Linus Olson, Andrew Whitelaw, Stephen K. Obaro, André Ricardo Araujo da Silva, Ruth Guinsburg, Eitan Naaman Berezin, Suman Chaurasia, Anil Kumar, Carlos Eduardo da Silva Figueiredo, Jayashree Pukayastha, Adrie Bekker, Lifeng Qi, Raghuprakash Reddy Nayakanti, Leslie Lewis, Cristiane Teixeira, Joy Fredericks, Vassiliki Papaevangelou, Mike Sharland, Reenu Thomas, Kosmas Sarafidis, Daynia E Ballot, Julia Bielicki, Kanchana Preedisripipat, Paola Marsela Pérez, Mohammad Shahidul Islam, Emmanuel Roilides, Paul Turner, Elias Iosifidis, Srinivas Murki, Praveen Kumar, Pinelope Triantafyllidou, Trusha Nana, Suppawat Boonkasidecha, Gary Reubenson, Jaime Orrego, Grace Li, Pimol Wong, Suvaporn Anugulruengkitt, Dounghatai Pongpanut, Pagakrong Lumbiganon, Anongnart Sirisub, Dasaratha Ramaiah Jinka, Sorasak Lochindarat, A S M Nawshad Uddin Ahmed, Hemasree Kandraju, Mattias Larsson, Vikas Gautam, Ladin Nhan, Vinayagam Prakash, Clery B Gallacci, Arasar Seeralar, and Rosilene Santarone Vieira
Subjects: medicine.medical_specialty, medicine.diagnostic_test, Neonatal sepsis, business.industry, Psychological intervention, Prevalence, Resistance (psychoanalysis), 16. Peace & justice, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, 030225 pediatrics, Pediatrics, Perinatology and Child Health, medicine, Blood culture, Observational study, 030212 general & internal medicine, Intensive care medicine, business, Cohort study
Abstract: ObjectiveTo gain an understanding of the variation in available resources and clinical practices between neonatal units (NNUs) in the low-income and middle-income country (LMIC) setting to inform the design of an observational study on the burden of unit-level antimicrobial resistance (AMR).DesignA web-based survey using a REDCap database was circulated to NNUs participating in the Neonatal AMR research network. The survey included questions about NNU funding structure, size, admission rates, access to supportive therapies, empirical antimicrobial guidelines and period prevalence of neonatal blood culture isolates and their resistance patterns.Setting39 NNUs from 12 countries.PatientsAny neonate admitted to one of the participating NNUs.InterventionsThis was an observational cohort study.ResultsThe number of live births per unit ranged from 513 to 27 700 over the 12-month study period, with the number of neonatal cots ranging from 12 to 110. The proportion of preterm admissions ConclusionAMR is already a significant issue in NNUs worldwide. The apparent burden of AMR in a given NNU in the LMIC setting can be influenced by a range of factors which will vary substantially between NNUs. These variations must be considered when designing interventions to improve neonatal mortality globally.
Published: 2019

36. Use of Ceftazidime-avibactam for the Treatment of Extensively drug-resistant or Pan drug-resistant Klebsiella pneumoniae in Neonates and Children <5 Years of Age

Author: A Violaki, Eleni-Ifigeneia Christou, Eleni Agakidou, Charalampos Zarras, Maria Sdougka, Eleni Volakli, Aggeliki Kontou, Elisavet Chorafa, Vassiliki Drossou-Agakidou, Elias Iosifidis, and Emmanuel Roilides
Subjects: Male, Microbiology (medical), medicine.medical_specialty, Klebsiella pneumoniae, MEDLINE, Pan drug resistant, Microbial Sensitivity Tests, Drug resistance, Ceftazidime, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Drug Resistance, Multiple, Bacterial, 030225 pediatrics, Internal medicine, Severity of illness, Humans, Medicine, 030212 general & internal medicine, Retrospective Studies, Cross Infection, biology, business.industry, Age Factors, Infant, Newborn, Infant, Retrospective cohort study, biology.organism_classification, Ceftazidime/avibactam, Enterobacteriaceae, Anti-Bacterial Agents, Klebsiella Infections, Drug Combinations, Treatment Outcome, Infectious Diseases, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, business, Azabicyclo Compounds, medicine.drug
Abstract: Emergence of extensively drug-resistant (XDR) or pan drug-resistant (PDR) Enterobacteriaceae is a major public threat especially for young patients. Treatment options for these bacteria are extremely limited with no safety data existing for neonates and children. Ceftazidime-avibactam has activity against Gram-negative bacteria producing Klebsiella pneumoniae carbapenemase, but virtually no data exist on its use in neonatal and pediatric patients.We present a single-center case series of neonates and children5 years treated with ceftazidime-avibactam for XDR or PDR K. pneumoniae infections until August 2018. Medical records of patients who received ceftazidime-avibactam for at least 2 days (6 doses) were reviewed. Clinical, laboratory and microbiologic data were collected using a prestructured form. Adverse events and clinical/microbiologic responses and 15- and 30-day outcome were assessed.In our case series, 8 patients (median age 53 days, range from 13 days to 4.5 years) received 9 courses of ceftazidime-avibactam at a dose of 62.5 mg/kg q8h for suspected or proven XDR/PDR K. pneumoniae infections including bloodstream infections (8 courses), central nervous system infections (2 courses) and urinary tract infection (1 course). All patients were critically ill and received other antibiotics prior and concomitantly with the administration of ceftazidime-avibactam. There was no treatment discontinuation due to adverse events. Clinical and microbiologic responses occurred in all patients, and no patient died by day 30.Administration of ceftazidime-avibactam appears to be well tolerated and efficacious against in vitro susceptible XDR or PDR Enterobacteriaceae without being associated with significant adverse events.
Published: 2019

37. The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: from colonization to bloodstream infection

Author: Symeon Metallidis, Efthymia Petinaki, Eleni Antoniadou, Elias Iosifidis, Nicolaos Malisiovas, Konstantina Kontopoulou, Ergina Malli, Alkiviadis Vatopoulos, and Polychronis Tasioudis
Subjects: Adult, Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Adolescent, Klebsiella pneumoniae, medicine.drug_class, Critical Illness, 030106 microbiology, Antibiotics, Bacteremia, Microbiology, law.invention, Young Adult, 03 medical and health sciences, Risk Factors, law, Internal medicine, Drug Resistance, Bacterial, Humans, Medicine, Clinical significance, Colonization, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Greece, biology, business.industry, Critically ill, Rectum, General Medicine, Middle Aged, biology.organism_classification, Antimicrobial, Intensive care unit, Anti-Bacterial Agents, Klebsiella Infections, Intensive Care Units, 030104 developmental biology, Carbapenems, Case-Control Studies, Female, business
Abstract: Purpose . To highlight the clinical significance of carbapenem-resistant Klebsiella pneumoniae (CRKP) rectal colonization by examining the risk factors for CRKP rectal colonization and subsequent bloodstream infection (BSI) in critically ill patients. Methodology . Prospective study of CRKP rectal colonization in an intensive care unit (ICU) during a 39-month period. CRKP strains isolated from both the blood cultures and corresponding rectal specimens (n=96) of patients were screened by PCR for the presence of antibiotic resistance-associated genes. Molecular analyses were conducted to investigate the clonal relatedness of CRKP strains from the rectal and blood specimens. Results . Among the 498 patients, 226 were rectally colonized by CRKP, 48 of whom developed a CRKP BSI. The median time from hospital admission to the detection of CRKP rectal colonization was 8 days, while the median time from colonization to BSI was 4 days. The duration of ICU stay, patient/nurse ratio and prior use of antianaerobic antimicrobials were associated with CRKP rectal colonization. No specific factor was associated with BSIs in the colonized patients. The bla KPC-2 gene was detected in all 96 strains, which were all classified as sequence type ST-258. Representative pairs (n=48) of CRKP strains colonizing and infecting the same patient shared the same pulsotype. Conclusion . Our results indicate that hospitalized patients become infected with their colonizing strains, supporting the strong association between colonization and BSI. Limiting antianaerobic antimicrobial administration, reducing the duration of ICU stay and maintaining a low patient/nurse ratio are possible strategies to restrict rectal CRKP colonization in ICUs.
Published: 2019

38. The value of open-source clinical science in pandemic response

Author: Ali Abbas, Sheryl Ann Abdukahil, Nurul Najmee Abdulkadir, Ryuzo Abe, Laurent Abel, Lara Absil, Subhash Acharya, Andrew Acker, Shingo Adachi, Elisabeth Adam, Diana Adrião, Saleh Al Ageel, Shakeel Ahmed, Quratul Ain, Kate Ainscough, Tharwat Aisa, Ali Ait Hssain, Younes Ait Tamlihat, Takako Akimoto, Ernita Akmal, Eman Al Qasim, Razi Alalqam, Tanvir Alam, Tala Al-dabbous, Senthilkumar Alegesan, Cynthia Alegre, Marta Alessi, Beatrice Alex, Kévin Alexandre, Abdulrahman Al-Fares, Huda Alfoudri, Imran Ali, Naseem Ali Shah, Kazali Enagnon Alidjnou, Jeffrey Aliudin, Qabas Alkhafajee, Clotilde Allavena, Nathalie Allou, Aneela Altaf, João Alves, João Melo Alves, Rita Alves, Maria Amaral, Nur Amira, Heidi Ammerlaan, Phoebe Ampaw, Roberto Andini, Claire Andrejak, Andrea Angheben, François Angoulvant, Séverine Ansart, Sivanesen Anthonidass, Massimo Antonelli, Carlos Alexandre Antunes de Brito, Kazi Rubayet Anwar, Ardiyan Apriyana, Yaseen Arabi, Irene Aragao, Rajeshwari Arali, Francisco Arancibia, Carolline Araujo, Antonio Arcadipane, Patrick Archambault, Lukas Arenz, Jean-Benoît Arlet, Christel Arnold-Day, Ana Aroca, Lovkesh Arora, Rakesh Arora, Elise Artaud-Macari, Diptesh Aryal, Motohiro Asaki, Angel Asensio, Elizabeth Ashley, Muhammad Ashraf, Sheharyar Ashraf, Mohammad Asim, Jean Baptiste Assie, Amirul Asyraf, Anika Atique, AM Udara Lakshan Attanyake, Johann Auchabie, Hugues Aumaitre, Adrien Auvet, Laurène Azemar, Cecile Azoulay, Benjamin Bach, Delphine Bachelet, Claudine Badr, Nadia Baig, J. Kenneth Baillie, J Kevin Baird, Erica Bak, Agamemnon Bakakos, Nazreen Abu Bakar, Andriy Bal, Mohanaprasanth Balakrishnan, Valeria Balan, Firouzé Bani-Sadr, Renata Barbalho, Nicholas Yuri Barbosa, Wendy S. Barclay, Saef Umar Barnett, Michaela Barnikel, Helena Barrasa, Audrey Barrelet, Cleide Barrigoto, Marie Bartoli, Cheryl Bartone, Joaquín Baruch, Mustehan Bashir, Romain Basmaci, Muhammad Fadhli Hassin Basri, Diego Bastos, Denise Battaglini, Jules Bauer, Diego Fernando Bautista Rincon, Denisse Bazan Dow, Alexandra Bedossa, Ker Hong Bee, Sylvie Behilill, Albertus Beishuizen, Aleksandr Beljantsev, David Bellemare, Anna Beltrame, Beatriz Amorim Beltrão, Marine Beluze, Nicolas Benech, Lionel Eric Benjiman, Dehbia Benkerrou, Suzanne Bennett, Luís Bento, Jan-Erik Berdal, Delphine Bergeaud, Hazel Bergin, José Luis Bernal Sobrino, Giulia Bertoli, Lorenzo Bertolino, Simon Bessis, Adam Betz, Sybille Bevilcaqua, Karine Bezulier, Amar Bhatt, Krishna Bhavsar, Isabella Bianchi, Claudia Bianco, Farah Nadiah Bidin, Moirangthem Bikram Singh, Felwa Bin Humaid, Mohd Nazlin Bin Kamarudin, François Bissuel, Patrick Biston, Laurent Bitker, Pablo Blanco-Schweizer, Catherine Blier, Frank Bloos, Mathieu Blot, Lucille Blumberg, Filomena Boccia, Laetitia Bodenes, Alice Bogaarts, Debby Bogaert, Anne-Hélène Boivin, Pierre-Adrien Bolze, François Bompart, Aurelius Bonfasius, Diogo Borges, Raphaël Borie, Hans Martin Bosse, Elisabeth Botelho-Nevers, Lila Bouadma, Olivier Bouchaud, Sabelline Bouchez, Dounia Bouhmani, Damien Bouhour, Kévin Bouiller, Laurence Bouillet, Camile Bouisse, Anne-Sophie Boureau, John Bourke, Maude Bouscambert, Aurore Bousquet, Jason Bouziotis, Bianca Boxma, Marielle Boyer-Besseyre, Maria Boylan, Fernando Augusto Bozza, Matthew Brack, Axelle Braconnier, Cynthia Braga, Timo Brandenburger, Filipa Brás Monteiro, Luca Brazzi, Dorothy Breen, Patrick Breen, Stephen Brett, Kathy Brickell, Tessa Broadley, Alex Browne, Shaunagh Browne, Nicolas Brozzi, Marjolein Brusse-Keizer, Nina Buchtele, Christian Buesaquillo, Polina Bugaeva, Marielle Buisson, Erlina Burhan, Aidan Burrell, Ingrid G. Bustos, Denis Butnaru, André Cabie, Susana Cabral, Eder Caceres, Cyril Cadoz, Mia Callahan, Kate Calligy, Jose Andres Calvache, João Cam, Valentine Campana, Paul Campbell, Josie Campisi, Cecilia Canepa, Mireia Cantero, Pauline Caraux-Paz, Sheila Cárcel, Chiara Simona Cardellino, Filipa Cardoso, Filipe Cardoso, Nelson Cardoso, Sofia Cardoso, Simone Carelli, Nicolas Carlier, Thierry Carmoi, Gayle Carney, Chloe Carpenter, Inês Carqueja, Marie-Christine Carret, François Martin Carrier, Ida Carroll, Gail Carson, Ed Carton, Maire-Laure Casanova, Mariana Cascão, Siobhan Casey, José Casimiro, Bailey Cassandra, Silvia Castañeda, Nidyanara Castanheira, Guylaine Castor-Alexandre, Henry Castrillón, Ivo Castro, Ana Catarino, François-Xavier Catherine, Paolo Cattaneo, Roberta Cavalin, Giulio Giovanni Cavalli, Alexandros Cavayas, Adrian Ceccato, Minerva Cervantes-Gonzalez, Anissa Chair, Catherine Chakveatze, Adrienne Chan, Meera Chand, Christelle Chantalat Auger, Jean-Marc Chapplain, Julie Chas, Mobin Chaudary, Jonathan Samuel Chávez Iñiguez, Anjellica Chen, Yih-Sharng Chen, Matthew Pellan Cheng, Antoine Cheret, Thibault Chiarabini, Julian Chica, Suresh Kumar Chidambaram, Leong Chin-Tho, Catherine Chirouze, Davide Chiumello, Hwa Jin Cho, Sung-Min Cho, Bernard Cholley, Marie-Charlotte Chopin, Ting Soo Chow, Yock Ping Chow, Hiu Jian Chua, Jonathan Chua, Jose Pedro Cidade, José Miguel Cisneros Herreros, Barbara Wanjiru Citarella, Anna Ciullo, Emma Clarke, Jennifer Clarke, Rolando Claure Del Granado, Sara Clohisey, J. Perren Cobb, Necsoi Coca, Cassidy Codan, Caitriona Cody, Alexandra Coelho, Megan Coles, Gwenhaël Colin, Michael Collins, Sebastiano Maria Colombo, Pamela Combs, Jennifer Connolly, Marie Connor, Anne Conrad, Sofía Contreras, Elaine Conway, Graham S. Cooke, Mary Copland, Hugues Cordel, Amanda Corley, Sarah Cormican, Sabine Cornelis, Alexander Daniel Cornet, Arianne Joy Corpuz, Andrea Cortegiani, Grégory Corvaisier, Emma Costigan, Camille Couffignal, Sandrine Couffin-Cadiergues, Roxane Courtois, Stéphanie Cousse, Rachel Cregan, Charles Crepy D'Orleans, Sabine Croonen, Gloria Crowl, Jonathan Crump, Claudina Cruz, Juan Luis Cruz Berm, Jaime Cruz Rojo, Marc Csete, Alberto Cucino, Ailbhe Cullen, Caroline Cullen, Matthew Cummings, Gerard Curley, Elodie Curlier, Colleen Curran, Paula Custodio, Ana da Silva Filipe, Charlene Da Silveira, Al-Awwab Dabaliz, Andrew Dagens, Darren Dahly, Heidi Dalton, Jo Dalton, Seamus Daly, Federico D'Amico, Nick Daneman, Corinne Daniel, Emmanuelle A Dankwa, Jorge Dantas, Frédérick D’Aragon, Mark de Boer, Gillian de Loughry, Diego de Mendoza, Etienne De Montmollin, Rafael Freitas de Oliveira França, Ana Isabel de Pinho Oliveira, Rosanna De Rosa, Thushan de Silva, Peter de Vries, Jillian Deacon, David Dean, Alexa Debard, Bianca DeBenedictis, Marie-Pierre Debray, Nathalie DeCastro, William Dechert, Lauren Deconninck, Romain Decours, Eve Defous, Isabelle Delacroix, Eric Delaveuve, Karen Delavigne, Nathalie M. Delfos, Ionna Deligiannis, Andrea Dell'Amore, Christelle Delmas, Pierre Delobel, Corine Delsing, Elisa Demonchy, Emmanuelle Denis, Dominique Deplanque, Pieter Depuydt, Mehul Desai, Diane Descamps, Mathilde Desvallée, Santi Dewayanti, Alpha Diallo, Sylvain Diamantis, André Dias, Priscila Diaz, Rodrigo Diaz, Juan Jose Diaz Diaz, Kévin Didier, Jean-Luc Diehl, Wim Dieperink, Jérôme Dimet, Vincent Dinot, Fara Diop, Alphonsine Diouf, Yael Dishon, Devika Dixit, Félix Djossou, Annemarie B. Docherty, Helen Doherty, Arjen M Dondorp, Andy Dong, Christl A. Donnelly, Maria Donnelly, Chloe Donohue, Sean Donohue, Yoann Donohue, Ciara Doran, Peter Doran, Céline Dorival, Eric D'Ortenzio, James Joshua Douglas, Renee Douma, Nathalie Dournon, Triona Downer, Joanne Downey, Mark Downing, Tom Drake, Aoife Driscoll, Murray Dryden, Claudio Duarte Fonseca, Vincent Dubee, François Dubos, Alexandre Ducancelle, Toni Duculan, Susanne Dudman, Abhijit Duggal, Paul Dunand, Jake Dunning, Mathilde Duplaix, Emanuele Durante-Mangoni, Lucian Durham III, Bertrand Dussol, Juliette Duthoit, Xavier Duval, Anne Margarita Dyrhol-Riise, Sim Choon Ean, Marco Echeverria-Villalobos, Siobhan Egan, Carla Eira, Mohammed El Sanharawi, Subbarao Elapavaluru, Brigitte Elharrar, Jacobien Ellerbroek, Philippine Eloy, Tarek Elshazly, Iqbal Elyazar, Isabelle Enderle, Tomoyuki Endo, Chan Chee Eng, Ilka Engelmann, Vincent Enouf, Olivier Epaulard, Martina Escher, Mariano Esperatti, Hélène Esperou, Marina Esposito-Farese, João Estevão, Manuel Etienne, Nadia Ettalhaoui, Anna Greti Everding, Mirjam Evers, Isabelle Fabre, Marc Fabre, Amna Faheem, Arabella Fahy, Cameron J. Fairfield, Zul Fakar, Pedro Faria, Ahmed Farooq, Jeremy J. Farrar, Nataly Farshait, Hanan Fateena, Arie Zainul Fatoni, Karine Faure, Raphaël Favory, Mohamed Fayed, Niamh Feely, Laura Feeney, Jorge Fernandes, Marília Fernandes, Susana Fernandes, François-Xavier Ferrand, Eglantine Ferrand Devouge, Joana Ferrão, Mário Ferraz, Benigno Ferreira, Sílvia Ferreira, Ricard Ferrer-Roca, Nicolas Ferriere, Céline Ficko, Claudia Figueiredo-Mello, Juan Fiorda, Thomas Flament, Clara Flateau, Tom Fletcher, Letizia Lucia Florio, Brigid Flynn, Deirdre Flynn, Claire Foley, Jean Foley, Victor Fomin, Tatiana Fonseca, Patricia Fontela, Simon Forsyth, Denise Foster, Giuseppe Foti, Erwan Fourn, Robert A. Fowler, Dr Marianne Fraher, Diego Franch-Llasat, Christophe Fraser, John F. Fraser, Marcela Vieira Freire, Ana Freitas Ribeiro, Caren Friedrich, Ricardo Fritz, Stéphanie Fry, Nora Fuentes, Masahiro Fukuda, Valérie Gaborieau, Rostane Gaci, Massimo Gagliardi, Jean-Charles Gagnard, Nathalie Gagné, Amandine Gagneux-Brunon, Sérgio Gaião, Linda Gail Skeie, Phil Gallagher, Elena Gallego Curto, Carrol Gamble, Yasmin Gani, Arthur Garan, Rebekha Garcia, Noelia García Barrio, Julia Garcia-Diaz, Esteban Garcia-Gallo, Navya Garimella, Denis Garot, Valérie Garrait, Basanta Gauli, Nathalie Gault, Aisling Gavin, Anatoliy Gavrylov, Alexandre Gaymard, Johannes Gebauer, Eva Geraud, Louis Gerbaud Morlaes, Nuno Germano, praveen kumar ghisulal, Jade Ghosn, Marco Giani, Carlo Giaquinto, Jess Gibson, Tristan Gigante, Morgane Gilg, Elaine Gilroy, Guillermo Giordano, Michelle Girvan, Valérie Gissot, Judy Gitahi, Gezy Giwangkancana, Daniel Glikman, Petr Glybochko, Eric Gnall, Geraldine Goco, François Goehringer, Siri Goepel, Jean-Christophe Goffard, Jin Yi Goh, Jonathan Golob, Rui Gomes, Kyle Gomez, Joan Gómez-Junyent, Marie Gominet, Alicia Gonzalez, Patricia Gordon, Anthony Gordon, Isabelle Gorenne, Laure Goubert, Cécile Goujard, Tiphaine Goulenok, Margarite Grable, Jeronimo Graf, Edward Wilson Grandin, Pascal Granier, Giacomo Grasselli, Lorenzo Grazioli, Christopher A. Green, Courtney Greene, William Greenhalf, Segolène Greffe, Domenico Luca Grieco, Matthew Griffee, Fiona Griffiths, Ioana Grigoras, Albert Groenendijk, Anja Grosse Lordemann, Heidi Gruner, Yusing Gu, Fabio Guarracino, Jérémie Guedj, Martin Guego, Dewi Guellec, Anne-Marie Guerguerian, Daniela Guerreiro, Romain Guery, Anne Guillaumot, Laurent Guilleminault, Maisa Guimarães de Castro, Thomas Guimard, Marieke Haalboom, Daniel Haber, Hannah Habraken, Ali Hachemi, Nadir Hadri, Olena Haidash, Saeeda Haider, Fakhir Haidri, Sheeba Hakak, Adam Hall, Matthew Hall, Sophie Halpin, Ansley Hamer, Raph Hamers, Rebecca Hamidfar, Terese Hammond, Lim Yuen Han, Rashan Haniffa, Kok Wei Hao, Hayley Hardwick, Ewen M. Harrison, Janet Harrison, Samuel Bernard Ekow Harrison, Alan Hartman, Junaid Hashmi, Madiha Hashmi, Muhammad Hayat, Ailbhe Hayes, Leanne Hays, Jan Heerman, Lars Heggelund, Ross Hendry, Martina Hennessy, Aquiles Henriquez, Maxime Hentzien, Fivzia Herekar, Jaime Hernandez-Montfort, Daniel Herr, Andrew Hershey, Liv Hesstvedt, Astarini Hidayah, Dawn Higgins, Eibhilin Higgins, Grainne HigginsOKeeffe, Rita Hinchion, Samuel Hinton, Hiroaki Hiraiwa, Hikombo Hitoto, Antonia Ho, Yi Bin Ho, Alexandre Hoctin, Isabelle Hoffmann, Wei Han Hoh, Oscar Hoiting, Rebecca Holt, Jan Cato Holter, Peter Horby, Juan Pablo Horcajada, Koji Hoshino, Kota Hoshino, Ikram Houas, Catherine L. Hough, Stuart Houltham, Jimmy Ming-Yang Hsu, Jean-Sébastien Hulot, Iqbal Hussain, Samreen Ijaz, Hajnal-Gabriela Illes, Patrick Imbert, Mohammad Imran, Rana Imran Sikander, Hugo Inácio, Carmen Infante Dominguez, Yun Sii Ing, Elias Iosifidis, Mariachiara Ippolito, Sarah Isgett, Palliya Guruge Pramodya Ishani Ishani, Tiago Isidoro, Nadiah Ismail, Margaux Isnard, Junji Itai, Asami Ito, Daniel Ivulich, Danielle Jaafar, Salma Jaafoura, Julien Jabot, Clare Jackson, Nina Jamieson, Pierre Jaquet, Waasila Jassat, Coline Jaud-Fischer, Stéphane Jaureguiberry, Jeffrey Javidfar, Issrah Jawad, Denise Jaworsky, Devachandran Jayakumar, Florence Jego, Anilawati Mat Jelani, Synne Jenum, Ruth Jimbo-Sotomayor, van der Palen Job, Ong Yiaw Joe, Ruth N. Jorge García, Cédric Joseph, Mark Joseph, Swosti Joshi, Mercé Jourdain, Philippe Jouvet, Jennifer June, Anna Jung, Hanna Jung, Dafsah Juzar, Ouifiya Kafif, Florentia Kaguelidou, Neerusha Kaisbain, Thavamany Kaleesvran, Sabina Kali, Alina Kalicinska, Smaragdi Kalomoiri, Saima Kamal, Muhammad Aisar Ayadi Kamaluddin, Zul Amali Che Kamaruddin, Nadiah Kamarudin, Darshana Hewa Kandamby, Chris Kandel, Kong Yeow Kang, Ravi Kant, Darakhshan Kanwal, Dyah Kanyawati, Bipin Karki, Pratap Karpayah, Todd Karsies, Christiana Kartsonaki, Daisuke Kasugai, Anant Kataria, Kevin Katz, Aasmine Kaur, Simreen Kaur Johal, Tatsuya Kawasaki, Christy Kay, Hannah Keane, Seán Keating, Paul Kellam, Andrea Kelly, Aoife Kelly, Claire Kelly, Niamh Kelly, Sadie Kelly, Yvelynne Kelly, Maeve Kelsey, Ryan Kennedy, Kalynn Kennon, Maeve Kernan, Younes Kerroumi, Sharma Keshav, Evelyne Kestelyn, Imrana Khalid, Osama Khalid, Antoine Khalil, Coralie Khan, Irfan Khan, Sushil Khanal, Michelle E Kho, Denisa Khoo, Ryan Khoo, Saye Khoo, Nasir Khoso, Khor How Kiat, Yuri Kida, Peter Kiiza, Anders Benjamin Kildal, Jae Burm Kim, Antoine Kimmoun, Detlef Kindgen-Milles, Alexander King, Nobuya Kitamura, Paul Klenerman, Rob Klont, Gry Kloumann Bekken, Stephen Knight, Robin Kobbe, Chamira Kodippily, Malte Kohns Vasconcelos, Sabin Koirala, Mamoru Komatsu, Volkan Korten, Caroline Kosgei, Arsène Kpangon, Karolina Krawczyk, Sudhir Krishnan, Vinothini Krishnan, Oksana Kruglova, Ashok Kumar, Deepali Kumar, Ganesh Kumar, Mukesh Kumar, Pavan Kumar Vecham, Dinesh Kuriakose, Ethan Kurtzman, Neurinda Permata Kusumastuti, Demetrios Kutsogiannis, Galyna Kutsyna, Konstantinos Kyriakoulis, Marie Lachatre, Marie Lacoste, John G. Laffey, Marie Lagrange, Fabrice Laine, Olivier Lairez, Sanjay Lakhey, Antonio Lalueza, Marc Lambert, François Lamontagne, Marie Langelot-Richard, Vincent Langlois, Eka Yudha Lantang, Marina Lanza, Cédric Laouénan, Samira Laribi, Delphine Lariviere, Stéphane Lasry, Naveed Latif, Odile Launay, Didier Laureillard, Yoan Lavie-Badie, Andy Law, Cassie Lawrence, Teresa Lawrence, Minh Le, Clément Le Bihan, Cyril Le Bris, Georges Le Falher, Lucie Le Fevre, Quentin Le Hingrat, Marion Le Maréchal, Soizic Le Mestre, Gwenaël Le Moal, Vincent Le Moing, Hervé Le Nagard, Paul Le Turnier, Ema Leal, Marta Leal Santos, Biing Horng Lee, Heng Gee Lee, James Lee, Su Hwan Lee, Todd C. Lee, Yi Lin Lee, Gary Leeming, Bénédicte Lefebvre, Laurent Lefebvre, Benjamin Lefevre, Sylvie LeGac, Jean-Daniel Lelievre, François Lellouche, Adrien Lemaignen, Véronique Lemee, Anthony Lemeur, Gretchen Lemmink, Ha Sha Lene, Jenny Lennon, Rafael León, Marc Leone, Michela Leone, Quentin Lepiller, François-Xavier Lescure, Olivier Lesens, Mathieu Lesouhaitier, Amy Lester-Grant, Bruno Levy, Yves Levy, Claire Levy-Marchal, Katarzyna Lewandowska, Erwan L'Her, Gianluigi Li Bassi, Janet Liang, Ali Liaquat, Geoffrey Liegeon, Kah Chuan Lim, Wei Shen Lim, Chantre Lima, Bruno Lina, Lim Lina, Andreas Lind, Guillaume Lingas, Sylvie Lion-Daolio, Samantha Lissauer, Keibun Liu, Marine Livrozet, Patricia Lizotte, Antonio Loforte, Navy Lolong, Leong Chee Loon, Diogo Lopes, Dalia Lopez-Colon, Anthony L. Loschner, Paul Loubet, Bouchra Loufti, Guillame Louis, Silvia Lourenco, Lara Lovelace-Macon, Lee Lee Low, Marije Lowik, Jia Shyi Loy, Jean Christophe Lucet, Carlos Lumbreras Bermejo, Carlos M. Luna, Olguta Lungu, Liem Luong, Nestor Luque, Dominique Luton, Nilar Lwin, Ruth Lyons, Olavi Maasikas, Oryane Mabiala, Samual MacDonald, Sarah MacDonald, Moïse Machado, Gabriel Macheda, Juan Macias Sanchez, Jai Madhok, Guillermo Maestro de la Calle, Rafael Mahieu, Sophie Mahy, Ana Raquel Maia, Lars S. Maier, Mylène Maillet, Thomas Maitre, Maximilian Malfertheiner, Nadia Malik, Paddy Mallon, Fernando Maltez, Denis Malvy, Victoria Manda, Jose M. Mandei, Laurent Mandelbrot, Frank Manetta, Kishore Mangal, Julie Mankikian, Edmund Manning, Aldric Manuel, Ceila Maria Sant`Ana Malaque, Daniel Marino, Flávio Marino, Samuel Markowicz, Charbel Maroun Eid, Ana Marques, Catherine Marquis, Brian Marsh, Laura Marsh, Megan Marshal, John Marshall, Celina Turchi Martelli, Dori-Ann Martin, Emily Martin, Guillaume Martin-Blondel, Alessandra Martinelli, Ignacio Martin-Loeches, Martin Martinot, Alejandro Martin-Quiros, Ana Martins, João Martins, Nuno Martins, Caroline Martins Rego, Gennaro Martucci, Olga Martynenko, Eva Miranda Marwali, Marsilla Marzukie, Juan Fernado Masa Jimenez, David Maslove, Phillip Mason, Sabina Mason, Sobia Masood, Basri Mat Nor, Moshe Matan, Henrique Mateus Fernandes, Meghena Mathew, Daniel Mathieu, Mathieu Mattei, Romans Matulevics, Laurence Maulin, Michael Maxwell, Javier Maynar, Thierry Mazzoni, Lisa Mc Sweeney, Lorraine McAndrew, Colin McArthur, Aine McCarthy, Anne McCarthy, Colin McCloskey, Rachael McConnochie, Sherry McDermott, Sarah E. McDonald, Aine McElroy, Samuel McElwee, Victoria McEneany, Natalie McEvoy, Allison McGeer, Chris McKay, Johnny McKeown, Kenneth A. McLean, Paul McNally, Bairbre McNicholas, Elaine McPartlan, Edel Meaney, Cécile Mear-Passard, Maggie Mechlin, Maqsood Meher, Omar Mehkri, Ferruccio Mele, Luis Melo, Kashif Memon, Joao Joao Mendes, Ogechukwu Menkiti, Kusum Menon, France Mentré, Alexander J. Mentzer, Emmanuelle Mercier, Noémie Mercier, Antoine Merckx, Mayka Mergeay-Fabre, Blake Mergler, Laura Merson, António Mesquita, Osama Metwally, Agnès Meybeck, Dan Meyer, Alison M. Meynert, Vanina Meysonnier, Amina Meziane, Mehdi Mezidi, Giuliano Michelagnoli, Céline Michelanglei, Isabelle Michelet, Efstathia Mihelis, Vladislav Mihnovit, Hugo Miranda-Maldonado, Nor Arisah Misnan, Nik Nur Eliza Mohamed, Tahira Jamal Mohamed, Asma Moin, David Molina, Elena Molinos, Brenda Molloy, Mary Mone, Agostinho Monteiro, Claudia Montes, Giorgia Montrucchio, Sarah Moore, Shona C. Moore, Lina Morales Cely, Lucia Moro, Diego Rolando Morocho Tutillo, Ben Morton, Catherine Motherway, Ana Motos, Hugo Mouquet, Clara Mouton Perrot, Julien Moyet, Caroline Mudara, Aisha Kalsoom Mufti, Ng Yong Muh, Dzawani Muhamad, Jimmy Mullaert, Fredrik Muller, Karl Erik Müller, Daniel Munblit, Syed Muneeb, Nadeem Munir, Laveena Munshi, Aisling Murphy, Lorna Murphy, Marlène Murris, Srinivas Murthy, Himed Musaab, Gugapriyaa Muyandy, Dimitra Melia Myrodia, Namra N, Dave Nagpal, Alex Nagrebetsky, Mangala Narasimhan, Nageswaran Narayanan, Rashid Nasim Khan, Alasdair Nazerali-Maitland, Nadège Neant, Holger Neb, Nikita A Nekliudov, Erni Nelwan, Raul Neto, Emily Neumann, Bernardo Neves, Pauline Yeung Ng, Anthony Nghi, Duc Nguyen, Orna Ni Choileain, Niamh Ni Leathlobhair, Alistair Nichol, Prompak Nitayavardhana, Stephanie Nonas, Nurul Amani Mohd Noordin, Marion Noret, Nurul Faten Izzati Norharizam, Lisa Norman, Alessandra Notari, Mahdad Noursadeghi, Karolina Nowicka, Adam Nowinski, Saad Nseir, Jose I Nunez, Nurnaningsih Nurnaningsih, Elsa Nyamankolly, Fionnuala O Brien, Annmarie O'Callaghan, Giovanna Occhipinti, Derbrenn OConnor, Max O'Donnell, Tawnya Ogston, Takayuki Ogura, Tak-Hyuk Oh, Sophie O'Halloran, Katie O'Hearn, Shinichiro Ohshimo, Agnieszka Oldakowska, João Oliveira, Larissa Oliveira, Piero L. Olliaro, Conar O'Neil, David S.Y. Ong, Jee Yan Ong, Wilna Oosthuyzen, Anne Opavsky, Peter Openshaw, Saijad Orakzai, Claudia Milena Orozco-Chamorro, Andrés Orquera, Jamel Ortoleva, Javier Osatnik, Linda O'Shea, Miriam O'Sullivan, Siti Zubaidah Othman, Nadia Ouamara, Rachida Ouissa, Clark Owyang, Eric Oziol, H M Upulee Pabasara, Maïder Pagadoy, Justine Pages, Amanda Palacios, Mario Palacios, Massimo Palmarini, Giovanna Panarello, Prasan Kumar Panda, Hem Paneru, Lai Hui Pang, Mauro Panigada, Nathalie Pansu, Aurélie Papadopoulos, Rachael Parke, Melissa Parker, Briseida Parra, Vieri Parrini, Taha Pasha, Jérémie Pasquier, Bruno Pastene, Fabian Patauner, Junaid Patel, Mohan Dass Pathmanathan, Luís Patrão, Patricia Patricio, Juliette Patrier, Lisa Patterson, Rajyabardhan Pattnaik, Christelle Paul, Mical Paul, Jorge Paulos, William A. Paxton, Jean-François Payen, Kalaiarasu Peariasamy, Miguel Pedrera Jiménez, Giles J. Peek, Florent Peelman, Nathan Peiffer-Smadja, Vincent Peigne, Mare Pejkovska, Paolo Pelosi, Ithan D. Peltan, Rui Pereira, Daniel Perez, Luis Periel, Thomas Perpoint, Antonio Pesenti, Vincent Pestre, Lenka Petrou, Ventzislava Petrov-Sanchez, Frank Olav Pettersen, Gilles Peytavin, Scott Pharand, Michael Piagnerelli, Walter Picard, Olivier Picone, Maria de Piero, Carola Pierobon, Djura Piersma, Carlos Pimentel, Raquel Pinto, Catarina Pires, Isabelle Pironneau, Lionel Piroth, Riinu Pius, Simone Piva, Laurent Plantier, Daniel Plotkin, Hon Shen Png, Julien Poissy, Ryadh Pokeerbux, Maria Pokorska-Spiewak, Sergio Poli, Georgios Pollakis, Diane Ponscarme, Jolanta Popielska, Andra-Maris Post, Douwe F. Postma, Pedro Povoa, Diana Póvoas, Jeff Powis, Sofia Prapa, Sébastien Preau, Christian Prebensen, Jean-Charles Preiser, Anton Prinssen, Mark G. Pritchard, Gamage Dona Dilanthi Priyadarshani, Lucia Proença, Sravya Pudota, Oriane Puéchal, Bambang Pujo Semedi, Mathew Pulicken, Matteo Puntoni, Gregory Purcell, Luisa Quesada, Vilmaris Quinones-Cardona, Víctor Quirós González, Else Quist-Paulsen, Mohammed Quraishi, Maia Rabaa, Christian Rabaud, Ebenezer Rabindrarajan, Aldo Rafael, Marie Rafiq, Gabrielle Ragazzo, Ahmad Kashfi Haji Ab Rahman, Rozanah Abd Rahman, Arsalan Rahutullah, Fernando Rainieri, Giri Shan Rajahram, Nipunie Rajapakse, Azrina Ralib, Nagarajan Ramakrishnan, Kollengode Ramanathan, Ahmad Afiq Ramli, Blandine Rammaert, Grazielle Viana Ramos, Asim Rana, Rajavardhan Rangappa, Ritika Ranjan, Christophe Rapp, Aasiyah Rashan, Thalha Rashan, Ghulam Rasheed, Menaldi Rasmin, Indrek Rätsep, Cornelius Rau, Tharmini Ravi, Ali Raza, Andre Real, Stanislas Rebaudet, Sarah Redl, Brenda Reeve, Ali Rehan, Attaur Rehman, Liadain Reid, Dag Henrik Reikvam, Renato Reis, Jordi Rello, Jonathan Remppis, Martine Remy, Hongru Ren, Hanna Renk, Liliana Resende, Anne-Sophie Resseguier, Matthieu Revest, Oleksa Rewa, Luis Felipe Reyes, Tiago Reyes, Maria Ines Ribeiro, David Richardson, Denise Richardson, Laurent Richier, Siti Nurul Atikah Ahmad Ridzuan, Jordi Riera, Ana L Rios, Asgar Rishu, Patrick Rispal, Karine Risso, Maria Angelica Rivera Nuñez, Nicholas Rizer, Doug Robb, Chiara Robba, André Roberto, Stephanie Roberts, David L. Robertson, Olivier Robineau, Ferran Roche-Campo, Paola Rodari, Simão Rodeia, Julia Rodriguez Abreu, Bernhard Roessler, Claire Roger, Pierre-Marie Roger, Emmanuel Roilides, Amanda Rojek, Juliette Romaru, Roberto Roncon-Albuquerque Jr, Mélanie Roriz, Manuel Rosa-Calatrava, Michael Rose, Dorothea Rosenberger, Andrea Rossanese, Matteo Rossetti, Bénédicte Rossignol, Patrick Rossignol, Stella Rousset, Carine Roy, Benoît Roze, Desy Rusmawatiningtyas, Clark D. Russell, Maeve Ryan, Maria Ryan, Steffi Ryckaert, Aleksander Rygh Holten, Isabela Saba, Sairah Sadaf, Musharaf Sadat, Valla Sahraei, Maximilien Saint-Gilles, Pranya Sakiyalak, Nawal Salahuddin, Leonardo Salazar, Jodat Saleem, Gabriele Sales, Stéphane Sallaberry, Charlotte Salmon Gandonniere, Hélène Salvator, Olivier Sanchez, Xavier Sánchez Choez, Kizy Sanchez de Oliveira, Angel Sanchez-Miralles, Vanessa Sancho-Shimizu, Gyan Sandhu, Zulfiqar Sandhu, Pierre-François Sandrine, Oana Sandulescu, Marlene Santos, Shirley Sarfo-Mensah, Bruno Sarmento Banheiro, Iam Claire E. Sarmiento, Benjamine Sarton, Sree Satyapriya, Rumaisah Satyawati, Egle Saviciute, Raymond Savio, Parthena Savvidou, Yen Tsen Saw, Justin Schaffer, Tjard Schermer, Arnaud Scherpereel, Marion Schneider, Stephan Schroll, Michael Schwameis, Gary Schwartz, Janet T. Scott, James Scott-Brown, Nicholas Sedillot, Tamara Seitz, Jaganathan Selvanayagam, Mageswari Selvarajoo, Caroline Semaille, Malcolm G. Semple, Rasidah Bt Senian, Eric Senneville, Claudia Sepulveda, Filipa Sequeira, Tânia Sequeira, Ary Serpa Neto, Pablo Serrano Balazote, Ellen Shadowitz, Syamin Asyraf Shahidan, Mohd Shahnaz Hasan, Mohammad Shamsah, Anuraj Shankar, Shaikh Sharjeel, Pratima Sharma, Catherine A. Shaw, Victoria Shaw, Haixia Shi, Nisreen Shiban, Mohiuddin Shiekh, Takuya Shiga, Nobuaki Shime, Hiroaki Shimizu, Keiki Shimizu, Naoki Shimizu, Nahoko Shindo, Sally Shrapnel, Hoi Ping Shum, Nassima Si Mohammed, Ng Yong Siang, Jeanne Sibiude, Atif Siddiqui, Louise Sigfrid, Piret Sillaots, Catarina Silva, Maria Joao Silva, Rogério Silva, Benedict Sim Lim Heng, Wai Ching Sin, Budha Charan Singh, Punam Singh, Pompini Agustina Sitompul, Karisha Sivam, Vegard Skogen, Sue Smith, Benjamin Smood, Coilin Smyth, Michelle Smyth, Morgane Snacken, Dominic So, Tze Vee Soh, Monserrat Solis, Joshua Solomon, Tom Solomon, Emily Somers, Agnès Sommet, Myung Jin Song, Rima Song, Tae Song, Jack Song Chia, Michael Sonntagbauer, Azlan Mat Soom, Alberto Sotto, Edouard Soum, Ana Chora Sousa, Marta Sousa, Maria Sousa Uva, Vicente Souza-Dantas, Alexandra Sperry, Elisabetta Spinuzza, B. P. Sanka Ruwan Sri Darshana, Shiranee Sriskandan, Sarah Stabler, Thomas Staudinger, Stephanie-Susanne Stecher, Trude Steinsvik, Ymkje Stienstra, Birgitte Stiksrud, Eva Stolz, Amy Stone, Adrian Streinu-Cercel, Anca Streinu-Cercel, Samantha Strudwick, Ami Stuart, David Stuart, Decy Subekti, Gabriel Suen, Jacky Y. Suen, Prasanth Sukumar, Asfia Sultana, Charlotte Summers, Dubravka Supic, Deepashankari Suppiah, Magdalena Surovcová, Suwarti Suwarti, Andrey A Svistunov, Sarah Syahrin, Konstantinos Syrigos, Jaques Sztajnbok, Konstanty Szuldrzynski, Shirin Tabrizi, Fabio S. Taccone, Lysa Tagherset, Shahdattul Mawarni Taib, Ewa Talarek, Sara Taleb, Jelmer Talsma, Maria Lawrensia Tampubolon, Kim Keat Tan, Le Van Tan, Yan Chyi Tan, Clarice Tanaka, Hiroyuki Tanaka, Taku Tanaka, Hayato Taniguchi, Hussain Tanveer, Huda Taqdees, Arshad Taqi, Coralie Tardivon, Pierre Tattevin, M Azhari Taufik, Hassan Tawfik, Richard S. Tedder, Tze Yuan Tee, João Teixeira, Sofia Tejada, Marie-Capucine Tellier, Sze Kye Teoh, Vanessa Teotonio, François Téoulé, Pleun Terpstra, Olivier Terrier, Nicolas Terzi, Hubert Tessier-Grenier, Adrian Tey, Alif Adlan Mohd Thabit, Zhang Duan Tham, Suvintheran Thangavelu, Vincent Thibault, Simon-Djamel Thiberville, Benoît Thill, Jananee Thirumanickam, Shaun Thompson, David Thomson, Emma C. Thomson, Surain Raaj Thanga Thurai, Duong Bich Thuy, Ryan S. Thwaites, Paul Tierney, Vadim Tieroshyn, Peter S Timashev, Jean-François Timsit, Bharath Kumar Tirupakuzhi Vijayaraghavan, Noémie Tissot, Jordan Zhien Yang Toh, Maria Toki, Timo Tolppa, Kristian Tonby, Sia Loong Tonnii, Antoni Torres, Margarida Torres, Rosario Maria Torres Santos-Olmo, Hernando Torres-Zevallos, Michael Towers, Tony Trapani, Damien Traynor, Théo Treoux, Huynh Trung Trieu, Swagata Tripathy, Cécile Tromeur, Ioannis Trontzas, Tiffany Trouillon, Jeanne Truong, Christelle Tual, Sarah Tubiana, Helen Tuite, Jean-Marie Turmel, Lance C.W. Turtle, Anders Tveita, Pawel Twardowski, Makoto Uchiyama, PG Ishara Udayanga, Andrew Udy, Roman Ullrich, Zubair Umer, Alberto Uribe, Asad Usman, Cristinava Vajdovics, Luís Val-Flores, Ana Luiza Valle, Amélie Valran, Stijn Van de Velde, Marcel van den Berge, Machteld van der Feltz, Paul van der Valk, Nicky Van Der Vekens, Peter Van der Voort, Sylvie Van Der Werf, Marlice van Dyk, Laura van Gulik, Jarne Van Hattem, Steven van Lelyveld, Carolien van Netten, Gitte Van Twillert, Ilonka van Veen, Noémie Vanel, Henk Vanoverschelde, Pooja Varghese, Michael Varrone, Shoban Raj Vasudayan, Charline Vauchy, Helen Vaughan, Shaminee Veeran, Aurélie Veislinger, Sebastian Vencken, Sara Ventura, Annelies Verbon, José Ernesto Vidal, César Vieira, Deepak Vijayan, Joy Ann Villanueva, Judit Villar, Pierre-Marc Villeneuve, Andrea Villoldo, Nguyen Van Vinh Chau, Benoit Visseaux, Hannah Visser, Chiara Vitiello, Harald Vonkeman, Fanny Vuotto, Noor Hidayu Wahab, Suhaila Abdul Wahab, Nadirah Abdul Wahid, Marina Wainstein, Wan Fadzlina Wan Muhd Shukeri, Chih-Hsien Wang, Steven Anthony Webb, Jia Wei, Katharina Weil, Tan Pei Wen, Sanne Wesselius, T. Eoin West, Murray Wham, Bryan Whelan, Nicole White, Paul Henri Wicky, Aurélie Wiedemann, Surya Otto Wijaya, Keith Wille, Suzette Willems, Virginie Williams, Evert-Jan Wils, Ng Wing Yiu, Calvin Wong, Teck Fung Wong, Xin Ci Wong, Yew Sing Wong, Gan Ee Xian, Lim Saio Xian, Kuan Pei Xuan, Ioannis Xynogalas, Sophie Yacoub, Siti Rohani Binti Mohd Yakop, Masaki Yamazaki, Yazdan Yazdanpanah, Nicholas Yee Liang Hing, Cécile Yelnik, Chian Hui Yeoh, Stephanie Yerkovich, Toshiki Yokoyama, Hodane Yonis, Obada Yousif, Saptadi Yuliarto, Akram Zaaqoq, Marion Zabbe, Kai Zacharowski, Masliza Zahid, Maram Zahran, Nor Zaila Binti Zaidan, Maria Zambon, Miguel Zambrano, Alberto Zanella, Konrad Zawadka, Nurul Zaynah, Hiba Zayyad, Alexander Zoufaly, David Zucman, ESTACA'Lab ( ESTACA'Lab ), École Supérieure des Techniques Aéronautiques et de Construction Automobile (ESTACA), Laboratoire d’Ingénierie Circulation Transport et Éco-gestion des systèmes énergétiques pour les transports (LICIT-Eco7), École Nationale des Travaux Publics de l'État (ENTPE)-Université Gustave Eiffel, St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller University [New York], Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Department of Mathematics and Statistics, Wichita State University, Indo-French Center for Groundwater Research (IFCGR), Bureau de Recherches Géologiques et Minières (BRGM) (BRGM)-National Geophysical Research Institute [Hyderabad] (NGRI), National Geophysical Research Institute [Hyderabad] (NGRI), Department of Zoology [Rawalpindi, Pakistan], Pir Mehr Ali Shah Arid Agriculture University = PMAS-Arid Agriculture University Rawalpindi (AAUR), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Institut Pasteur [Paris] (IP)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Abbas A., Abdukahil S.A., Abdulkadir N.N., Abe R., Abel L., Absil L., Acharya S., Acker A., Adachi S., Adam E., Adriao D., Ageel S.A., Ahmed S., Ain Q., Ainscough K., Aisa T., Ait Hssain A., Ait Tamlihat Y., Akimoto T., Akmal E., Al Qasim E., Alalqam R., Alam T., Al-dabbous T., Alegesan S., Alegre C., Alessi M., Alex B., Alexandre K., Al-Fares A., Alfoudri H., Ali I., Ali Shah N., Alidjnou K.E., Aliudin J., Alkhafajee Q., Allavena C., Allou N., Altaf A., Alves J., Alves J.M., Alves R., Amaral M., Amira N., Ammerlaan H., Ampaw P., Andini R., Andrejak C., Angheben A., Angoulvant F., Ansart S., Anthonidass S., Antonelli M., Antunes de Brito C.A., Anwar K.R., Apriyana A., Arabi Y., Aragao I., Arali R., Arancibia F., Araujo C., Arcadipane A., Archambault P., Arenz L., Arlet J.-B., Arnold-Day C., Aroca A., Arora L., Arora R., Artaud-Macari E., Aryal D., Asaki M., Asensio A., Ashley E., Ashraf M., Ashraf S., Asim M., Assie J.B., Asyraf A., Atique A., Attanyake A.U.L., Auchabie J., Aumaitre H., Auvet A., Azemar L., Azoulay C., Bach B., Bachelet D., Badr C., Baig N., Baillie J.K., Baird J.K., Bak E., Bakakos A., Bakar N.A., Bal A., Balakrishnan M., Balan V., Bani-Sadr F., Barbalho R., Barbosa N.Y., Barclay W.S., Barnett S.U., Barnikel M., Barrasa H., Barrelet A., Barrigoto C., Bartoli M., Bartone C., Baruch J., Bashir M., Basmaci R., Basri M.F.H., Bastos D., Battaglini D., Bauer J., Bautista Rincon D.F., Bazan Dow D., Bedossa A., Bee K.H., Behilill S., Beishuizen A., Beljantsev A., Bellemare D., Beltrame A., Beltrao B.A., Beluze M., Benech N., Benjiman L.E., Benkerrou D., Bennett S., Bento L., Berdal J.-E., Bergeaud D., Bergin H., Bernal Sobrino J.L., Bertoli G., Bertolino L., Bessis S., Betz A., Bevilcaqua S., Bezulier K., Bhatt A., Bhavsar K., Bianchi I., Bianco C., Bidin F.N., Bikram Singh M., Bin Humaid F., Bin Kamarudin M.N., Bissuel F., Biston P., Bitker L., Blanco-Schweizer P., Blier C., Bloos F., Blot M., Blumberg L., Boccia F., Bodenes L., Bogaarts A., Bogaert D., Boivin A.-H., Bolze P.-A., Bompart F., Bonfasius A., Borges D., Borie R., Bosse H.M., Botelho-Nevers E., Bouadma L., Bouchaud O., Bouchez S., Bouhmani D., Bouhour D., Bouiller K., Bouillet L., Bouisse C., Boureau A.-S., Bourke J., Bouscambert M., Bousquet A., Bouziotis J., Boxma B., Boyer-Besseyre M., Boylan M., Bozza F.A., Brack M., Braconnier A., Braga C., Brandenburger T., Bras Monteiro F., Brazzi L., Breen D., Breen P., Brett S., Brickell K., Broadley T., Browne A., Browne S., Brozzi N., Brusse-Keizer M., Buchtele N., Buesaquillo C., Bugaeva P., Buisson M., Burhan E., Burrell A., Bustos I.G., Butnaru D., Cabie A., Cabral S., Caceres E., Cadoz C., Callahan M., Calligy K., Calvache J.A., Cam J., Campana V., Campbell P., Campisi J., Canepa C., Cantero M., Caraux-Paz P., Carcel S., Cardellino C.S., Cardoso F., Cardoso N., Cardoso S., Carelli S., Carlier N., Carmoi T., Carney G., Carpenter C., Carqueja I., Carret M.-C., Carrier F.M., Carroll I., Carson G., Carton E., Casanova M.-L., Cascao M., Casey S., Casimiro J., Cassandra B., Castaneda S., Castanheira N., Castor-Alexandre G., Castrillon H., Castro I., Catarino A., Catherine F.-X., Cattaneo P., Cavalin R., Cavalli G.G., Cavayas A., Ceccato A., Cervantes-Gonzalez M., Chair A., Chakveatze C., Chan A., Chand M., Chantalat Auger C., Chapplain J.-M., Chas J., Chaudary M., Chavez Iniguez J.S., Chen A., Chen Y.-S., Cheng M.P., Cheret A., Chiarabini T., Chica J., Chidambaram S.K., Chin-Tho L., Chirouze C., Chiumello D., Cho H.J., Cho S.-M., Cholley B., Chopin M.-C., Chow T.S., Chow Y.P., Chua H.J., Chua J., Cidade J.P., Cisneros Herreros J.M., Citarella B.W., Ciullo A., Clarke E., Clarke J., Claure Del Granado R., Clohisey S., Cobb J.P., Coca N., Codan C., Cody C., Coelho A., Coles M., Colin G., Collins M., Colombo S.M., Combs P., Connolly J., Connor M., Conrad A., Contreras S., Conway E., Cooke G.S., Copland M., Cordel H., Corley A., Cormican S., Cornelis S., Cornet A.D., Corpuz A.J., Cortegiani A., Corvaisier G., Costigan E., Couffignal C., Couffin-Cadiergues S., Courtois R., Cousse S., Cregan R., Crepy D'Orleans C., Croonen S., Crowl G., Crump J., Cruz C., Cruz Berm J.L., Cruz Rojo J., Csete M., Cucino A., Cullen A., Cullen C., Cummings M., Curley G., Curlier E., Curran C., Custodio P., da Silva Filipe A., Da Silveira C., Dabaliz A.-A., Dagens A., Dahly D., Dalton H., Dalton J., Daly S., D'Amico F., Daneman N., Daniel C., Dankwa E.A., Dantas J., D'Aragon F., de Boer M., de Loughry G., de Mendoza D., De Montmollin E., de Oliveira Franca R.F., de Pinho Oliveira A.I., De Rosa R., de Silva T., de Vries P., Deacon J., Dean D., Debard A., DeBenedictis B., Debray M.-P., DeCastro N., Dechert W., Deconninck L., Decours R., Defous E., Delacroix I., Delaveuve E., Delavigne K., Delfos N.M., Deligiannis I., Dell'Amore A., Delmas C., Delobel P., Delsing C., Demonchy E., Denis E., Deplanque D., Depuydt P., Desai M., Descamps D., Desvallee M., Dewayanti S., Diallo A., Diamantis S., Dias A., Diaz P., Diaz R., Diaz Diaz J.J., Didier K., Diehl J.-L., Dieperink W., Dimet J., Dinot V., Diop F., Diouf A., Dishon Y., Dixit D., Djossou F., Docherty A.B., Doherty H., Dondorp A.M., Dong A., Donnelly C.A., Donnelly M., Donohue C., Donohue S., Donohue Y., Doran C., Doran P., Dorival C., D'Ortenzio E., Douglas J.J., Douma R., Dournon N., Downer T., Downey J., Downing M., Drake T., Driscoll A., Dryden M., Duarte Fonseca C., Dubee V., Dubos F., Ducancelle A., Duculan T., Dudman S., Duggal A., Dunand P., Dunning J., Duplaix M., Durante-Mangoni E., Durham III L., Dussol B., Duthoit J., Duval X., Dyrhol-Riise A.M., Ean S.C., Echeverria-Villalobos M., Egan S., Eira C., El Sanharawi M., Elapavaluru S., Elharrar B., Ellerbroek J., Eloy P., Elshazly T., Elyazar I., Enderle I., Endo T., Eng C.C., Engelmann I., Enouf V., Epaulard O., Escher M., Esperatti M., Esperou H., Esposito-Farese M., Estevao J., Etienne M., Ettalhaoui N., Everding A.G., Evers M., Fabre I., Fabre M., Faheem A., Fahy A., Fairfield C.J., Fakar Z., Faria P., Farooq A., Farrar J.J., Farshait N., Fateena H., Fatoni A.Z., Faure K., Favory R., Fayed M., Feely N., Feeney L., Fernandes J., Fernandes M., Fernandes S., Ferrand F.-X., Ferrand Devouge E., Ferrao J., Ferraz M., Ferreira B., Ferreira S., Ferrer-Roca R., Ferriere N., Ficko C., Figueiredo-Mello C., Fiorda J., Flament T., Flateau C., Fletcher T., Florio L.L., Flynn B., Flynn D., Foley C., Foley J., Fomin V., Fonseca T., Fontela P., Forsyth S., Foster D., Foti G., Fourn E., Fowler R.A., Fraher D.M., Franch-Llasat D., Fraser C., Fraser J.F., Freire M.V., Freitas Ribeiro A., Friedrich C., Fritz R., Fry S., Fuentes N., Fukuda M., Gaborieau V., Gaci R., Gagliardi M., Gagnard J.-C., Gagne N., Gagneux-Brunon A., Gaiao S., Gail Skeie L., Gallagher P., Gallego Curto E., Gamble C., Gani Y., Garan A., Garcia R., Garcia Barrio N., Garcia-Diaz J., Garcia-Gallo E., Garimella N., Garot D., Garrait V., Gauli B., Gault N., Gavin A., Gavrylov A., Gaymard A., Gebauer J., Geraud E., Gerbaud Morlaes L., Germano N., ghisulal P.K., Ghosn J., Giani M., Giaquinto C., Gibson J., Gigante T., Gilg M., Gilroy E., Giordano G., Girvan M., Gissot V., Gitahi J., Giwangkancana G., Glikman D., Glybochko P., Gnall E., Goco G., Goehringer F., Goepel S., Goffard J.-C., Goh J.Y., Golob J., Gomes R., Gomez K., Gomez-Junyent J., Gominet M., Gonzalez A., Gordon P., Gordon A., Gorenne I., Goubert L., Goujard C., Goulenok T., Grable M., Graf J., Grandin E.W., Granier P., Grasselli G., Grazioli L., Green C.A., Greene C., Greenhalf W., Greffe S., Grieco D.L., Griffee M., Griffiths F., Grigoras I., Groenendijk A., Grosse Lordemann A., Gruner H., Gu Y., Guarracino F., Guedj J., Guego M., Guellec D., Guerguerian A.-M., Guerreiro D., Guery R., Guillaumot A., Guilleminault L., Guimaraes de Castro M., Guimard T., Haalboom M., Haber D., Habraken H., Hachemi A., Hadri N., Haidash O., Haider S., Haidri F., Hakak S., Hall A., Hall M., Halpin S., Hamer A., Hamers R., Hamidfar R., Hammond T., Han L.Y., Haniffa R., Hao K.W., Hardwick H., Harrison E.M., Harrison J., Harrison S.B.E., Hartman A., Hashmi J., Hashmi M., Hayat M., Hayes A., Hays L., Heerman J., Heggelund L., Hendry R., Hennessy M., Henriquez A., Hentzien M., Herekar F., Hernandez-Montfort J., Herr D., Hershey A., Hesstvedt L., Hidayah A., Higgins D., Higgins E., HigginsOKeeffe G., Hinchion R., Hinton S., Hiraiwa H., Hitoto H., Ho A., Ho Y.B., Hoctin A., Hoffmann I., Hoh W.H., Hoiting O., Holt R., Holter J.C., Horby P., Horcajada J.P., Hoshino K., Houas I., Hough C.L., Houltham S., Hsu J.M.-Y., Hulot J.-S., Hussain I., Ijaz S., Illes H.-G., Imbert P., Imran M., Imran Sikander R., Inacio H., Infante Dominguez C., Ing Y.S., Iosifidis E., Ippolito M., Isgett S., Ishani P.G.P.I., Isidoro T., Ismail N., Isnard M., Itai J., Ito A., Ivulich D., Jaafar D., Jaafoura S., Jabot J., Jackson C., Jamieson N., Jaquet P., Jassat W., Jaud-Fischer C., Jaureguiberry S., Javidfar J., Jawad I., Jaworsky D., Jayakumar D., Jego F., Jelani A.M., Jenum S., Jimbo-Sotomayor R., Job V.D.P., Joe O.Y., Jorge Garcia R.N., Joseph C., Joseph M., Joshi S., Jourdain M., Jouvet P., June J., Jung A., Jung H., Juzar D., Kafif O., Kaguelidou F., Kaisbain N., Kaleesvran T., Kali S., Kalicinska A., Kalomoiri S., Kamal S., Kamaluddin M.A.A., Kamaruddin Z.A.C., Kamarudin N., Kandamby D.H., Kandel C., Kang K.Y., Kant R., Kanwal D., Kanyawati D., Karki B., Karpayah P., Karsies T., Kartsonaki C., Kasugai D., Kataria A., Katz K., Kaur A., Kaur Johal S., Kawasaki T., Kay C., Keane H., Keating S., Kellam P., Kelly A., Kelly C., Kelly N., Kelly S., Kelly Y., Kelsey M., Kennedy R., Kennon K., Kernan M., Kerroumi Y., Keshav S., Kestelyn E., Khalid I., Khalid O., Khalil A., Khan C., Khan I., Khanal S., Kho M.E., Khoo D., Khoo R., Khoo S., Khoso N., Kiat K.H., Kida Y., Kiiza P., Kildal A.B., Kim J.B., Kimmoun A., Kindgen-Milles D., King A., Kitamura N., Klenerman P., Klont R., Kloumann Bekken G., Knight S., Kobbe R., Kodippily C., Kohns Vasconcelos M., Koirala S., Komatsu M., Korten V., Kosgei C., Kpangon A., Krawczyk K., Krishnan S., Krishnan V., Kruglova O., Kumar A., Kumar D., Kumar G., Kumar M., Kumar Vecham P., Kuriakose D., Kurtzman E., Kusumastuti N.P., Kutsogiannis D., Kutsyna G., Kyriakoulis K., Lachatre M., Lacoste M., Laffey J.G., Lagrange M., Laine F., Lairez O., Lakhey S., Lalueza A., Lambert M., Lamontagne F., Langelot-Richard M., Langlois V., Lantang E.Y., Lanza M., Laouenan C., Laribi S., Lariviere D., Lasry S., Latif N., Launay O., Laureillard D., Lavie-Badie Y., Law A., Lawrence C., Lawrence T., Le M., Le Bihan C., Le Bris C., Le Falher G., Le Fevre L., Le Hingrat Q., Le Marechal M., Le Mestre S., Le Moal G., Le Moing V., Le Nagard H., Le Turnier P., Leal E., Leal Santos M., Lee B.H., Lee H.G., Lee J., Lee S.H., Lee T.C., Lee Y.L., Leeming G., Lefebvre B., Lefebvre L., Lefevre B., LeGac S., Lelievre J.-D., Lellouche F., Lemaignen A., Lemee V., Lemeur A., Lemmink G., Lene H.S., Lennon J., Leon R., Leone M., Lepiller Q., Lescure F.-X., Lesens O., Lesouhaitier M., Lester-Grant A., Levy B., Levy Y., Levy-Marchal C., Lewandowska K., L'Her E., Li Bassi G., Liang J., Liaquat A., Liegeon G., Lim K.C., Lim W.S., Lima C., Lina B., Lina L., Lind A., Lingas G., Lion-Daolio S., Lissauer S., Liu K., Livrozet M., Lizotte P., Loforte A., Lolong N., Loon L.C., Lopes D., Lopez-Colon D., Loschner A.L., Loubet P., Loufti B., Louis G., Lourenco S., Lovelace-Macon L., Low L.L., Lowik M., Loy J.S., Lucet J.C., Lumbreras Bermejo C., Luna C.M., Lungu O., Luong L., Luque N., Luton D., Lwin N., Lyons R., Maasikas O., Mabiala O., MacDonald S., Machado M., Macheda G., Macias Sanchez J., Madhok J., Maestro de la Calle G., Mahieu R., Mahy S., Maia A.R., Maier L.S., Maillet M., Maitre T., Malfertheiner M., Malik N., Mallon P., Maltez F., Malvy D., Manda V., Mandei J.M., Mandelbrot L., Manetta F., Mangal K., Mankikian J., Manning E., Manuel A., Maria Sant`Ana Malaque C., Marino D., Marino F., Markowicz S., Maroun Eid C., Marques A., Marquis C., Marsh B., Marsh L., Marshal M., Marshall J., Martelli C.T., Martin D.-A., Martin E., Martin-Blondel G., Martinelli A., Martin-Loeches I., Martinot M., Martin-Quiros A., Martins A., Martins J., Martins N., Martins Rego C., Martucci G., Martynenko O., Marwali E.M., Marzukie M., Masa Jimenez J.F., Maslove D., Mason P., Mason S., Masood S., Mat Nor B., Matan M., Mateus Fernandes H., Mathew M., Mathieu D., Mattei M., Matulevics R., Maulin L., Maxwell M., Maynar J., Mazzoni T., Mc Sweeney L., McAndrew L., McArthur C., McCarthy A., McCloskey C., McConnochie R., McDermott S., McDonald S.E., McElroy A., McElwee S., McEneany V., McEvoy N., McGeer A., McKay C., McKeown J., McLean K.A., McNally P., McNicholas B., McPartlan E., Meaney E., Mear-Passard C., Mechlin M., Meher M., Mehkri O., Mele F., Melo L., Memon K., Mendes J.J., Menkiti O., Menon K., Mentre F., Mentzer A.J., Mercier E., Mercier N., Merckx A., Mergeay-Fabre M., Mergler B., Merson L., Mesquita A., Metwally O., Meybeck A., Meyer D., Meynert A.M., Meysonnier V., Meziane A., Mezidi M., Michelagnoli G., Michelanglei C., Michelet I., Mihelis E., Mihnovit V., Miranda-Maldonado H., Misnan N.A., Mohamed N.N.E., Mohamed T.J., Moin A., Molina D., Molinos E., Molloy B., Mone M., Monteiro A., Montes C., Montrucchio G., Moore S., Moore S.C., Morales Cely L., Moro L., Morocho Tutillo D.R., Morton B., Motherway C., Motos A., Mouquet H., Mouton Perrot C., Moyet J., Mudara C., Mufti A.K., Muh N.Y., Muhamad D., Mullaert J., Muller F., Muller K.E., Munblit D., Muneeb S., Munir N., Munshi L., Murphy A., Murphy L., Murris M., Murthy S., Musaab H., Muyandy G., Myrodia D.M., N N., Nagpal D., Nagrebetsky A., Narasimhan M., Narayanan N., Nasim Khan R., Nazerali-Maitland A., Neant N., Neb H., Nekliudov N.A., Nelwan E., Neto R., Neumann E., Neves B., Ng P.Y., Nghi A., Nguyen D., Ni Choileain O., Ni Leathlobhair N., Nichol A., Nitayavardhana P., Nonas S., Noordin N.A.M., Noret M., Norharizam N.F.I., Norman L., Notari A., Noursadeghi M., Nowicka K., Nowinski A., Nseir S., Nunez J.I., Nurnaningsih N., Nyamankolly E., O Brien F., O'Callaghan A., Occhipinti G., OConnor D., O'Donnell M., Ogston T., Ogura T., Oh T.-H., O'Halloran S., O'Hearn K., Ohshimo S., Oldakowska A., Oliveira J., Oliveira L., Olliaro P.L., O'Neil C., Ong D.S.Y., Ong J.Y., Oosthuyzen W., Opavsky A., Openshaw P., Orakzai S., Orozco-Chamorro C.M., Orquera A., Ortoleva J., Osatnik J., O'Shea L., O'Sullivan M., Othman S.Z., Ouamara N., Ouissa R., Owyang C., Oziol E., Pabasara H.M.U., Pagadoy M., Pages J., Palacios A., Palacios M., Palmarini M., Panarello G., Panda P.K., Paneru H., Pang L.H., Panigada M., Pansu N., Papadopoulos A., Parke R., Parker M., Parra B., Parrini V., Pasha T., Pasquier J., Pastene B., Patauner F., Patel J., Pathmanathan M.D., Patrao L., Patricio P., Patrier J., Patterson L., Pattnaik R., Paul C., Paul M., Paulos J., Paxton W.A., Payen J.-F., Peariasamy K., Pedrera Jimenez M., Peek G.J., Peelman F., Peiffer-Smadja N., Peigne V., Pejkovska M., Pelosi P., Peltan I.D., Pereira R., Perez D., Periel L., Perpoint T., Pesenti A., Pestre V., Petrou L., Petrov-Sanchez V., Pettersen F.O., Peytavin G., Pharand S., Piagnerelli M., Picard W., Picone O., de Piero M., Pierobon C., Piersma D., Pimentel C., Pinto R., Pires C., Pironneau I., Piroth L., Pius R., Piva S., Plantier L., Plotkin D., Png H.S., Poissy J., Pokeerbux R., Pokorska-Spiewak M., Poli S., Pollakis G., Ponscarme D., Popielska J., Post A.-M., Postma D.F., Povoa P., Povoas D., Powis J., Prapa S., Preau S., Prebensen C., Preiser J.-C., Prinssen A., Pritchard M.G., Priyadarshani G.D.D., Proenca L., Pudota S., Puechal O., Pujo Semedi B., Pulicken M., Puntoni M., Purcell G., Quesada L., Quinones-Cardona V., Quiros Gonzalez V., Quist-Paulsen E., Quraishi M., Rabaa M., Rabaud C., Rabindrarajan E., Rafael A., Rafiq M., Ragazzo G., Rahman A.K.H.A., Rahman R.A., Rahutullah A., Rainieri F., Rajahram G.S., Rajapakse N., Ralib A., Ramakrishnan N., Ramanathan K., Ramli A.A., Rammaert B., Ramos G.V., Rana A., Rangappa R., Ranjan R., Rapp C., Rashan A., Rashan T., Rasheed G., Rasmin M., Ratsep I., Rau C., Ravi T., Raza A., Real A., Rebaudet S., Redl S., Reeve B., Rehan A., Rehman A., Reid L., Reikvam D.H., Reis R., Rello J., Remppis J., Remy M., Ren H., Renk H., Resende L., Resseguier A.-S., Revest M., Rewa O., Reyes L.F., Reyes T., Ribeiro M.I., Richardson D., Richier L., Ridzuan S.N.A.A., Riera J., Rios A.L., Rishu A., Rispal P., Risso K., Rivera Nunez M.A., Rizer N., Robb D., Robba C., Roberto A., Roberts S., Robertson D.L., Robineau O., Roche-Campo F., Rodari P., Rodeia S., Rodriguez Abreu J., Roessler B., Roger C., Roger P.-M., Roilides E., Rojek A., Romaru J., Roncon-Albuquerque Jr R., Roriz M., Rosa-Calatrava M., Rose M., Rosenberger D., Rossanese A., Rossetti M., Rossignol B., Rossignol P., Rousset S., Roy C., Roze B., Rusmawatiningtyas D., Russell C.D., Ryan M., Ryckaert S., Rygh Holten A., Saba I., Sadaf S., Sadat M., Sahraei V., Saint-Gilles M., Sakiyalak P., Salahuddin N., Salazar L., Saleem J., Sales G., Sallaberry S., Salmon Gandonniere C., Salvator H., Sanchez O., Sanchez Choez X., Sanchez de Oliveira K., Sanchez-Miralles A., Sancho-Shimizu V., Sandhu G., Sandhu Z., Sandrine P.-F., Sandulescu O., Santos M., Sarfo-Mensah S., Sarmento Banheiro B., Sarmiento I.C.E., Sarton B., Satyapriya S., Satyawati R., Saviciute E., Savio R., Savvidou P., Saw Y.T., Schaffer J., Schermer T., Scherpereel A., Schneider M., Schroll S., Schwameis M., Schwartz G., Scott J.T., Scott-Brown J., Sedillot N., Seitz T., Selvanayagam J., Selvarajoo M., Semaille C., Semple M.G., Senian R.B., Senneville E., Sepulveda C., 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G., Suen J.Y., Sukumar P., Sultana A., Summers C., Supic D., Suppiah D., Surovcova M., Suwarti S., Svistunov A.A., Syahrin S., Syrigos K., Sztajnbok J., Szuldrzynski K., Tabrizi S., Taccone F.S., Tagherset L., Taib S.M., Talarek E., Taleb S., Talsma J., Tampubolon M.L., Tan K.K., Tan L.V., Tan Y.C., Tanaka C., Tanaka H., Tanaka T., Taniguchi H., Tanveer H., Taqdees H., Taqi A., Tardivon C., Tattevin P., Taufik M.A., Tawfik H., Tedder R.S., Tee T.Y., Teixeira J., Tejada S., Tellier M.-C., Teoh S.K., Teotonio V., Teoule F., Terpstra P., Terrier O., Terzi N., Tessier-Grenier H., Tey A., Thabit A.A.M., Tham Z.D., Thangavelu S., Thibault V., Thiberville S.-D., Thill B., Thirumanickam J., Thompson S., Thomson D., Thomson E.C., Thurai S.R.T., Thuy D.B., Thwaites R.S., Tierney P., Tieroshyn V., Timashev P.S., Timsit J.-F., Tirupakuzhi Vijayaraghavan B.K., Tissot N., Toh J.Z.Y., Toki M., Tolppa T., Tonby K., Tonnii S.L., Torres A., Torres M., Torres Santos-Olmo R.M., Torres-Zevallos H., Towers M., Trapani T., Traynor D., Treoux T., Trieu H.T., Tripathy S., Tromeur C., Trontzas I., Trouillon T., Truong J., Tual C., Tubiana S., Tuite H., Turmel J.-M., Turtle L.C.W., Tveita A., Twardowski P., Uchiyama M., Udayanga P.I., Udy A., Ullrich R., Umer Z., Uribe A., Usman A., Vajdovics C., Val-Flores L., Valle A.L., Valran A., Van de Velde S., van den Berge M., van der Feltz M., van der Valk P., Van Der Vekens N., Van der Voort P., Van Der Werf S., van Dyk M., van Gulik L., Van Hattem J., van Lelyveld S., van Netten C., Van Twillert G., van Veen I., Vanel N., Vanoverschelde H., Varghese P., Varrone M., Vasudayan S.R., Vauchy C., Vaughan H., Veeran S., Veislinger A., Vencken S., Ventura S., Verbon A., Vidal J.E., Vieira C., Vijayan D., Villanueva J.A., Villar J., Villeneuve P.-M., Villoldo A., Vinh Chau N.V., Visseaux B., Visser H., Vitiello C., Vonkeman H., Vuotto F., Wahab N.H., Wahab S.A., Wahid N.A., Wainstein M., Wan Muhd Shukeri W.F., Wang C.-H., Webb S.A., Wei J., Weil K., Wen T.P., Wesselius S., West T.E., Wham M., Whelan B., White N., Wicky P.H., Wiedemann A., Wijaya S.O., Wille K., Willems S., Williams V., Wils E.-J., Wing Yiu N., Wong C., Wong T.F., Wong X.C., Wong Y.S., Xian G.E., Xian L.S., Xuan K.P., Xynogalas I., Yacoub S., Yakop S.R.B.M., Yamazaki M., Yazdanpanah Y., Yee Liang Hing N., Yelnik C., Yeoh C.H., Yerkovich S., Yokoyama T., Yonis H., Yousif O., Yuliarto S., Zaaqoq A., Zabbe M., Zacharowski K., Zahid M., Zahran M., Zaidan N.Z.B., Zambon M., Zambrano M., Zanella A., Zawadka K., Zaynah N., Zayyad H., Zoufaly A., Zucman D., NIHR, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Abbas, A., Abdukahil, S. 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Z., Faure, K., Favory, R., Fayed, M., Feely, N., Feeney, L., Fernandes, J., Fernandes, M., Fernandes, S., Ferrand, F. -X., Ferrand Devouge, E., Ferrao, J., Ferraz, M., Ferreira, B., Ferreira, S., Ferrer-Roca, R., Ferriere, N., Ficko, C., Figueiredo-Mello, C., Fiorda, J., Flament, T., Flateau, C., Fletcher, T., Florio, L. L., Flynn, B., Flynn, D., Foley, C., Foley, J., Fomin, V., Fonseca, T., Fontela, P., Forsyth, S., Foster, D., Foti, G., Fourn, E., Fowler, R. A., Fraher, D. M., Franch-Llasat, D., Fraser, C., Fraser, J. F., Freire, M. V., Freitas Ribeiro, A., Friedrich, C., Fritz, R., Fry, S., Fuentes, N., Fukuda, M., Gaborieau, V., Gaci, R., Gagliardi, M., Gagnard, J. -C., Gagne, N., Gagneux-Brunon, A., Gaiao, S., Gail Skeie, L., Gallagher, P., Gallego Curto, E., Gamble, C., Gani, Y., Garan, A., Garcia, R., Garcia Barrio, N., Garcia-Diaz, J., Garcia-Gallo, E., Garimella, N., Garot, D., Garrait, V., Gauli, B., Gault, N., Gavin, A., Gavrylov, A., Gaymard, A., Gebauer, J., Geraud, E., Gerbaud Morlaes, L., Germano, N., Ghisulal, P. K., Ghosn, J., Giani, M., Giaquinto, C., Gibson, J., Gigante, T., Gilg, M., Gilroy, E., Giordano, G., Girvan, M., Gissot, V., Gitahi, J., Giwangkancana, G., Glikman, D., Glybochko, P., Gnall, E., Goco, G., Goehringer, F., Goepel, S., Goffard, J. -C., Goh, J. Y., Golob, J., Gomes, R., Gomez, K., Gomez-Junyent, J., Gominet, M., Gonzalez, A., Gordon, P., Gordon, A., Gorenne, I., Goubert, L., Goujard, C., Goulenok, T., Grable, M., Graf, J., Grandin, E. 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S., Lennon, J., Leon, R., Leone, M., Lepiller, Q., Lescure, F. -X., Lesens, O., Lesouhaitier, M., Lester-Grant, A., Levy, B., Levy, Y., Levy-Marchal, C., Lewandowska, K., L'Her, E., Li Bassi, G., Liang, J., Liaquat, A., Liegeon, G., Lim, K. C., Lim, W. S., Lima, C., Lina, B., Lina, L., Lind, A., Lingas, G., Lion-Daolio, S., Lissauer, S., Liu, K., Livrozet, M., Lizotte, P., Loforte, A., Lolong, N., Loon, L. C., Lopes, D., Lopez-Colon, D., Loschner, A. L., Loubet, P., Loufti, B., Louis, G., Lourenco, S., Lovelace-Macon, L., Low, L. L., Lowik, M., Loy, J. S., Lucet, J. C., Lumbreras Bermejo, C., Luna, C. M., Lungu, O., Luong, L., Luque, N., Luton, D., Lwin, N., Lyons, R., Maasikas, O., Mabiala, O., Macdonald, S., Machado, M., Macheda, G., Macias Sanchez, J., Madhok, J., Maestro de la Calle, G., Mahieu, R., Mahy, S., Maia, A. R., Maier, L. S., Maillet, M., Maitre, T., Malfertheiner, M., Malik, N., Mallon, P., Maltez, F., Malvy, D., Manda, V., Mandei, J. M., Mandelbrot, L., Manetta, F., Mangal, K., Mankikian, J., Manning, E., Manuel, A., Maria Sant`Ana Malaque, C., Marino, D., Marino, F., Markowicz, S., Maroun Eid, C., Marques, A., Marquis, C., Marsh, B., Marsh, L., Marshal, M., Marshall, J., Martelli, C. T., Martin, D. -A., Martin, E., Martin-Blondel, G., Martinelli, A., Martin-Loeches, I., Martinot, M., Martin-Quiros, A., Martins, A., Martins, J., Martins, N., Martins Rego, C., Martucci, G., Martynenko, O., Marwali, E. M., Marzukie, M., Masa Jimenez, J. F., Maslove, D., Mason, P., Mason, S., Masood, S., Mat Nor, B., Matan, M., Mateus Fernandes, H., Mathew, M., Mathieu, D., Mattei, M., Matulevics, R., Maulin, L., Maxwell, M., Maynar, J., Mazzoni, T., Mc Sweeney, L., Mcandrew, L., Mcarthur, C., Mccarthy, A., Mccloskey, C., Mcconnochie, R., Mcdermott, S., Mcdonald, S. E., Mcelroy, A., Mcelwee, S., Mceneany, V., Mcevoy, N., Mcgeer, A., Mckay, C., Mckeown, J., Mclean, K. A., Mcnally, P., Mcnicholas, B., Mcpartlan, E., Meaney, E., Mear-Passard, C., Mechlin, M., Meher, M., Mehkri, O., Mele, F., Melo, L., Memon, K., Mendes, J. J., Menkiti, O., Menon, K., Mentre, F., Mentzer, A. J., Mercier, E., Mercier, N., Merckx, A., Mergeay-Fabre, M., Mergler, B., Merson, L., Mesquita, A., Metwally, O., Meybeck, A., Meyer, D., Meynert, A. M., Meysonnier, V., Meziane, A., Mezidi, M., Michelagnoli, G., Michelanglei, C., Michelet, I., Mihelis, E., Mihnovit, V., Miranda-Maldonado, H., Misnan, N. A., Mohamed, N. N. E., Mohamed, T. J., Moin, A., Molina, D., Molinos, E., Molloy, B., Mone, M., Monteiro, A., Montes, C., Montrucchio, G., Moore, S., Moore, S. C., Morales Cely, L., Moro, L., Morocho Tutillo, D. R., Morton, B., Motherway, C., Motos, A., Mouquet, H., Mouton Perrot, C., Moyet, J., Mudara, C., Mufti, A. K., Muh, N. Y., Muhamad, D., Mullaert, J., Muller, F., Muller, K. E., Munblit, D., Muneeb, S., Munir, N., Munshi, L., Murphy, A., Murphy, L., Murris, M., Murthy, S., Musaab, H., Muyandy, G., Myrodia, D. M., N, N., Nagpal, D., Nagrebetsky, A., Narasimhan, M., Narayanan, N., Nasim Khan, R., Nazerali-Maitland, A., Neant, N., Neb, H., Nekliudov, N. A., Nelwan, E., Neto, R., Neumann, E., Neves, B., Ng, P. Y., Nghi, A., Nguyen, D., Ni Choileain, O., Ni Leathlobhair, N., Nichol, A., Nitayavardhana, P., Nonas, S., Noordin, N. A. M., Noret, M., Norharizam, N. F. I., Norman, L., Notari, A., Noursadeghi, M., Nowicka, K., Nowinski, A., Nseir, S., Nunez, J. I., Nurnaningsih, N., Nyamankolly, E., O Brien, F., O'Callaghan, A., Occhipinti, G., Oconnor, D., O'Donnell, M., Ogston, T., Ogura, T., Oh, T. -H., O'Halloran, S., O'Hearn, K., Ohshimo, S., Oldakowska, A., Oliveira, J., Oliveira, L., Olliaro, P. L., O'Neil, C., Ong, D. S. Y., Ong, J. Y., Oosthuyzen, W., Opavsky, A., Openshaw, P., Orakzai, S., Orozco-Chamorro, C. M., Orquera, A., Ortoleva, J., Osatnik, J., O'Shea, L., O'Sullivan, M., Othman, S. Z., Ouamara, N., Ouissa, R., Owyang, C., Oziol, E., Pabasara, H. M. U., Pagadoy, M., Pages, J., Palacios, A., Palacios, M., Palmarini, M., Panarello, G., Panda, P. K., Paneru, H., Pang, L. H., Panigada, M., Pansu, N., Papadopoulos, A., Parke, R., Parker, M., Parra, B., Parrini, V., Pasha, T., Pasquier, J., Pastene, B., Patauner, F., Patel, J., Pathmanathan, M. D., Patrao, L., Patricio, P., Patrier, J., Patterson, L., Pattnaik, R., Paul, C., Paul, M., Paulos, J., Paxton, W. A., Payen, J. -F., Peariasamy, K., Pedrera Jimenez, M., Peek, G. J., Peelman, F., Peiffer-Smadja, N., Peigne, V., Pejkovska, M., Pelosi, P., Peltan, I. D., Pereira, R., Perez, D., Periel, L., Perpoint, T., Pesenti, A., Pestre, V., Petrou, L., Petrov-Sanchez, V., Pettersen, F. O., Peytavin, G., Pharand, S., Piagnerelli, M., Picard, W., Picone, O., de Piero, M., Pierobon, C., Piersma, D., Pimentel, C., Pinto, R., Pires, C., Pironneau, I., Piroth, L., Pius, R., Piva, S., Plantier, L., Plotkin, D., Png, H. S., Poissy, J., Pokeerbux, R., Pokorska-Spiewak, M., Poli, S., Pollakis, G., Ponscarme, D., Popielska, J., Post, A. -M., Postma, D. F., Povoa, P., Povoas, D., Powis, J., Prapa, S., Preau, S., Prebensen, C., Preiser, J. -C., Prinssen, A., Pritchard, M. G., Priyadarshani, G. D. D., Proenca, L., Pudota, S., Puechal, O., Pujo Semedi, B., Pulicken, M., Puntoni, M., Purcell, G., Quesada, L., Quinones-Cardona, V., Quiros Gonzalez, V., Quist-Paulsen, E., Quraishi, M., Rabaa, M., Rabaud, C., Rabindrarajan, E., Rafael, A., Rafiq, M., Ragazzo, G., Rahman, A. K. H. A., Rahman, R. A., Rahutullah, A., Rainieri, F., Rajahram, G. S., Rajapakse, N., Ralib, A., Ramakrishnan, N., Ramanathan, K., Ramli, A. A., Rammaert, B., Ramos, G. V., Rana, A., Rangappa, R., Ranjan, R., Rapp, C., Rashan, A., Rashan, T., Rasheed, G., Rasmin, M., Ratsep, I., Rau, C., Ravi, T., Raza, A., Real, A., Rebaudet, S., Redl, S., Reeve, B., Rehan, A., Rehman, A., Reid, L., Reikvam, D. H., Reis, R., Rello, J., Remppis, J., Remy, M., Ren, H., Renk, H., Resende, L., Resseguier, A. -S., Revest, M., Rewa, O., Reyes, L. F., Reyes, T., Ribeiro, M. I., Richardson, D., Richier, L., Ridzuan, S. N. A. A., Riera, J., Rios, A. L., Rishu, A., Rispal, P., Risso, K., Rivera Nunez, M. A., Rizer, N., Robb, D., Robba, C., Roberto, A., Roberts, S., Robertson, D. L., Robineau, O., Roche-Campo, F., Rodari, P., Rodeia, S., Rodriguez Abreu, J., Roessler, B., Roger, C., Roger, P. -M., Roilides, E., Rojek, A., Romaru, J., Roncon-Albuquerque Jr, R., Roriz, M., Rosa-Calatrava, M., Rose, M., Rosenberger, D., Rossanese, A., Rossetti, M., Rossignol, B., Rossignol, P., Rousset, S., Roy, C., Roze, B., Rusmawatiningtyas, D., Russell, C. D., Ryan, M., Ryckaert, S., Rygh Holten, A., Saba, I., Sadaf, S., Sadat, M., Sahraei, V., Saint-Gilles, M., Sakiyalak, P., Salahuddin, N., Salazar, L., Saleem, J., Sales, G., Sallaberry, S., Salmon Gandonniere, C., Salvator, H., Sanchez, O., Sanchez Choez, X., Sanchez de Oliveira, K., Sanchez-Miralles, A., Sancho-Shimizu, V., Sandhu, G., Sandhu, Z., Sandrine, P. -F., Sandulescu, O., Santos, M., Sarfo-Mensah, S., Sarmento Banheiro, B., Sarmiento, I. C. E., Sarton, B., Satyapriya, S., Satyawati, R., Saviciute, E., Savio, R., Savvidou, P., Saw, Y. T., Schaffer, J., Schermer, T., Scherpereel, A., Schneider, M., Schroll, S., Schwameis, M., Schwartz, G., Scott, J. T., Scott-Brown, J., Sedillot, N., Seitz, T., Selvanayagam, J., Selvarajoo, M., Semaille, C., Semple, M. G., Senian, R. B., Senneville, E., Sepulveda, C., Sequeira, F., Sequeira, T., Serpa Neto, A., Serrano Balazote, P., Shadowitz, E., Shahidan, S. A., Shahnaz Hasan, M., Shamsah, M., Shankar, A., Sharjeel, S., Sharma, P., Shaw, C. A., Shaw, V., Shi, H., Shiban, N., Shiekh, M., Shiga, T., Shime, N., Shimizu, H., Shimizu, K., Shimizu, N., Shindo, N., Shrapnel, S., Shum, H. P., Si Mohammed, N., Siang, N. Y., Sibiude, J., Siddiqui, A., Sigfrid, L., Sillaots, P., Silva, C., Silva, M. J., Silva, R., Sim Lim Heng, B., Sin, W. C., Singh, B. C., Singh, P., Sitompul, P. A., Sivam, K., Skogen, V., Smith, S., Smood, B., Smyth, C., Smyth, M., Snacken, M., So, D., Soh, T. V., Solis, M., Solomon, J., Solomon, T., Somers, E., Sommet, A., Song, M. J., Song, R., Song, T., Song Chia, J., Sonntagbauer, M., Soom, A. M., Sotto, A., Soum, E., Sousa, A. C., Sousa, M., Sousa Uva, M., Souza-Dantas, V., Sperry, A., Spinuzza, E., Sri Darshana, B. P. S. R., Sriskandan, S., Stabler, S., Staudinger, T., Stecher, S. -S., Steinsvik, T., Stienstra, Y., Stiksrud, B., Stolz, E., Stone, A., Streinu-Cercel, A., Strudwick, S., Stuart, A., Stuart, D., Subekti, D., Suen, G., Suen, J. Y., Sukumar, P., Sultana, A., Summers, C., Supic, D., Suppiah, D., Surovcova, M., Suwarti, S., Svistunov, A. A., Syahrin, S., Syrigos, K., Sztajnbok, J., Szuldrzynski, K., Tabrizi, S., Taccone, F. S., Tagherset, L., Taib, S. M., Talarek, E., Taleb, S., Talsma, J., Tampubolon, M. L., Tan, K. K., Tan, L. V., Tan, Y. C., Tanaka, C., Tanaka, H., Tanaka, T., Taniguchi, H., Tanveer, H., Taqdees, H., Taqi, A., Tardivon, C., Tattevin, P., Taufik, M. A., Tawfik, H., Tedder, R. S., Tee, T. Y., Teixeira, J., Tejada, S., Tellier, M. -C., Teoh, S. K., Teotonio, V., Teoule, F., Terpstra, P., Terrier, O., Terzi, N., Tessier-Grenier, H., Tey, A., Thabit, A. A. M., Tham, Z. D., Thangavelu, S., Thibault, V., Thiberville, S. -D., Thill, B., Thirumanickam, J., Thompson, S., Thomson, D., Thomson, E. C., Thurai, S. R. T., Thuy, D. B., Thwaites, R. S., Tierney, P., Tieroshyn, V., Timashev, P. S., Timsit, J. -F., Tirupakuzhi Vijayaraghavan, B. K., Tissot, N., Toh, J. Z. Y., Toki, M., Tolppa, T., Tonby, K., Tonnii, S. L., Torres, A., Torres, M., Torres Santos-Olmo, R. M., Torres-Zevallos, H., Towers, M., Trapani, T., Traynor, D., Treoux, T., Trieu, H. T., Tripathy, S., Tromeur, C., Trontzas, I., Trouillon, T., Truong, J., Tual, C., Tubiana, S., Tuite, H., Turmel, J. -M., Turtle, L. C. W., Tveita, A., Twardowski, P., Uchiyama, M., Udayanga, P. I., Udy, A., Ullrich, R., Umer, Z., Uribe, A., Usman, A., Vajdovics, C., Val-Flores, L., Valle, A. L., Valran, A., Van de Velde, S., van den Berge, M., van der Feltz, M., van der Valk, P., Van Der Vekens, N., Van der Voort, P., Van Der Werf, S., van Dyk, M., van Gulik, L., Van Hattem, J., van Lelyveld, S., van Netten, C., Van Twillert, G., van Veen, I., Vanel, N., Vanoverschelde, H., Varghese, P., Varrone, M., Vasudayan, S. R., Vauchy, C., Vaughan, H., Veeran, S., Veislinger, A., Vencken, S., Ventura, S., Verbon, A., Vidal, J. E., Vieira, C., Vijayan, D., Villanueva, J. A., Villar, J., Villeneuve, P. -M., Villoldo, A., Vinh Chau, N. V., Visseaux, B., Visser, H., Vitiello, C., Vonkeman, H., Vuotto, F., Wahab, N. H., Wahab, S. A., Wahid, N. A., Wainstein, M., Wan Muhd Shukeri, W. F., Wang, C. -H., Webb, S. A., Wei, J., Weil, K., Wen, T. P., Wesselius, S., West, T. E., Wham, M., Whelan, B., White, N., Wicky, P. H., Wiedemann, A., Wijaya, S. O., Wille, K., Willems, S., Williams, V., Wils, E. -J., Wing Yiu, N., Wong, C., Wong, T. F., Wong, X. C., Wong, Y. S., Xian, G. E., Xian, L. S., Xuan, K. P., Xynogalas, I., Yacoub, S., Yakop, S. R. B. M., Yamazaki, M., Yazdanpanah, Y., Yee Liang Hing, N., Yelnik, C., Yeoh, C. H., Yerkovich, S., Yokoyama, T., Yonis, H., Yousif, O., Yuliarto, S., Zaaqoq, A., Zabbe, M., Zacharowski, K., Zahid, M., Zahran, M., Zaidan, N. Z. B., Zambon, M., Zambrano, M., Zanella, A., Zawadka, K., Zaynah, N., Zayyad, H., Zoufaly, A., Zucman, D., Intensive Care Medicine, and Group, The ISARIC Clinical Characterisation
Subjects: Biomedical Research, [SDV]Life Sciences [q-bio], Clinical science, Global Health, Corrections, Microbiology, 1117 Public Health and Health Services, 1108 Medical Microbiology, Pandemic, Economics, Humans, ISARIC Clinical Characterisation Group, Pandemics, COVID-19/epidemiology, Actuarial science, Information Dissemination, SARS-CoV-2, Comment, ISARIC, COVID-19, 1103 Clinical Sciences, Communicable Disease Control/methods, Infectious Diseases, Open source, Communicable Disease Control, Value (mathematics), Human
Abstract: International audience
Published: 2021

39. SARS-CoV-2 molecular testing in Greek hospital paediatric departments: a nationwide study

Author: Athanasios Michos, Maria Tsolia, George A. Syrogiannopoulos, Eirini Eleftheriou, Elias Iosifidis, Ioanna N. Grivea, Emmanuel Roilides, Emmanouil Galanakis, Garyfallia Syridou, Parthena Savvidou, Vassiliki Papaevangelou, and Vana Spoulou
Subjects: Male, Pediatrics, medicine.medical_specialty, Adolescent, diagnosis, Epidemiology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Population, Hospital Departments, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Special Collection Question, 030225 pediatrics, Pandemic, medicine, Humans, 030212 general & internal medicine, Child, education, Children, Original Paper, education.field_of_study, Greece, SARS-CoV-2, business.industry, Incidence, Incidence (epidemiology), Infant, Newborn, COVID-19, Infant, Outbreak, testing, Post-Covid 19, Disease Hotspot, Infectious Diseases, COVID-19 Nucleic Acid Testing, Child, Preschool, Etiology, Female, medicine.symptom, business
Abstract: As most children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present with mild symptoms or they are asymptomatic, the optimal strategy for molecular testing it is not well defined. The aim of the study was to determine the extent and aetiology of molecular testing for SARS-CoV-2 in Greek paediatric departments during the first phase of the pandemic and identify possible differences in incidence, depending on the age group and geographical area. We conducted a nationwide study of molecular testing for SARS-CoV-2 of children in paediatric departments between March and June 2020. A total of 65 paediatric departments participated in the study, representing 4901 children who were tested for SARS-CoV-2 and 90 (1.8%) were positive. Most paediatric cases were associated with topical outbreaks. Adolescents 11–16 years had the highest positivity rate (3.6%) followed by children 6–10 years (1.9%). However, since the testing rate significantly differed between age groups, the modified incidence of SARS-CoV-2 infection per age group was highest in infants 5 population). Most children tested presented with fever (70.9%), respiratory (50.1%) or gastrointestinal symptoms (28.1%). Significant differences were detected between public and private hospitals regarding the positivity rate (2.34% vs. 0.39%, P-value
Published: 2021

40. Recent Progress in Microbiology and Biotechnology Vol. 4

Author: O. R. Ejinaka, Elizabeth Margaret, A. R. Abdulmumin, S. B. Mohammed, Umamah Iram, S. K. Malang, Fathima Mohammadi, I. R. Jwanse, V. Venugopal Rao, Savvas Papachristou, Y. Ya’aba, Emmanuel Roilides, Mary A. Oladipo, V. Nandini, O. C. Daniel, Sudhir Kumar, S. D. Cherukuri, Valery Yu. Davydkin, M. U. Obeta, S Mailafia, Ashwin Rammohan, H. U. Abhijith, Nousheen Fatima, Aleshkin Va, Halah H. Al-Haideri, M. Usoroh, Kinikanwo Confidence Wachukwu, T.R.Prashith Kekuda, K. T. Olatunji, Sarita Yadav, B. R. Mohammed, P. I. Agbalaka, Sumera Naaz, Elias Iosifidis, Clara Idara Eleazar, Mikhail Lakhtin, Stanislav S. Afanasiev, Constancy Prisca Aleru, K. S. Shreya, R. I. S. Agbede, J. G. Yakubu, Richa Rani, Adebomi A. Ikotun, Vladimir Lakhtin, and Oladipupo O. Awosika
Subjects: Engineering, business.industry, Library science, business
Published: 2020

41. Perioperative antimicrobial prophylaxis in adult patients: The first multicenter clinical practice audit with intervention in Greek surgical departments

Author: Evangelia Chorianopoulou, Athanasios Skoutelis, Eleni Kourkouni, Elias Iosifidis, Theoklis E. Zaoutis, Grammatiki-Christina Tsopela, Ioannis Kopsidas, Emmanuel Roilides, Christos Triantafyllou, Georgia Kourlaba, Elisavet Chorafa, and Sotirios Tsiodras
Subjects: 0301 basic medicine, Microbiology (medical), Adult, medicine.medical_specialty, Epidemiology, 030106 microbiology, MEDLINE, Audit, 03 medical and health sciences, 0302 clinical medicine, Anti-Infective Agents, Intervention (counseling), medicine, Humans, Surgical Wound Infection, 030212 general & internal medicine, Prospective Studies, Antibiotic prophylaxis, Prospective cohort study, Greece, business.industry, Perioperative, Antibiotic Prophylaxis, Antimicrobial, Anti-Bacterial Agents, Infectious Diseases, Emergency medicine, Guideline Adherence, business, Elective Surgical Procedure
Abstract: Objective:To audit clinical practice and implement an intervention to promote appropriate use of perioperative antimicrobial prophylaxis (PAP).Design:Prospective multicenter before-and-after study.Setting:This study was conducted in 7 surgical departments of 3 major Greek hospitals.Methods:Active PAP surveillance in adults undergoing elective surgical procedures was performed before and after implementation of a multimodal intervention. The surveillance monitored use of appropriate antimicrobial agent according to international and local guidelines, appropriate timing and duration of PAP, overall compliance with all 3 parameters and the occurrence of surgical site infections (SSIs). The intervention included education, audit, and feedback.Results:Overall, 1,447 patients were included: 768 before and 679 after intervention. Overall compliance increased from 28.2% to 43.9% (P = .001). Use of antimicrobial agents compliant to international guidelines increased from 89.6% to 96.3% (P = .001). In 4 of 7 departments, compliance with appropriate timing was already >90%; an increase from 44.3% to 73% (P = .001) and from 20.4% to 60% (P = .001), respectively, was achieved in 2 other departments, whereas a decrease from 64.1% to 10.9% (P = .001) was observed in 1 department. All but one department achieved a shorter PAP duration, and most achieved duration of ~2 days. SSIs significantly decreased from 6.9% to 4% (P = .026). After the intervention, it was 2.3 times more likely for appropriate antimicrobial use, 14.7 times more likely to administer an antimicrobial for the appropriate duration and 5.3 times more likely to administer an overall appropriate PAP.Conclusion:An intervention based on education, audit, and feedback can significantly contribute to improvement of appropriate PAP administration; further improvement in duration is needed.
Published: 2020

42. Symptoms at presentation for patients admitted to hospital with Covid-19: results from the ISARIC prospective multinational observational study

Author: Nikita Nekliudov, Charlotte Summers, Anne Sophie Boureau, Pawel Twardowski, Mark Pritchard, Elias Iosifidis, Daniel Ivulich, Emanuele Durante-Mangoni, Konstantinos Kyriakoulis, Lance Turtle, Thushan De Silva, Sergio Poli, Malcolm Gracie Semple, Jordi Riera del Brio, Jose Andres Calvache, Giorgia Montrucchio, Alexandre Gaymard, Martina Hennessy, Juan Pablo Horcajada, Christophe Fraser, Paul Klenerman, Mary Catherine Mone, Jeffrey Javidfar, Meera Chand, Francois Lamontagne, Carolline De Araújo Mariz, Mauro Panigada, Christopher Green, Ruth Jimbo Sotomayor, Kevin Bouiller, Emmanuelle A. Dankwa, William Paxton, Alberto Cucino, and Andrea Dell'Amore
Subjects: Male, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Nausea, Hospitalized patients, diagnosis, Logistic regression, Age and sex, Article, medicine, Humans, Prospective Studies, Child, Aged, Original Paper, business.industry, SARS-CoV-2, COVID-19, Middle Aged, Hospitals, Hospitalization, Cohort, Vomiting, symptoms, Observational study, Female, medicine.symptom, business, case definition
Abstract: Background Symptom recognition is necessary to identify people with possible Covid-19. Clinical case definitions vary in type and number of symptoms included. No large studies have investigated how these perform for hospitalized patients of different ages and sex. Methods We used international prospective observational data from patients admitted to hospital with laboratory-confirmed Covid-19. We investigated how symptoms varied by age and sex. We performed logistic regression to assess the relationship of age and sex with the most prevalent symptoms in our dataset and with published case definitions, allowing for clustering by country as a random intercept. Results 60 161 patients from 43 countries were included, with median age 70 years (interquartile range 55–82). Fever (68%), cough (68%) and shortness of breath (63%) were the most prevalent symptoms. Their prevalence was greater among patients aged 30–60 years (respectively 79%, 78%, 66%), and lower in children (≤18 years: 68%, 47%, 22%) and older adults (≥70 years: 61%, 62%, 61%). The most sensitive case definition assessed was one or more of cough, shortness of breath, fever, muscle pains or sore throat, met by 92% of the whole cohort. Confusion was the most prevalent symptom for patients whose symptoms did not meet any of the assessed case definitions. Regression models showed significant differences in symptoms with age, and considerable heterogeneity between countries. Conclusions Older adults and children admitted to hospital with Covid-19 are less likely to present with typical symptoms of cough, fever and shortness of breath. Vigilance for atypical symptoms towards extremities of age increases sensitivity of identifying Covid-19., Summary Typical symptoms of fever, cough and shortness of breath are less common in people admitted to hospital with Covid-19 toward extremities of age. Published case definitions appear less sensitive toward extremes of age, and atypical symptoms need to be recognised.
Published: 2020

43. ISARIC COVID-19 Clinical Data Report issued: 27 March 2022

Author: Charlotte Summers, Aysylu Gamirova, Anne Sophie Boureau, Pawel Twardowski, Fernando Augusto Bozza, Martina Escher, Mark Pritchard, Elias Iosifidis, Jamel Ortoleva, Tessa Broadley, Matthew Hall, Murray Dryden, Emanuele Durante-Mangoni, Hayley Hardwick, Konstantinos Kyriakoulis, Lance Turtle, Thushan De Silva, Daniel Alejandro Pérez Muñoz, Kyle Young, M. Shahnaz Hasan, Wei Shen Lim, Malcolm Gracie Semple, Christl Donnelly, Fakhir Haidri, Giorgia Montrucchio, Alexandre Gaymard, Gail Carson, Rashan Haniffa, Waasila Jassat, Oksana Kruglova, Ewen Harrison, Pablo Serrano Balazote, Juan Pablo Horcajada, Christophe Fraser, France Mentré, Paul Klenerman, Mary Catherine Mone, Louise Sigfrid, Joaquin Baruch, Andrew Dagens, Jeffrey Javidfar, Francois Lamontagne, Srinivas Murthy, Madiha Hashmi, Christopher Green, Kevin Bouiller, Helena Barrasa, Miguel Pedrera-Jiménez, Emmanuelle A. Dankwa, Clarice Tanaka, Cédric LAOUENAN, William Paxton, Andrea Dell'Amore, Barbara Wanjiru Citarella, Abigail Beane, Devachandran Jayakumar, and John Kenneth Baillie
Subjects: medicine.medical_specialty, Data collection, Constitutional symptoms, business.industry, Public health, Outbreak, medicine.disease, Intensive care unit, Malaise, law.invention, law, Emergency medicine, Case fatality rate, Cohort, medicine, medicine.symptom, business
Abstract: ISARIC (International Severe Acute Respiratory and emerging Infections Consortium) partnerships and outbreak preparedness initiatives enabled the rapid launch of standardised clinical data collection on COVID-19 in Jan 2020. Extensive global participation has resulted in a large, standardised collection of comprehensive clinical data from hundreds of sites across dozens of countries. Data are analysed regularly and reported publicly to inform patient care and public health response. This report, our 17th report, is a part of a series published over the past 2 years. Data have been entered for 800,459 individuals from 1701 partner institutions and networks across 60 countries.The comprehensive analyses detailed in this report includes hospitalised individuals of all ages for whom data collection occurred between 30 January 2020 and up to and including 5 January 2022, AND who have laboratory-confirmed SARS-COV-2 infection or clinically diagnosed COVID-19.For the 699,014 cases who meet eligibility criteria for this report, selected findings include: median age of 58 years, with an approximately equal (50/50) male:female sex distribution29% of the cohort are at least 70 years of age, whereas 4% are 0-19 years of agethe most common symptom combination in this hospitalised cohort is shortness of breath, cough, and history of fever, which has remained constant over timethe five most common symptoms at admission were shortness of breath, cough, history of fever, fatigue/malaise, and altered consciousness/confusion, which is unchanged from the previous reportsage-associated differences in symptoms are evident, including the frequency of altered consciousness increasing with age, and fever, respiratory and constitutional symptoms being present mostly in those 40 years and above16% of patients with relevant data available were admitted at some point during their illness into an intensive care unit (ICU), which is slightly lower than previously reported (19%)antibiotic agents were used in 35% of patients for whom relevant data are available (669,630), a significant reduction from our previous reports (80%) which reflects a shifting proportion of data contributed by different institutions; in ICU/HDU admitted patients with data available (50,560), 91% received antibioticsuse of corticosteroids was reported in 24% of all patients for whom data were available (677,012); in ICU/HDU admitted patients with data available (50,646), 69% received corticosteroidsoutcomes are known for 632,518 patients and the overall estimated case fatality ratio (CFR) is 23.9% (95%CI 23.8-24.1), rising to 37.1% (95%CI 36.8-37.4) for patients who were admitted to ICU/HDU, demonstrating worse outcomes in those with the most severe disease To access previous versions of ISARIC COVID-19 Clinical Data Report please use the link below: https://isaric.org/research/covid-19-clinical-research-resources/evidence-reports/
Published: 2020

44. Treatment and Outcomes of Children with Febrile Urinary Tract Infection due to Extended Spectrum Beta-lactamase-producing Bacteria in Europe: TOO CUTE Study

Author: Ana Isabel Valdivielso Martínez, Mike Sharland, Tina Plankar Srovin, Maia De Luca, Eleni Vergadi, Ángela Gómez Manzanares, Alasdair Bamford, Romain Basmaci, Ana Maria Oliveira Brett, Julia Bielicki, John Kopsidas, Andrew Riordan, Yingfen Hsia, Elise Aguadisch, Marion Caseris, Elias Iosifidis, Tim Planche, Konstantinos Vazouras, Laura Folgori, Rimante Cerkauskiene, University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Universidad de Málaga [Málaga] = University of Málaga [Málaga], St George's, University of London, The Stavros Niarchos Foundation [Athens, Greece], Queen's University [Belfast] (QUB), University of Milan, University Children's Hospital [Basel, Switzerland]], Service de Pédiatrie-Urgences [Hopital Louis Mourier - APHP, Colombes], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Great Ormond Street Hospital for Children NHS Foundation Trust [London, UK], Universidade de Coimbra [Coimbra], Hôpital Robert Debré, Vilnius University [Vilnius], Children's Hospital Bambino Gesù IRCCS [Rome], Aristotle University of Thessaloniki, Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), St George's Hospital Medical School [London], Liverpool Women's NHS Foundation Trust, University of Crete [Heraklion] (UOC), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Comets, Emmanuelle, Università degli Studi di Milano = University of Milan (UNIMI), Great Ormond Street Hospital for Children NHS Foundation Trust [London, UK] (GOSHC), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord
Subjects: Microbiology (medical), Male, medicine.medical_specialty, Combination therapy, Urinalysis, Adolescent, medicine.drug_class, Urinary system, Antibiotics, Urine, Drug resistance, beta-Lactamases, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, 030225 pediatrics, Internal medicine, Drug Resistance, Bacterial, Medicine, Humans, 030212 general & internal medicine, Child, Retrospective Studies, [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], medicine.diagnostic_test, Pyelonephritis, business.industry, Infant, Newborn, Infant, Retrospective cohort study, Bacterial Infections, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], 3. Good health, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Child, Preschool, Pediatrics, Perinatology and Child Health, Urinary Tract Infections, Epsilonproteobacteria, Female, business
Abstract: Background: \ud The prevalence of extended-spectrum beta-lactamase producing Εnterobacteriaceae (ESBL-PE) is increasing globally. ESBL-PE are an important cause of urinary tract infections (UTIs) in children. We aimed to characterize the clinical presentation, treatment and outcomes of childhood UTI caused by ESBL-PE in Europe.\ud \ud Methods: \ud Multicenter retrospective cohort study. Children 0 to 18 years of age with fever, positive urinalysis and positive urine culture for an ESBL-PE uropathogen, seen in a participating hospital from January 2016 to July 2017, were included.\ud \ud Main Outcome Measures: \ud Primary outcome measure: day of defervescence was compared between (1) initial microbiologically effective treatment (IET) versus initial microbiologically ineffective treatment (IIT) and (2) single initial antibiotic treatment versus combined initial antibiotic treatment. Secondary outcome measures: Clinical and microbiological failure of initial treatment.\ud \ud Results: \ud We included 142 children from 14 hospitals in 8 countries. Sixty-one children had IET and 77 IIT. There was no statistical difference in time to defervescence for effective/ineffective groups (P = 0.722) and single/combination therapy groups (P = 0.574). Two out of 59 (3.4%) and 4/66 (6.1%) patients exhibited clinical failure during treatment (P = 0.683) when receiving IET or IIT, respectively. Eight of 51 (15.7%) receiving IET and 6/58 (10.3%) receiving IIT patients (P = 0.568) had recurring symptoms/signs suggestive of a UTI. Recurrence of a UTI occurred 15.5 days (interquartile range, 9.0–19.0) after the end of treatment.\ud \ud Conclusions: \ud Time to defervescence and clinical failure did not differ between IET/IIT groups. Non-carbapenem beta-lactam antibiotics may be used for the empiric treatment of ESBL febrile UTIs, until susceptibility testing results become available.
Published: 2020

45. Impact of active surveillance and infection control measures on carbapenem-resistant Gram-negative bacterial colonization and infections in intensive care

Author: N. Gritsi-Gerogianni, Charalampos Antachopoulos, Elias Iosifidis, Athanasios Tsakris, Theodoros Karampatakis, Emmanuel Roilides, Angeliki Karyoti, A. Karapanagiotou, and Katerina Tsergouli
Subjects: Acinetobacter baumannii, Male, 0301 basic medicine, Non-Randomized Controlled Trials as Topic, 030501 epidemiology, medicine.disease_cause, law.invention, law, Hygiene, Prevalence, Infection control, Colonization, Prospective Studies, media_common, Aged, 80 and over, biology, Incidence, Incidence (epidemiology), General Medicine, Middle Aged, Intensive care unit, Anti-Bacterial Agents, Intensive Care Units, Klebsiella pneumoniae, Infectious Diseases, Epidemiological Monitoring, Pseudomonas aeruginosa, Female, 0305 other medical science, Adult, Microbiology (medical), medicine.medical_specialty, Adolescent, Critical Illness, media_common.quotation_subject, 030106 microbiology, beta-Lactam Resistance, Young Adult, 03 medical and health sciences, Intensive care, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Infection Control, business.industry, biology.organism_classification, Carbapenems, Gram-Negative Bacterial Infections, business
Abstract: Summary Background Carbapenem-resistant Gram-negative bacteria (CRGNB) infections constitute a global threat for critically ill patients and the outcome of their hospitalization. Early identification of CRGNB through rectal surveillance cultures and routine infection control measures including contact precautions, use of appropriate disinfectants, staff education on cleaning, and hand hygiene may reduce the dissemination of CRGNB. Aim To assess the impact of enhanced infection control measures on CRGNB infections in a nine-bed polyvalent intensive care unit in a tertiary level hospital in an endemic area. Methods A quasi-experimental study, which included patients with CRGNB infection retrospectively for six months and those participating in an active surveillance programme prospectively for the subsequent 22 months. Active surveillance programme (weekly rectal swabs) was implemented including two sub-periods with infection control measures and enhanced infection control measures. CRGNB incidence, prevalence, colonization pressure, infections and compliance with infection control measures and enhanced infection control measures were recorded. Analysis was performed through time-series and interrupted time-series. Findings During the active surveillance programme, enhanced infection control measures led to a steeper downwards trend in incidence, prevalence, and colonization pressure for CRGNB compared to the infection control measures sub-period. The linear trend was for carbapenem-resistant Klebsiella pneumoniae (CRKP) and Pseudomonas aeruginosa (CRPA) infections to decrease from 19.6 to 8.1 infections per 1000 bed-days (IBD) (P = 0.001) and from 5.1 to 1.79 IBD (P = 0.043), respectively. By contrast, carbapenem-resistant Acinetobacter baumannii infections increased from 5.2 to 15.3 IBD (P = 0.001). Conclusion Enhanced infection control measures including enhanced hand hygiene, active surveillance combined with contact precautions, education, audits and feedback policies and interventions could reduce CRKP and CRPA in endemic areas.
Published: 2018

46. Current and potential treatment options for invasiveCandidainfections

Author: Elias Iosifidis, A. Pyrpasopoulou, and Emmanuel Roilides
Subjects: 0301 basic medicine, Antifungal, medicine.medical_specialty, biology, business.industry, medicine.drug_class, Health Policy, 030106 microbiology, Treatment options, Candida parapsilosis, biology.organism_classification, Candida infections, Surgery, 03 medical and health sciences, Medicine, Pharmacology (medical), In patient, Clinical efficacy, Partially able, business, Intensive care medicine, Candida albicans, Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
Abstract: Introduction: Milestones in the history of antifungal development have only been partially able to alter the severity of prognosis associated with invasive candidiasis. This review aims to address current therapeutic strategies in the treatment of invasive candidiasis, their strengths and weaknesses, and present novel antifungals and clinical evidence of their potential.Areas covered: Candidemia, the most frequently encountered form of invasive candidiasis, is associated with an aggravated prognosis. Besides the obvious unfavourable host factors present in patients with severe underlying pathology, microbe characteristics, such as the ability to form immune system evading biofilm structures, or the emergence of resistance, further impact prognosis. The utility of biochemical markers and diagnostic techniques for a prompt and accurate diagnosis is discussed. Moreover, historical and up to date pharmacological and clinical efficacy data of licensed antifungals are reviewed, and their individual prop...
Published: 2017

47. Empiric Therapy With Carbapenem-Sparing Regimens for Bloodstream Infections due to Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae: Results From the INCREMENT Cohort

Author: Ilias Karaiskos, Mitchell J. Schwaber, Julián Torre-Cisneros, Belén Gutiérrez-Gutiérrez, Isabel Machuca, Jesús Rodríguez-Baño, David L. Paterson, Pierluigi Viale, Zaira R. Palacios-Baena, Núria Prim, C. I. Marinescu, Elias Iosifidis, Jorge Galvez, Yohei Doi, Beatriz Mirelis, Enrico Maria Trecarichi, Felipe Francisco Tuon, José Antonio Martínez, José Molina Gil-Bermejo, N. Larrosa, José Ramón Paño-Pardo, Vicente Pintado, Manel Almela, Maria Souli, Mario Venditti, Spyros Pournaras, Fe Tubau, Michele Bartoletti, M.C. Fariñas, Yehuda Carmeli, Angela Raffaella Losito, Luis Martínez-Martínez, M. E. Cano, Oriol Gasch, Johann D. D. Pitout, Federico Perez, Silvia Gómez-Zorrilla, Benito Almirante, V. Rucci, E. Jové, Mario Tumbarello, José Molina, Germán Bou, Carmen Peña, A. O. Sahin, S. Peter, Mónica Gozalo, Evelina Tacconelli, Warren Lowman, D. Fontanals, R. San Juan, Po-Ren Hsueh, Joaquín Bermejo, Garyphallia Poulakou, Esther Calbo, Robert A. Bonomo, M. Xercavins, Murat Akova, Álvaro Pascual, Athanassios Tsakris, Anastasia Antoniadou, Alessandro Russo, C. de la Calle, Helvaci, Cristina Badia, L. Morata, Cano, Maddalena Giannella, Antonio Oliver, J. Gómez, Axel Hamprecht, O. Zarkotou, V. González, D. Virmani, M. Mora-Rillo, M. Fernández-Ruiz, Ferran Navarro, E. Ruiz de Gopegui, Alicia Hernandez, George L. Daikos, Helen Giamarellou, Emmanuel Roilides, Marco Falcone, Mireia Puig, K. Azap, Patricia Ruiz-Garbajosa, İç Hastalıkları, and Palacios-Baena ZR, Gutiérrez-Gutiérrez B, Calbo E, Almirante B, Viale P, Oliver A, Pintado V, Gasch O, Martínez-Martínez L, Pitout J, Akova M, Peña C, Molina Gil-Bermejo J, Hernández A, Venditti M, Prim N, Bou G, Tacconelli E, Tumbarello M, Hamprecht A, Giamarellou H, Almela M, Pérez F, Schwaber MJ, Bermejo J, Lowman W, Hsueh PR, Paño-Pardo JR, Torre-Cisneros J, Souli M, Bonomo RA, Carmeli Y, Paterson DL, Pascual Á, Rodríguez-Baño J
Subjects: Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Carbapenem, bloodstream infections, Immunology, 030106 microbiology, Bacteremia, bloodstream infection, Kaplan-Meier Estimate, Microbiology, beta-Lactam Resistance, beta-Lactamases, 03 medical and health sciences, Antibiotic resistance, Enterobacteriaceae, Internal medicine, polycyclic compounds, medicine, Humans, antimicrobial resistance, Articles and Commentaries, Retrospective Studies, extended-spectrum beta-lactamase-producing Enterobacteriaceae, aminoglycosides, therapy, biology, business.industry, Enterobacteriaceae Infections, extended-spectrum β-lactamase–producing Enterobacteriaceae, Middle Aged, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Anti-Bacterial Agents, Infectious Diseases, Carbapenems, Cohort, aminoglycoside, bacteria, Female, business, Empiric therapy, medicine.drug
Abstract: Background. There is little information about the efficacy of active alternative drugs to carbapenems except beta-lactam/beta-lactamase inhibitors for the treatment of bloodstream infections (BSIs) due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). The objective of this study was to assess the outcomes of patients with BSI due to ESBL-E who received empiric therapy with such drugs (other active drugs [OADs]) or carbapenems. Methods. A multinational retrospective cohort study of patients with BSI due to ESBL-E who received empiric treatment with OADs or carbapenems was performed. Cox regression including a propensity score for receiving OADs was performed to analyze 30-day all-cause mortality as main outcome. Clinical failure and length of stay were also analyzed. Results. Overall, 335 patients were included; 249 received empiric carbapenems and 86 OADs. The most frequent OADs were aminoglycosides (43 patients) and fluoroquinolones (20 patients). Empiric therapy with OADs was not associated with mortality (hazard ratio [HR], 0.75; 95% confidence interval [CI],.38-1.48) in the Cox regression analysis. Propensity score-matched pairs, subgroups, and sensitivity analyses did not show different trends; specifically, the adjusted HR for aminoglycosides was 1.05 (95% CI,.51-2.16). OADs were neither associated with 14-day clinical failure (adjusted odds ratio, 0.62; 95% CI,.29-1.36) nor length of hospital stay. Conclusions. We were unable to show that empiric treatment with OAD was associated with a worse outcome compared with carbapenems. This information allows more options to be considered for empiric therapy, at least for some patients, depending on local susceptibility patterns of ESBL-E.
Published: 2017

48. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study

Author: Manel Almela, Angela Raffaella Losito, Deepali Virmani, Silvia Gómez-Zorrilla, Alicia Hernandez, Maria Souli, George L. Daikos, F. Riemenschneider, V. Rucci, José Molina, Carmen Peña, C. I. Marinescu, Mireia Puig-Asensio, Mónica Gozalo, José Miguel Cisneros, E. Ruiz de Gopegui, A. O. Sahin, Joaquín Bermejo, R. San Juan, Esther Calbo, Mario Fernández-Ruiz, Emmanuel Roilides, Warren Lowman, Evelina Tacconelli, Maddalena Giannella, Julia Origüen, Antonio Oliver, M.D. del Toro, Elena Salamanca, Garyphallia Poulakou, Nieves Larrosa, Jorge Galvez, Özlem Kurt Azap, Po-Ren Hsueh, Pierluigi Viale, Elias Iosifidis, Felipe Francisco Tuon, Ilias Karaiskos, Marina de Cueto, V. González, M.C. Fariñas, Belén Gutiérrez-Gutiérrez, M. Xercavins, E. Jové, Athanassios Tsakris, M. E. Cano, Oriol Gasch, Alessandro Russo, Johann D. D. Pitout, Anna Skiada, Michele Bartoletti, Mario Tumbarello, Vicente Pintado, Mitchell J. Schwaber, C. Navarro-San Francisco, O. Zarkotou, Benito Almirante, Murat Akova, E. García-Vázquez, Yohei Doi, Beatriz Mirelis, Álvaro Pascual, Jesús Rodríguez-Baño, David L. Paterson, Federico Perez, N. Prim, Cristina Badia, Luis Martínez-Martínez, J. Gómez, Elena Pérez-Nadales, Julia Guzmán-Puche, José Ramón Paño-Pardo, Mario Venditti, Yehuda Carmeli, J. Torre-Cisneros, Ö. Helvaci, D. Fontanals, Enrico Maria Trecarichi, Helen Giamarellou, Marco Falcone, Ferran Navarro, Robert A. Bonomo, Rafael Cantón, Anastasia Antoniadou, Germán Bou, Spyros Pournaras, Fe Tubau, Marta Mora-Rillo, Patricia Cordero Ruiz, Gutiérrez-Gutiérrez, Belén, Salamanca, Elena, de Cueto, Marina, Hsueh, Po-Ren, Viale, Pierluigi, Paño-Pardo, José Ramón, Venditti, Mario, Tumbarello, Mario, Daikos, George, Cantón, Rafael, Doi, Yohei, Tuon, Felipe Francisco, Karaiskos, Ilia, Pérez-Nadales, Elena, Schwaber, Mitchell J, Azap, Özlem Kurt, Souli, Maria, Roilides, Emmanuel, Pournaras, Spyro, Akova, Murat, Pérez, Federico, Bermejo, Joaquín, Oliver, Antonio, Almela, Manel, Lowman, Warren, Almirante, Benito, Bonomo, Robert A, Carmeli, Yehuda, Paterson, David L, Pascual, Alvaro, Rodríguez-Baño, Jesú, del Toro, M.D., Gálvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E.M., Losito, A.R., García-Vázquez, E., Hernández, A., Gómez, J., Bou, G., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Skiada, A., Origüen, J., Juan, R San, Fernández-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J.M., Molina, J., González, V., Rucci, V., de Gopegui, E Ruiz, Marinescu, C.I., Martínez-Martínez, L., Fariñas, M.C., Cano, M.E., Gozalo, M., Mora-Rillo, M., Francisco, C Navarro-San, Peña, C., Gómez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Pitout, J., Virmani, D., Torre-Cisneros, J., Guzmán-Puche, J., Helvaci, Ã ., Sahin, A.O., Pintado, V., Ruiz, P., Bartoletti, M., Giannella, M., Tacconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, O., Fontanals, D., and Jové, E.
Subjects: Male, 0301 basic medicine, Pediatrics, medicine.medical_specialty, Combination therapy, 030106 microbiology, Bacteremia, Settore MED/17 - MALATTIE INFETTIVE, beta-Lactamases, 03 medical and health sciences, Pharmacotherapy, Drug Therapy, Bacterial Proteins, Risk Factors, medicine, Humans, Propensity Score, Aged, Retrospective Studies, business.industry, Hazard ratio, Retrospective cohort study, Odds ratio, Anti-Bacterial Agents, Drug Therapy, Combination, Female, Klebsiella Infections, Klebsiella pneumoniae, medicine.disease, Infectious Diseases, Infectious Diseases, bloodstream infection, carbapenemase-prodicing Enterobacteriaceae, N/A, Combination, Propensity score matching, Cohort, business
Abstract: Background The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. Methods In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries. Exclusion criteria were missing key data, death sooner than 24 h after the index date, therapy with an active antibiotic for at least 2 days when blood cultures were taken, and subsequent episodes in the same patient. We compared 30 day all-cause mortality between patients receiving appropriate (including an active drug against the blood isolate and started in the first 5 days after infection) or inappropriate therapy, and for patients receiving appropriate therapy, between those receiving active monotherapy (only one active drug) or combination therapy (more than one). We used a propensity score for receiving combination therapy and a validated mortality score (INCREMENT-CPE mortality score) to control for confounders in Cox regression analyses. We stratified analyses of combination therapy according to INCREMENT-CPE mortality score (0â7 [low mortality score] vs 8â15 [high mortality score]). INCREMENT is registered with ClinicalTrials.gov, number NCT01764490. Findings Between Jan 1, 2004, and Dec 31, 2013, 480 patients with BSIs due to CPE were enrolled in the INCREMENT cohort, of whom we included 437 (91%) in this study. 343 (78%) patients received appropriate therapy compared with 94 (22%) who received inappropriate therapy. The most frequent organism was Klebsiella pneumoniae (375 [86%] of 437; 291 [85%] of 343 patients receiving appropriate therapy vs 84 [89%] of 94 receiving inappropriate therapy) and the most frequent carbapenemase was K pneumoniae carbapenemase (329 [75%]; 253 [74%] vs 76 [81%]). Appropriate therapy was associated with lower mortality than was inappropriate therapy (132 [38Â·5%] of 343 patients died vs 57 [60Â·6%] of 94; absolute difference 22Â·1% [95% CI 11Â·0â33Â·3]; adjusted hazard ratio [HR] 0Â·45 [95% CI 0Â·33â0Â·62]; p
Published: 2017

49. Effects of an Active Surveillance Program and Enhanced Infection Control Measures on Carbapenem-Resistant Gram-Negative Bacterial Carriage and Infections in Pediatric Intensive Care

Author: Angeliki Karyoti, Katerina Tsergouli, Emmanuel Roilides, Elias Iosifidis, Maria Sdougka, Athanassios Tsakris, Charalampos Antachopoulos, Eleni Volakli, and Theodoros Karampatakis
Subjects: Microbiology (medical), Male, medicine.medical_specialty, Gram-negative bacteria, Adolescent, medicine.drug_class, Immunology, Antibiotics, Prevalence, Intensive Care Units, Pediatric, Microbiology, 03 medical and health sciences, Internal medicine, Intensive care, Epidemiology, Drug Resistance, Bacterial, Gram-Negative Bacteria, medicine, Infection control, Humans, Hand Hygiene, Prospective Studies, Child, Watchful Waiting, 030304 developmental biology, Retrospective Studies, Pharmacology, Pediatric intensive care unit, 0303 health sciences, biology, 030306 microbiology, business.industry, Infant, Interrupted Time Series Analysis, biology.organism_classification, Anti-Bacterial Agents, Carriage, Carbapenems, Child, Preschool, Carrier State, Female, business, Gram-Negative Bacterial Infections
Abstract: We evaluated the effects of enhanced infection control measures (ICMs) on carriage and infections of carbapenem-resistant Gram-negative bacteria (CRGNB) in a pediatric intensive care unit. We conducted a quasi-experimental study, including patients with infections of CRGNB retrospectively for 13 months and those participating in an active surveillance program prospectively for 22 months. Active surveillance (weekly rectal swabs) was implemented during a 63-week subperiod with standard ICMs and a subsequent 27-week subperiod with enhanced ICMs (intensified ICMs supplemented with audits and feedback). Prevalence, colonization pressure, incidence, and infections of CRGNB and compliance with ICMs and enhanced ICMs were recorded. Evaluation of results was performed using time series (TS) and interrupted TS. Compliance with hand hygiene improved during the second subperiod of active surveillance compared with the first; prevalence, colonization pressure, and incidence of CRGNB decreased significantly. The linear trend of centered moving average for carbapenem-resistant
Published: 2019

50. Perioperative Chemoprophylaxis οr Treatment for Extensively Drug Resistant Gram-Negative Bacteria in Patients Undergoing Liver Transplantation Based on Preoperative Donor/Recipient Surveillance Cultures: A Prospective Study

Author: Ioannis Fouzas, E. Vagdatli, S. Papadopoulos, Dimitrios G. Vasilakos, D. Xarisopoulos, Elias Iosifidis, D. Philis, I. Kotsamidi, D. Agapakis, E. Massa, M. Daoudaki, E. Mouloudi, E. Michailidou, G. Imvrios, and V. Papanikolaou
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Drug resistance, Liver transplantation, law.invention, Liver disease, Immunocompromised Host, law, Internal medicine, Gram-Negative Bacteria, Medicine, Humans, Colonization, Prospective Studies, Prospective cohort study, Transplantation, business.industry, Perioperative, Antibiotic Prophylaxis, Middle Aged, medicine.disease, Intensive care unit, Tissue Donors, Anti-Bacterial Agents, Liver Transplantation, Chemoprophylaxis, Surgery, Female, business, Gram-Negative Bacterial Infections
Abstract: The importance of preoperative donor/recipient colonization or donor infection by extensively drug-resistant Gram-negative bacteria (XDR-GNB) and its relation to serious post-transplantation infection pathogenicity in liver transplantation (LT) patients has not been clarified.Prevention of postoperative infection due to XDR-GNB with the appropriate perioperative chemoprophylaxis or treatment based on preoperative donor/recipient surveillance cultures in LT patients, as well as their outcome.Twenty-six patients (20 male, 6 female) were studied (average preoperative Model for End-Stage Liver Disease score ≈15, range: 8-29) from January 2017 to January 2018. In all patients, blood, urine, and bronchial secretions culture samples as well as a rectal colonization culture were taken pre- and postoperatively, once weekly after LT, and after intensive care unit discharge. Recipients with positive XDR-GNB colonization and patients receiving a transplant from a donor with an XDR-GNB positive culture or colonization received the appropriate chemoprophylaxis one half hour preoperatively according to culture results. De-escalation of the antibiotic regimen was done in 2 to 5 days based on the colonization/culture results of the donor and recipient and their clinical condition. Evaluation for serious infection was done at 1 week and at 28 days for outcome results.Fourteen out of 26 recipients (53.8%) were positive for XDR-GNB colonization preoperative, with 2/14 (14.28%) presenting serious infection due to the same pathogen. Intensive care unit length of stay was significantly longer in colonized with XDR-GNB patients (P .0001). The outcome of colonized patients was 6/14 (42.8%) expired, but only in 2/14 (14.2%) was mortality attributable to infection.Administering appropriate perioperative chemoprophylaxis and treatment may limit the frequency of XDR-GNB infections and intensive care unit length of stay and may improve the outcome in LT recipients.
Published: 2019

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