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5. Primary care physician perceptions on the diagnosis and management of chronic obstructive pulmonary disease in diverse regions of the world

Author

Aisanov Z, Bai CX, Bauerle O, Colodenco FD, Feldman C, Hashimoto S, Jardim J, Lai CKW, Laniado-Laborin R, Nadeau G, Sayiner A, Shim JJ, Tsai YH, Walters RD, and Waterer G

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Zaurbek Aisanov1,*, Chunxue Bai2,*, Otto Bauerle3,*, Federico D Colodenco4,*, Charles Feldman5,6,*, Shu Hashimoto7,*, Jose Jardim8,*, Christopher KW Lai9,*, Rafael Laniado-Laborin10,*, Gilbert Nadeau11,*, Abdullah Sayiner12,*, Jae Jeong Shim13,*, Ying Huang Tsai14,*, Richard D Walters11,*, Grant Waterer15,* 1Pulmonology Research Institute, Moscow, Russia; 2Department of Pulmonary Medicine, Fudan University, Shanghai, People's Republic of China; 3Centro Médico de las Américas, Mérida, Yucatán, Mexico; 4Hospital de Rehabilitación Respiratoria "María Ferrer," Buenos Aires, Argentina; 5Department of Internal Medicine, Charlotte Maxeke Johannesburg Hospital, Johannesburg, South Africa; 6Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 7Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan; 8Federal University of São Paulo, São Paulo, Brazil; 9Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China; 10Faculty of Medicine, Universidad Autónoma de Baja California, Tijuana, Baja California, Mexico; 11Medical Affairs, GlaxoSmithKline, Brentford, UK; 12Department of Chest Diseases, Ege University Medical School, Izmir, Turkey; 13Department of Pulmonology, Guro Hospital, Korea University Medical Center, Seoul, South Korea; 14Department of Respiratory Care Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan; 15School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia*ICON group (International COPD Network), listed in alphabetical orderAbstract: Chronic obstructive pulmonary disease (COPD) is a multicomponent disorder that leads to substantial disability, impaired quality of life, and increased mortality. Although the majority of COPD patients are first diagnosed and treated in primary care practices, there is comparatively little information on the management of COPD patients in primary care. A web-based pilot survey was conducted to evaluate the primary care physician's, or general practitioner's (GP's), knowledge, understanding, and management of COPD in twelve territories across the Asia-Pacific region, Africa, eastern Europe, and Latin America, using a 10-minute questionnaire comprising 20 questions and translated into the native language of each participating territory. The questionnaire was administered to a total of 600 GPs (50 from each territory) involved in the management of COPD patients and all data were collated and analyzed by an independent health care research consultant. This survey demonstrated that the GPs' understanding of COPD was variable across the territories, with large numbers of GPs having very limited knowledge of COPD and its management. A consistent finding across all territories was the underutilization of spirometry (median 26%; range 10%–48%) and reliance on X-rays (median 14%; range 5%–22%) for COPD diagnosis, whereas overuse of blood tests (unspecified) was particularly high in Russia and South Africa. Similarly, there was considerable underrecognition of the importance of exacerbation history as an important factor of COPD and its initial management in most territories (median 4%; range 0%–22%). Management of COPD was well below guideline-recommended levels in most of the regions investigated. The findings of this survey suggest there is a need for more ongoing education and information, specifically directed towards GPs outside of Europe and North America, and that global COPD guidelines appear to have limited reach and application in most of the areas studied.Keywords: COPD, questionnaire, survey, guidelines

Published
2012

6. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2019: the Influenza Complications Alert Network (FluCAN).

Author

Cheng A.C., Dwyer D.E., Holmes M., Irving L., Simpson G., Senenayake S., Korman T., Friedman N.D., Cooley L., Wark P., Holwell A., Bowler S., Upham J., Fatovich D.M., Waterer G., Blyth C.C., Crawford N., Buttery J., Marshall H.S., Clark J.E., Francis J., Macartney K., Kotsimbos T., Kelly P., Cheng A.C., Dwyer D.E., Holmes M., Irving L., Simpson G., Senenayake S., Korman T., Friedman N.D., Cooley L., Wark P., Holwell A., Bowler S., Upham J., Fatovich D.M., Waterer G., Blyth C.C., Crawford N., Buttery J., Marshall H.S., Clark J.E., Francis J., Macartney K., Kotsimbos T., and Kelly P.

Abstract

Influenza is a common cause of acute respiratory infection, and is a major cause of morbidity and mortality. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2019 influenza season. The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. Cases were defined as patients hospitalised at any of the 17 sentinel hospitals with influenza confirmed by nucleic acid detection. Data were also collected on a frequency matched control group of influenza-negative patients admitted with acute respiratory infection. During the period 1 April to 31 October 2019 (the 2019 influenza season), there were 4,154 patients admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 44% were elderly (>= 65 years), 21% were children (< 16 years), 7.7% were Aboriginal and Torres Strait Islander peoples, 1.7% were pregnant and 73% had chronic comorbidities. Most admissions were due to influenza A infection (85%). Estimated vaccine coverage was 75% in the elderly, 49% in non-elderly adults with medical comorbidities, and 27% in young children (< 5 years). The estimated vaccine effectiveness in the target adult population was 42% (95% confidence interval [95% CI]: 36%, 49%). There were a larger number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2019 than in 2018.Copyright © Commonwealth of Australia CC BY-NC-ND.

Published
2022

7. Surveillance for severe influenza and COVID-19 in patients admitted to sentinel Australian hospitals in 2020: the Influenza Complications Alert Network (FluCAN).

Author

Begum H., Dwyer D.E., Holmes M., Irving L., Simpson G., Senenayake S., Korman T., Friedman N.D., Cooley L., Wark P., Bowler S., Kok J., Upham J., Fatovich D.M., Waterer G., Macartney K., Blyth C.C., Crawford N., Buttery J., Marshall H.S., Clark J.E., Francis J.R., Kotsimbos T., Kelly P., Cheng A., Begum H., Dwyer D.E., Holmes M., Irving L., Simpson G., Senenayake S., Korman T., Friedman N.D., Cooley L., Wark P., Bowler S., Kok J., Upham J., Fatovich D.M., Waterer G., Macartney K., Blyth C.C., Crawford N., Buttery J., Marshall H.S., Clark J.E., Francis J.R., Kotsimbos T., Kelly P., and Cheng A.

Abstract

Introduction: Influenza is a common cause of acute respiratory infection, and is a major cause of morbidity and mortality. Coronavirus disease 2019 (COVID-19) is an acute respiratory infection that emerged as a pandemic worldwide before the start of the 2020 Australian influenza season. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza and COVID-19 during the 2020 influenza season in a sentinel surveillance system. Method(s): The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. Influenza and COVID-19 cases were defined as patients hospitalised at sentinel hospitals and confirmed by nucleic acid detection. Result(s): There were 448 patients with COVID-19 admitted between 16 March and 31 December 2020, and only 20 patients with influenza admitted between 1 April and 30 November 2020, to one of 22 FluCAN hospitals. Of the COVID-19 cases, 173 (39%) were > 65 years of age, 36 (8%) were children (< 16 years), 6 (1%) were Aboriginal and Torres Strait Islander peoples, 4 (1%) were pregnant and 289 (65%) had chronic comorbidities. COVID-19 hospital admissions peaked between weeks 13 and 15 (first wave) nationally, and again between weeks 31 and 35 (Victoria), with most admissions represented by those above 40 years of age. Discussion(s): There was an unusually low number of hospital admissions with laboratory-confirmed influenza in this season, compared to recent seasons. This is likely to be due to effective public health interventions and international border closures as a result of a rise in COVID-19 respiratory infections and associated hospitalisations.Copyright © Commonwealth of Australia CC BY-NC-ND.

Published
2022

8. Surveillance for severe influenza and COVID-19 in patients admitted to sentinel Australian hospitals in 2020: the Influenza Complications Alert Network (FluCAN)

Author

Begum, H, Dwyer, DE, Holmes, M, Irving, L, Simpson, G, Senenayake, S, Korman, T, Friedman, Deb, Cooley, L, Wark, P, Bowler, S, Kok, J, Upham, J, Fatovich, DM, Waterer, G, Macartney, K, Blyth, CC, Crawford, N, Buttery, J, Marshall, HS, Clark, JE, Francis, JR, Kotsimbos, T, Kelly, P, Cheng, A, Begum, H, Dwyer, DE, Holmes, M, Irving, L, Simpson, G, Senenayake, S, Korman, T, Friedman, Deb, Cooley, L, Wark, P, Bowler, S, Kok, J, Upham, J, Fatovich, DM, Waterer, G, Macartney, K, Blyth, CC, Crawford, N, Buttery, J, Marshall, HS, Clark, JE, Francis, JR, Kotsimbos, T, Kelly, P, and Cheng, A

Abstract

Introduction: Influenza is a common cause of acute respiratory infection, and is a major cause of morbidity and mortality. Coronavirus disease 2019 (COVID-19) is an acute respiratory infection that emerged as a pandemic worldwide before the start of the 2020 Australian influenza season. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza and COVID-19 during the 2020 influenza season in a sentinel surveillance system. Methods: The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. Influenza and COVID-19 cases were defined as patients hospitalised at sentinel hospitals and confirmed by nucleic acid detection. Results: There were 448 patients with COVID-19 admitted between 16 March and 31 December 2020, and only 20 patients with influenza admitted between 1 April and 30 November 2020, to one of 22 FluCAN hospitals. Of the COVID-19 cases, 173 (39%) were > 65 years of age, 36 (8%) were children (< 16 years), 6 (1%) were Aboriginal and Torres Strait Islander peoples, 4 (1%) were pregnant and 289 (65%) had chronic comorbidities. COVID-19 hospital admissions peaked between weeks 13 and 15 (first wave) nationally, and again between weeks 31 and 35 (Victoria), with most admissions represented by those above 40 years of age. Discussion: There was an unusually low number of hospital admissions with laboratory-confirmed influenza in this season, compared to recent seasons. This is likely to be due to effective public health interventions and international border closures as a result of a rise in COVID-19 respiratory infections and associated hospitalisations.

Published
2022

9. Communicable Diseases Intelligence Surveillance for severe influenza and COVID-19 in patients admitted to sentinel Australian hospitals in 2020: the Influenza Complications Alert Network (FluCAN)

Author

Begum, H, Dwyer, DE, Holmes, M, Irving, L, Simpson, G, Senenayake, S, Korman, T, Friedman, ND, Cooley, L, Wark, P, Bowler, S, Kok, J, Upham, J, Fatovich, DM, Waterer, G, Macartney, K, Blyth, CC, Crawford, N, Buttery, J, Marshall, HS, Clark, JE, Francis, JR, Kotsimbos, T, Kelly, P, Cheng, A, Begum, H, Dwyer, DE, Holmes, M, Irving, L, Simpson, G, Senenayake, S, Korman, T, Friedman, ND, Cooley, L, Wark, P, Bowler, S, Kok, J, Upham, J, Fatovich, DM, Waterer, G, Macartney, K, Blyth, CC, Crawford, N, Buttery, J, Marshall, HS, Clark, JE, Francis, JR, Kotsimbos, T, Kelly, P, and Cheng, A

Abstract

INTRODUCTION: Influenza is a common cause of acute respiratory infection, and is a major cause of morbidity and mortality. Coronavirus disease 2019 (COVID-19) is an acute respiratory infection that emerged as a pandemic worldwide before the start of the 2020 Australian influenza season. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza and COVID-19 during the 2020 influenza season in a sentinel surveillance system. METHODS: The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. Influenza and COVID-19 cases were defined as patients hospitalised at sentinel hospitals and confirmed by nucleic acid detection. RESULTS: There were 448 patients with COVID-19 admitted between 16 March and 31 December 2020, and only 20 patients with influenza admitted between 1 April and 30 November 2020, to one of 22 FluCAN hospitals. Of the COVID-19 cases, 173 (39%) were > 65 years of age, 36 (8%) were children (< 16 years), 6 (1%) were Aboriginal and Torres Strait Islander peoples, 4 (1%) were pregnant and 289 (65%) had chronic comorbidities. COVID-19 hospital admissions peaked between weeks 13 and 15 (first wave) nationally, and again between weeks 31 and 35 (Victoria), with most admissions represented by those above 40 years of age. DISCUSSION: There was an unusually low number of hospital admissions with laboratory-confirmed influenza in this season, compared to recent seasons. This is likely to be due to effective public health interventions and international border closures as a result of a rise in COVID-19 respiratory infections and associated hospitalisations.

Published
2022

24. Update in COVID-19 in the intensive care unit from the 2020 HELLENIC Athens International symposium

Author

Rello, J. Belliato, M. Dimopoulos, M.-A. Giamarellos-Bourboulis, E.J. Jaksic, V. Martin-Loeches, I. Mporas, I. Pelosi, P. Poulakou, G. Pournaras, S. Tamae-Kakazu, M. Timsit, J.-F. Waterer, G. Tejada, S. Dimopoulos, G.

Abstract

The 2020 International Web Scientific Event in COVID-19 pandemic in critically ill patients aimed at updating the information and knowledge on the COVID-19 pandemic in the intensive care unit. Experts reviewed the latest literature relating to the COVID-19 pandemic in critically ill patients, such as epidemiology, pathophysiology, phenotypes of infection, COVID-19 as a systematic infection, molecular diagnosis, mechanical ventilation, thromboprophylaxis, COVID-19 associated co-infections, immunotherapy, plasma treatment, catheter-related bloodstream infections, artificial intelligence for COVID-19, and vaccination. Antiviral therapy and co-infections are out of the scope of this review. In this review, each of these issues is discussed with key messages regarding management and further research being presented after a brief review of available evidence. © 2020 Société française d'anesthésie et de réanimation (Sfar)

Published
2020

25. Inhaled molgramostim therapy in autoimmune pulmonary alveolar proteinosis

Author

Trapnell, B.C. Inoue, Y. Bonella, F. Morgan, C. Jouneau, S. Bendstrup, E. Campo, I. Papiris, S.A. Yamaguchi, E. Cetinkaya, E. Ilkovich, M.M. Kramer, M.R. Veltkamp, M. Kreuter, M. Baba, T. Ganslandt, C. Tarnow, I. Waterer, G. Jouhikainen, T. IMPALA Trial Investigators

Abstract

BACKGROUND Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease characterized by progressive surfactant accumulation and hypoxemia. It is caused by disruption of granulocyte-macrophage colony-stimulating factor (GM-CSF) signaling, which pulmonary alveolar macrophages require to clear surfactant. Recently, inhaled GM-CSF was shown to improve the partial pressure of arterial oxygen in patients with aPAP. METHODS In a double-blind, placebo-controlled, three-group trial, we randomly assigned patients with aPAP to receive the recombinant GM-CSF molgramostim (300 μg once daily by inhalation), either continuously or intermittently (every other week), or matching placebo. The 24-week intervention period was followed by an open-label treatment-extension period. The primary end point was the change from baseline in the alveolar-arterial difference in oxygen concentration (A-aDo2) at week 24. RESULTS In total, 138 patients underwent randomization; 46 were assigned to receive continuous molgramostim, 45 to receive intermittent molgramostim, and 47 to receive placebo. Invalid A-aDo2 data for 4 patients (1 in each molgramostim group and 2 in the placebo group) who received nasal oxygen therapy during arterial blood gas measurement were replaced by means of imputation. For the primary end point - the change from baseline in the A-aDo2 at week 24 - improvement was greater among patients receiving continuous molgramostim than among those receiving placebo (-12.8 mm Hg vs. -6.6 mm Hg; estimated treatment difference, -6.2 mm Hg; P = 0.03 by comparison of least-squares means). Patients receiving continuous molgramostim also had greater improvement than those receiving placebo for secondary end points, including the change from baseline in the St. George's Respiratory Questionnaire total score at week 24 (-12.4 points vs. -5.1 points; estimated treatment difference, -7.4 points; P = 0.01 by comparison of least-squares means). For multiple end points, improvement was greater with continuous molgramostim than with intermittent molgramostim. The percentages of patients with adverse events and serious adverse events were similar in the three groups, except for the percentage of patients with chest pain, which was higher in the continuous-molgramostim group. CONCLUSIONS In patients with aPAP, daily administration of inhaled molgramostim resulted in greater improvements in pulmonary gas transfer and functional health status than placebo, with similar rates of adverse events. (Funded by Savara Pharmaceuticals; IMPALA ClinicalTrials.gov number, NCT02702180.). Copyright © 2020 Massachusetts Medical Society.

Published
2020

32. Treatment of Community-Acquired Pneumonia in Immunocompromised Adults: A Consensus Statement Regarding Initial Strategies

Author

Ramirez, JA, Musher, DM, Evans, SE, Dela Cruz, C, Crothers, KA, Hage, CA, Aliberti, S, Anzueto, A, Arancibia, F, Arnold, F, Azoulay, E, Blasi, F, Bordon, J, Burdette, S, Cao, B, Cavallazzi, R, Chalmers, J, Charles, P, Chastre, J, Claessens, Y-E, Dean, N, Duval, X, Fartoukh, M, Feldman, C, File, T, Froes, F, Furmanek, S, Gnoni, M, Lopardo, G, Luna, C, Maruyama, T, Menendez, R, Metersky, M, Mildvan, D, Mortensen, E, Niederman, MS, Pletz, M, Rello, J, Restrepo, M, Shindo, Y, Torres, A, Waterer, G, Webb, B, Welte, T, Witzenrath, M, Wunderink, R, Ramirez, JA, Musher, DM, Evans, SE, Dela Cruz, C, Crothers, KA, Hage, CA, Aliberti, S, Anzueto, A, Arancibia, F, Arnold, F, Azoulay, E, Blasi, F, Bordon, J, Burdette, S, Cao, B, Cavallazzi, R, Chalmers, J, Charles, P, Chastre, J, Claessens, Y-E, Dean, N, Duval, X, Fartoukh, M, Feldman, C, File, T, Froes, F, Furmanek, S, Gnoni, M, Lopardo, G, Luna, C, Maruyama, T, Menendez, R, Metersky, M, Mildvan, D, Mortensen, E, Niederman, MS, Pletz, M, Rello, J, Restrepo, M, Shindo, Y, Torres, A, Waterer, G, Webb, B, Welte, T, Witzenrath, M, and Wunderink, R

Abstract

BACKGROUND: Community-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients. RESEARCH QUESTION: There is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP. STUDY DESIGN AND METHODS: This consensus document was created by a multidisciplinary panel of 45 physicians with experience in the treatment of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus. RESULTS: The panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiologic workup, general principles of empirical therapy, and empirical therapy for specific pathogens. INTERPRETATION: This document offers general suggestions for the initial treatment of the immunocompromised patient who arrives at the hospital with pneumonia.

Published
2020

33. The educational needs of people with bronchiectasis in a pulmonary rehabilitation setting

Author

Lee, A, Smith, R, Osadnik, C, Burr, L, Chang, A, Holmes-Liew, C-L, Jayaram, L, King, P, Middleton, P, Morgan, L, Tu, N, Smith, D, Stroil-Salama, E, Thomson, R, Waring, J, Waterer, G, Wong, C, Mcaleer, R, Lee, A, Smith, R, Osadnik, C, Burr, L, Chang, A, Holmes-Liew, C-L, Jayaram, L, King, P, Middleton, P, Morgan, L, Tu, N, Smith, D, Stroil-Salama, E, Thomson, R, Waring, J, Waterer, G, Wong, C, and Mcaleer, R

Published
2020

37. Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017: Results from the PAEDS-FluCAN Collaboration.

Author

Booy R., Britton P., Kesson A., Richmond P., Snelling T., Crawford N., Gold M., Kynasto A., Blyth C.C., Macartney K.K., McRae J., Clark J.E., Marshall H.S., Buttery J., Francis J.R., Kotsimbos T., Kelly P.M., Cheng A.C., Holmes M., Dwyer D.E., Senenayake S., Cooley L., Irving L., Simpson G., Korman T., Friedman N.D., Wark P., Holwell A., Bowler S., Upham J., Waterer G., Elliott E., McIntyre P., Wood N., Booy R., Britton P., Kesson A., Richmond P., Snelling T., Crawford N., Gold M., Kynasto A., Blyth C.C., Macartney K.K., McRae J., Clark J.E., Marshall H.S., Buttery J., Francis J.R., Kotsimbos T., Kelly P.M., Cheng A.C., Holmes M., Dwyer D.E., Senenayake S., Cooley L., Irving L., Simpson G., Korman T., Friedman N.D., Wark P., Holwell A., Bowler S., Upham J., Waterer G., Elliott E., McIntyre P., and Wood N.

Abstract

Background In 2017, Australia experienced record influenza notifications. Two surveillance programs combined to summarize the epidemiology of hospitalized influenza in children and report on vaccine effectiveness (VE) in the context of a limited nationally funded vaccination program. Methods Subjects were prospectively recruited (April-October 2017). Case patients were children aged <=16 years admitted to 11 hospitals with an acute respiratory illness and laboratory-confirmed influenza. Controls were hospitalized with acute respiratory illness and tested negative for influenza. VE estimates were calculated using the test-negative design. Results A total of 1268 children were hospitalized with influenza: 31.5% were <2 years old, 8.3% were indigenous, and 45.1% had comorbid conditions predisposing to severe influenza. Influenza B was detected in 34.1% with influenza A/H1N1 and A/H3N2 detected in 47.2% and 52.8% of subtyped influenza A specimens. The median length of stay was 3 days (interquartile range, 1-5), 14.5% were admitted to the intensive care unit, and 15.9% received oseltamivir. Four in-hospital deaths occurred (0.3%): one was considered influenza associated. Only 17.1% of test-negative-controls were vaccinated. The VE of inactivated quadrivalent influenza vaccine for preventing hospitalized influenza was estimated at 30.3% (95% confidence interval, 2.6%-50.2%). Conclusions Significant influenza-associated morbidity was observed in 2017 in Australia. Most hospitalized children had no comorbid conditions. Vaccine coverage and antiviral use was inadequate. Influenza vaccine was protective in 2017, yet VE was lower than previous seasons. Multiple Australian states have introduced funded preschool vaccination programs in 2018. Additional efforts to promote vaccination and monitor effectiveness are required.Copyright © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.

Published
2019

38. Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017: Results from the PAEDS-FluCAN Collaboration

Author

Blyth, CC, Macartney, KK, McRae, J, Clark, JE, Marshall, HS, Buttery, J, Francis, JR, Kotsimbos, T, Kelly, PM, Cheng, AC, Holmes, M, Dwyer, DE, Senenayake, S, Cooley, L, Irving, L, Simpson, G, Korman, T, Friedman, Deb, Wark, P, Holwell, A, Bowler, S, Upham, J, Waterer, G, Elliott, E, McIntyre, P, Booy, R, Wood, N, Britton, P, Kesson, A, Richmond, P, Snelling, T, Crawford, N, Gold, M, Kynasto, A, Blyth, CC, Macartney, KK, McRae, J, Clark, JE, Marshall, HS, Buttery, J, Francis, JR, Kotsimbos, T, Kelly, PM, Cheng, AC, Holmes, M, Dwyer, DE, Senenayake, S, Cooley, L, Irving, L, Simpson, G, Korman, T, Friedman, Deb, Wark, P, Holwell, A, Bowler, S, Upham, J, Waterer, G, Elliott, E, McIntyre, P, Booy, R, Wood, N, Britton, P, Kesson, A, Richmond, P, Snelling, T, Crawford, N, Gold, M, and Kynasto, A

Published
2019

40. World alliance against antibiotic resistance: The WAAAR declaration against antibiotic resistance

Author

Carlet, J, Aaron, L, Abassi, M, Abbo, L, Aboderin, O, Abraham, E, Abroug, F, Acar, J, Achour, W, Adachi, J, Al-Abri, S, Al-Mousa, H, Albaya-Moreno, A, Alberti, C, Alfandari, S, Alnimr, A, Aranda, C, de Lerma, F, Amer, F, Andremont, A, Angoulvant, F, Anguill, M, Antonelli, M, Antoniadou, E, Arlet, G, Armaganidis, A, Arnera, A, Artigas, A, Attali, C, Auber, F, Aubert, J, Augereau, B, Aupee, M, Bahri, O, Ballereau, F, Bapt, G, Baquero, F, Barkhan, T, Barouti, O, Barthelemy, M, Barton, G, Bastoni, D, Baussier, M, Bavestrello, L, Beger, B, Benenson, S, Bensalem, F, Beraud, G, Bergheau, F, Bernard, G, Berthelot, P, Bertrand, X, Beuhorry-Sassus, F, Beuret, P, Billington, J, Birge, J, Biscardi, S, Blanch, L, Blanchard, H, Bleck, T, Blondeau, J, Blot, F, Borgey, F, Bousquet-Melou, A, Brami, J, Brard, C, Bretagne, S, Bretonniere, C, Brink, A, Brown, S, Bruant-Rodier, C, Brun-Buisson, C, Bruneel, F, de Carvalho, F, Buhot, C, Bukharie, H, Cabie, A, Calandra, T, Caniaux, I, Canica, M, Canton, R, Carenco, P, Carlet, C, Carlet, F, Carlet, R, Cars, O, Cassiano-Neves, M, Castan, B, Castellan, V, Cazenave-Roblot, F, Ceretti, A, Chakarian, J, Chalumeau-Lemoine, L, Chandy, J, Chanfreau, B, Chastre, J, Chausset, R, Chavanet, P, Cheadle, W, Chiche, J, Chidiac, C, Chosidow, O, Chueca, N, Cohen, J, Cohen, R, Collignon, P, Collot, F, Coloby, P, Conly, J, Cordero, C, Cordonnier, C, Corso, A, Cosgrove, S, Courcol, R, Crane, S, Craven, D, Crespin, A, Cyrillo, M, Danin, P, Waele, J, Dellamonica, P, Patchen Dellinger, E, Dellinger, P, Delmont, J, Denes, E, Dimopoulos, G, Drekonja, D, Mansilla, A, Druais, P, Dufour-Pierrat, S, Dumartin, C, Dunser, M, Dupont, M, Durlach, R, Dyar, O, Echaniz, G, Edelstein, P, Eggimann, P, Elghonemi, M, Elmdaghri, N, Elsaid, R, Elsokari, R, Engelhard, D, Fabry, J, Farmer, C, Fernandez, J, Finfer, S, Finn, P, Fjeldsted, K, Floret, D, Flozaro, F, Foegle, J, Forceville, X, Fournier, S, Frachon, I, Friedrich, A, Funuel, P, Gaillard, D, Gaillat, J, Galperine, T, Gambarotto, K, Garo, B, Garrouste-Orgeas, M, Gastemeier, P, Gauchot, J, Gauzit, R, Gavazzi, G, Gazagne, L, Gerberding, J, Ghafur, A, Giamarellos-Bourboulis, E, Giamarellou, E, Giard, M, Gilchrist, M, Gilquin, J, Gilsanz, F, Gniadkowski, M, Gogos, C, Goldman, D, Gordon, F, Gottlieb, T, Gould, I, Gouveia, J, Grant, J, Grason, L, Greder, A, Grundman, H, Guaguere, E, Gueroult-Locher, G, Guery, B, Guidet, B, Guignabert, C, Gupta, P, Gupta, S, Gurjar, M, Guzman, M, Hajjar, J, Hammad, N, Hammerum, A, Hanberger, H, Hanke, R, Harbarth, S, Harel, A, Heisbourg, E, Hermes, I, Hermet, J, Hirschel, B, Hoen, B, Hollis, A, Honghong, X, Hooper, D, Horcajada, J, Housset, B, Hryniewicz, W, Hsu, L, Huang, S, Hughes, J, Hunault, J, Jakobsen, L, Jalil, N, Jansens, H, Jarlier, V, Jarvis, W, Jean, D, Jereb, M, Johnson, J, Joly-Guillou, M, Jonquet, O, Kac, G, Kaddu-Mulindwa, D, Kaku, M, Kilani, B, Kim, E, Gazard, D, Klugman, K, Klutts, S, Kluytmans, J, Kollef, M, Koulenti, D, Kresken, M, Lacoin, F, Lajonchere, J, Landgraf, N, Larroussinie, G, Laterre, P, Lavenaire, A, Lavigne, T, Laxminarayan, R, Le, T, Leblanc-Jouffre, F, Lee, N, Lehiani, O, Lelouet, H, Lemanach-Kergueris, F, Lepape, A, Leroy, J, Lescure, X, Levy, M, Levy-Hara, G, Lin, L, Lipman, J, Livartowski, J, Looke, D, Cardozo, F, Medrano, F, Lotthe, A, Lucet, J, Lupande, D, Madec, J, Mainardi, J, Maiylagan, S, Mancebo, J, Mansour-Adeoti, F, Maravi, E, Marchou, B, Marciniuk, D, Marshall, J, Martin, C, Martin, D, Martinez-Martinez, L, Martinot, A, Maseda, E, Matamis, D, Matheron, S, Matos, R, Matthews, M, May, T, Mayet, T, Mcgowan, J, Mehtar, S, Teles, J, Mendelson, M, Michelet, C, Mifsud, A, Mikaszewska-Sokolewicz, M, Minion, J, Miquel, C, Mira, J, Miro, J, Misset, B, Monot, J, Montravers, P, Mootien, J, Moreno, R, Morris, A, Moulin, G, Mourlan, C, Mouthon, G, Mowafy, W, Muhl, E, Muruganathan, A, Mushira, E, N'Doye, B, Nana, A, Niederman, M, Nitenberg, G, Nordman, P, Novira, A, Nowak, C, Okeke, I, Olaechea, P, Omar, A, Opal, S, Leyba, C, Oudega, B, Oziol, E, Page, B, Paiva, J, Palmer, L, Palomar-Martinez, M, Parneix, P, de la Garanderie, D, Perencevich, E, Perl, T, Perronne, C, Peters, G, Peters, M, Peyramond, D, Philippart, F, Pittet, D, Pittet, J, Plesiat, P, Pletz, M, Ploy, M, Pospisil, F, Pouedras, P, Poulakou, G, Poursinoff, A, Pronovost, P, Pulcini, C, Puoti, M, Puvanendiram, S, Quintel, M, Rabaud, C, Rambaud, C, Ramos, H, Rassla, O, Raymond, J, Regnier, B, Reinhart, K, Condomines, J, Revil, J, Riche, A, Richman, P, Richmann, R, Rodriguez, V, Rodriguez-Bano, J, Romain, O, Romand, K, Rossines, E, Rothan-Tondeur, M, Rousselot, J, Rubinstein, E, Rudnov, V, Saini, N, Salmon, D, Salomao, R, Garcia, M, Santos-Bouza, A, Saux, M, Savey, A, Saxinger, L, Schlemmer, B, Schmit, J, Schneider, D, Schoemaker, J, Singh, S, Sole-Violan, J, Soto, S, Stahl, J, Stoclin, A, Tabah, A, Tabut, J, Tambyah, P, Tamion, F, Tarr, P, Tattevin, P, Tenover, F, Terzi, N, Lecompte, M, Theodore, J, Thevenin, D, Thevenot, P, Thiriet, L, Thompson, C, Thurn, J, Tillotson, G, Tiouiri, H, Torres, A, Tremolieres, F, Troadec, M, Umar, R, Upham, G, Urban, C, Vaarten, J, Valla, D, Van Der Mee-Marquet, N, Van der Meer, J, Van Der Poll, T, Vancel, J, Vanhems, P, Varin, R, Varon, E, Vaughan, D, Veilly, M, Vijayakumar, K, Villanueva, A, Vincent, J, Vitrat, V, Voss, A, Wachter, R, Walsh, T, Wark, P, Waterer, G, Wegener, H, Weinbreck, P, Weinstein, R, Weissman, S, Wiener-Kronish, J, Wilmer, A, Wyplosz, B, Yacoub-Agha, I, Young, M, Yusuf, I, Zein, E, Zhanel, G, Zinner, S, Zoungrana, J, Zubareva, N, Carlet J., Aaron L., Abassi M. S., Abbo L., Aboderin O., Abraham E., Abroug F., Acar J., Achour W., Adachi J., Al-Abri S., Al-Mousa H., Albaya-Moreno A., Alberti C., Alfandari S., Alnimr A., Aranda C. A., de Lerma F. A., Amer F., Andremont A., Angoulvant F., Anguill M., Antonelli M., Antoniadou E., Arlet G., Armaganidis A., Arnera A., Artigas A., Attali C., Auber F., Aubert J. -P., Augereau B., Aupee M., Bahri O., Ballereau F., Bapt G., Baquero F., Barkhan T., Barouti O., Barthelemy M. -A., Barton G., Bastoni D., Baussier M., Bavestrello L., Beger B., Benenson S., Bensalem F., Beraud G., Bergheau F., Bernard G., Berthelot P., Bertrand X., Beuhorry-Sassus F., Beuret P., Billington J., Birge J., Biscardi S., Blanch L., Blanchard H., Bleck T., Blondeau J., Blot F., Borgey F., Bousquet-Melou A., Brami J., Brard C., Bretagne S., Bretonniere C., Brink A., Brown S., Bruant-Rodier C., Brun-Buisson C., Bruneel F., de Carvalho F. B., Buhot C., Bukharie H., Cabie A., Calandra T., Caniaux I., Canica M., Canton R., Carenco P., Carlet C., Carlet F., Carlet R., Cars O., Cassiano-Neves M., Castan B., Castellan V., Cazenave-Roblot F., Ceretti A. -M., Chakarian J. -C., Chalumeau-Lemoine L., Chandy J., Chanfreau B., Chastre J., Chausset R., Chavanet P., Cheadle W., Chiche J. -D., Chidiac C., Chosidow O., Chueca N., Cohen J., Cohen R., Collignon P., Collot F., Coloby P., Conly J., Cordero C., Cordonnier C., Corso A., Cosgrove S., Courcol R., Crane S., Craven D., Crespin A., Cyrillo M., Danin P. -E., Waele J. D., Dellamonica P., Patchen Dellinger E., Dellinger P., Delmont J., Denes E., Dimopoulos G., Drekonja D., Mansilla A. D., Druais P. -L., Dufour-Pierrat S., Dumartin C., Dunser M., Dupont M., Durlach R., Dyar O., Echaniz G., Edelstein P., Eggimann P., Elghonemi M., Elmdaghri N., Elsaid R., Elsokari R., Engelhard D., Fabry J., Farmer C., Fernandez J., Finfer S., Finn P., Fjeldsted K., Floret D., Flozaro F., Foegle J., Forceville X., Fournier S., Frachon I., Friedrich A., Funuel P., Gaillard D., Gaillat J., Galperine T., Gambarotto K., Garo B., Garrouste-Orgeas M., Gastemeier P., Gauchot J. -Y., Gauzit R., Gavazzi G., Gazagne L., Gerberding J., Ghafur A., Giamarellos-Bourboulis E., Giamarellou E., Giard M., Gilchrist M., Gilquin J., Gilsanz F., Gniadkowski M., Gogos C., Goldman D., Gordon F., Gottlieb T., Gould I., Gouveia J., Grant J., Grason L., Greder A., Grundman H., Guaguere E., Gueroult-Locher G., Guery B., Guidet B., Guignabert C., Gupta P., Gupta S., Gurjar M., Guzman M., Hajjar J., Hammad N., Hammerum A., Hanberger H., Hanke R., Harbarth S., Harel A., Heisbourg E., Hermes I., Hermet J. -P., Hirschel B., Hoen B., Hollis A., Honghong X., Hooper D., Horcajada J. P., Housset B., Hryniewicz W., Hsu L. Y., Huang S., Hughes J., Hunault J. -L., Jakobsen L., Jalil N., Jansens H., Jarlier V., Jarvis W., Jean D., Jereb M., Johnson J., Joly-Guillou M. -L., Jonquet O., Kac G., Kaddu-Mulindwa D., Kaku M., Kilani B., Kim E. -C., Gazard D. K., Klugman K., Klutts S., Kluytmans J., Kollef M., Koulenti D., Kresken M., Lacoin F., Lajonchere J. -P., Landgraf N., Larroussinie G., Laterre P. -F., Lavenaire A. -M., Lavigne T., Laxminarayan R., Le T. A. T., Leblanc-Jouffre F., Lee N. Y., Lehiani O., Lelouet H., Lemanach-Kergueris F., Lepape A., Leroy J., Lescure X., Levy M., Levy-Hara G., Lin L. M., Lipman J., Livartowski J., Looke D., Cardozo F. L. L., Medrano F. L., Lotthe A., Lucet J. C., Lupande D., Madec J. -Y., Mainardi J. -L., Maiylagan S., Mancebo J., Mansour-Adeoti F., Maravi E., Marchou B., Marciniuk D., Marshall J., Martin C., Martin D., Martinez-Martinez L., Martinot A., Maseda E., Matamis D., Matheron S., Matos R., Matthews M., May T., Mayet T., McGowan J., Mehtar S., Teles J. M. M., Mendelson M., Michelet C., Mifsud A., Mikaszewska-Sokolewicz M., Minion J., Miquel C., Mira J. -P., Miro J., Misset B., Monot J. -J., Montravers P., Mootien J., Moreno R., Morris A., Moulin G., Mourlan C., Mouthon G., Mowafy W., Muhl E., Muruganathan A., Mushira E., N'Doye B., Nana A., Niederman M., Nitenberg G., Nordman P., Novira A., Nowak C., Okeke I., Olaechea P. M., Omar A., Opal S., Leyba C. O., Oudega B., Oziol E., Page B., Paiva J. A., Palmer L., Palomar-Martinez M., Parneix P., de la Garanderie D. P., Perencevich E., Perl T., Perronne C., Peters G., Peters M., Peyramond D., Philippart F., Pittet D., Pittet J. -F., Plesiat P., Pletz M., Ploy M. -C., Pospisil F., Pouedras P., Poulakou G., Poursinoff A., Pronovost P., Pulcini C., Puoti M., Puvanendiram S., Quintel M., Rabaud C., Rambaud C., Ramos H., Rassla O., Raymond J., Regnier B., Reinhart K., Condomines J. R., Revil J. -C., Riche A., Richman P., Richmann R., Rodriguez V., Rodriguez-Bano J., Romain O., Romand K., Rossines E., Rothan-Tondeur M. I., Rousselot J. -F., Rubinstein E., Rudnov V., Saini N., Salmon D., Salomao R., Garcia M. S., Santos-Bouza A., Saux M. -C., Savey A., Saxinger L., Schlemmer B., Schmit J. -L., Schneider D., Schoemaker J., Singh S., Sole-Violan J., Soto S., Stahl J. -P., Stoclin A., Tabah A., Tabut J. -P., Tambyah P. A., Tamion F., Tarr P., Tattevin P., Tenover F., Terzi N., Lecompte M. T., Theodore J., Thevenin D., Thevenot P., Thiriet L., Thompson C., Thurn J., Tillotson G., Tiouiri H., Torres A., Tremolieres F., Troadec M., Umar R., Upham G., Urban C., Vaarten J., Valla D., Van Der Mee-Marquet N., Van der Meer J., Van Der Poll T., Vancel J., Vanhems P., Varin R., Varon E., Vaughan D., Veilly M., Vijayakumar K., Villanueva A., Vincent J. -L., Vitrat V., Voss A., Wachter R., Walsh T., Wark P., Waterer G., Wegener H. C., Weinbreck P., Weinstein R., Weissman S., Wiener-Kronish J., Wilmer A., Wyplosz B., Yacoub-Agha I., Young M., Yusuf I., Zein E., Zhanel G., Zinner S., Zoungrana J., Zubareva N., Carlet, J, Aaron, L, Abassi, M, Abbo, L, Aboderin, O, Abraham, E, Abroug, F, Acar, J, Achour, W, Adachi, J, Al-Abri, S, Al-Mousa, H, Albaya-Moreno, A, Alberti, C, Alfandari, S, Alnimr, A, Aranda, C, de Lerma, F, Amer, F, Andremont, A, Angoulvant, F, Anguill, M, Antonelli, M, Antoniadou, E, Arlet, G, Armaganidis, A, Arnera, A, Artigas, A, Attali, C, Auber, F, Aubert, J, Augereau, B, Aupee, M, Bahri, O, Ballereau, F, Bapt, G, Baquero, F, Barkhan, T, Barouti, O, Barthelemy, M, Barton, G, Bastoni, D, Baussier, M, Bavestrello, L, Beger, B, Benenson, S, Bensalem, F, Beraud, G, Bergheau, F, Bernard, G, Berthelot, P, Bertrand, X, Beuhorry-Sassus, F, Beuret, P, Billington, J, Birge, J, Biscardi, S, Blanch, L, Blanchard, H, Bleck, T, Blondeau, J, Blot, F, Borgey, F, Bousquet-Melou, A, Brami, J, Brard, C, Bretagne, S, Bretonniere, C, Brink, A, Brown, S, Bruant-Rodier, C, Brun-Buisson, C, Bruneel, F, de Carvalho, F, Buhot, C, Bukharie, H, Cabie, A, Calandra, T, Caniaux, I, Canica, M, Canton, R, Carenco, P, Carlet, C, Carlet, F, Carlet, R, Cars, O, Cassiano-Neves, M, Castan, B, Castellan, V, Cazenave-Roblot, F, Ceretti, A, Chakarian, J, Chalumeau-Lemoine, L, Chandy, J, Chanfreau, B, Chastre, J, Chausset, R, Chavanet, P, Cheadle, W, Chiche, J, Chidiac, C, Chosidow, O, Chueca, N, Cohen, J, Cohen, R, Collignon, P, Collot, F, Coloby, P, Conly, J, Cordero, C, Cordonnier, C, Corso, A, Cosgrove, S, Courcol, R, Crane, S, Craven, D, Crespin, A, Cyrillo, M, Danin, P, Waele, J, Dellamonica, P, Patchen Dellinger, E, Dellinger, P, Delmont, J, Denes, E, Dimopoulos, G, Drekonja, D, Mansilla, A, Druais, P, Dufour-Pierrat, S, Dumartin, C, Dunser, M, Dupont, M, Durlach, R, Dyar, O, Echaniz, G, Edelstein, P, Eggimann, P, Elghonemi, M, Elmdaghri, N, Elsaid, R, Elsokari, R, Engelhard, D, Fabry, J, Farmer, C, Fernandez, J, Finfer, S, Finn, P, Fjeldsted, K, Floret, D, Flozaro, F, Foegle, J, Forceville, X, Fournier, S, Frachon, I, Friedrich, A, Funuel, P, Gaillard, D, Gaillat, J, Galperine, T, Gambarotto, K, Garo, B, Garrouste-Orgeas, M, Gastemeier, P, Gauchot, J, Gauzit, R, Gavazzi, G, Gazagne, L, Gerberding, J, Ghafur, A, Giamarellos-Bourboulis, E, Giamarellou, E, Giard, M, Gilchrist, M, Gilquin, J, Gilsanz, F, Gniadkowski, M, Gogos, C, Goldman, D, Gordon, F, Gottlieb, T, Gould, I, Gouveia, J, Grant, J, Grason, L, Greder, A, Grundman, H, Guaguere, E, Gueroult-Locher, G, Guery, B, Guidet, B, Guignabert, C, Gupta, P, Gupta, S, Gurjar, M, Guzman, M, Hajjar, J, Hammad, N, Hammerum, A, Hanberger, H, Hanke, R, Harbarth, S, Harel, A, Heisbourg, E, Hermes, I, Hermet, J, Hirschel, B, Hoen, B, Hollis, A, Honghong, X, Hooper, D, Horcajada, J, Housset, B, Hryniewicz, W, Hsu, L, Huang, S, Hughes, J, Hunault, J, Jakobsen, L, Jalil, N, Jansens, H, Jarlier, V, Jarvis, W, Jean, D, Jereb, M, Johnson, J, Joly-Guillou, M, Jonquet, O, Kac, G, Kaddu-Mulindwa, D, Kaku, M, Kilani, B, Kim, E, Gazard, D, Klugman, K, Klutts, S, Kluytmans, J, Kollef, M, Koulenti, D, Kresken, M, Lacoin, F, Lajonchere, J, Landgraf, N, Larroussinie, G, Laterre, P, Lavenaire, A, Lavigne, T, Laxminarayan, R, Le, T, Leblanc-Jouffre, F, Lee, N, Lehiani, O, Lelouet, H, Lemanach-Kergueris, F, Lepape, A, Leroy, J, Lescure, X, Levy, M, Levy-Hara, G, Lin, L, Lipman, J, Livartowski, J, Looke, D, Cardozo, F, Medrano, F, Lotthe, A, Lucet, J, Lupande, D, Madec, J, Mainardi, J, Maiylagan, S, Mancebo, J, Mansour-Adeoti, F, Maravi, E, Marchou, B, Marciniuk, D, Marshall, J, Martin, C, Martin, D, Martinez-Martinez, L, Martinot, A, Maseda, E, Matamis, D, Matheron, S, Matos, R, Matthews, M, May, T, Mayet, T, Mcgowan, J, Mehtar, S, Teles, J, Mendelson, M, Michelet, C, Mifsud, A, Mikaszewska-Sokolewicz, M, Minion, J, Miquel, C, Mira, J, Miro, J, Misset, B, Monot, J, Montravers, P, Mootien, J, Moreno, R, Morris, A, Moulin, G, Mourlan, C, Mouthon, G, Mowafy, W, Muhl, E, Muruganathan, A, Mushira, E, N'Doye, B, Nana, A, Niederman, M, Nitenberg, G, Nordman, P, Novira, A, Nowak, C, Okeke, I, Olaechea, P, Omar, A, Opal, S, Leyba, C, Oudega, B, Oziol, E, Page, B, Paiva, J, Palmer, L, Palomar-Martinez, M, Parneix, P, de la Garanderie, D, Perencevich, E, Perl, T, Perronne, C, Peters, G, Peters, M, Peyramond, D, Philippart, F, Pittet, D, Pittet, J, Plesiat, P, Pletz, M, Ploy, M, Pospisil, F, Pouedras, P, Poulakou, G, Poursinoff, A, Pronovost, P, Pulcini, C, Puoti, M, Puvanendiram, S, Quintel, M, Rabaud, C, Rambaud, C, Ramos, H, Rassla, O, Raymond, J, Regnier, B, Reinhart, K, Condomines, J, Revil, J, Riche, A, Richman, P, Richmann, R, Rodriguez, V, Rodriguez-Bano, J, Romain, O, Romand, K, Rossines, E, Rothan-Tondeur, M, Rousselot, J, Rubinstein, E, Rudnov, V, Saini, N, Salmon, D, Salomao, R, Garcia, M, Santos-Bouza, A, Saux, M, Savey, A, Saxinger, L, Schlemmer, B, Schmit, J, Schneider, D, Schoemaker, J, Singh, S, Sole-Violan, J, Soto, S, Stahl, J, Stoclin, A, Tabah, A, Tabut, J, Tambyah, P, Tamion, F, Tarr, P, Tattevin, P, Tenover, F, Terzi, N, Lecompte, M, Theodore, J, Thevenin, D, Thevenot, P, Thiriet, L, Thompson, C, Thurn, J, Tillotson, G, Tiouiri, H, Torres, A, Tremolieres, F, Troadec, M, Umar, R, Upham, G, Urban, C, Vaarten, J, Valla, D, Van Der Mee-Marquet, N, Van der Meer, J, Van Der Poll, T, Vancel, J, Vanhems, P, Varin, R, Varon, E, Vaughan, D, Veilly, M, Vijayakumar, K, Villanueva, A, Vincent, J, Vitrat, V, Voss, A, Wachter, R, Walsh, T, Wark, P, Waterer, G, Wegener, H, Weinbreck, P, Weinstein, R, Weissman, S, Wiener-Kronish, J, Wilmer, A, Wyplosz, B, Yacoub-Agha, I, Young, M, Yusuf, I, Zein, E, Zhanel, G, Zinner, S, Zoungrana, J, Zubareva, N, Carlet J., Aaron L., Abassi M. S., Abbo L., Aboderin O., Abraham E., Abroug F., Acar J., Achour W., Adachi J., Al-Abri S., Al-Mousa H., Albaya-Moreno A., Alberti C., Alfandari S., Alnimr A., Aranda C. A., de Lerma F. A., Amer F., Andremont A., Angoulvant F., Anguill M., Antonelli M., Antoniadou E., Arlet G., Armaganidis A., Arnera A., Artigas A., Attali C., Auber F., Aubert J. -P., Augereau B., Aupee M., Bahri O., Ballereau F., Bapt G., Baquero F., Barkhan T., Barouti O., Barthelemy M. -A., Barton G., Bastoni D., Baussier M., Bavestrello L., Beger B., Benenson S., Bensalem F., Beraud G., Bergheau F., Bernard G., Berthelot P., Bertrand X., Beuhorry-Sassus F., Beuret P., Billington J., Birge J., Biscardi S., Blanch L., Blanchard H., Bleck T., Blondeau J., Blot F., Borgey F., Bousquet-Melou A., Brami J., Brard C., Bretagne S., Bretonniere C., Brink A., Brown S., Bruant-Rodier C., Brun-Buisson C., Bruneel F., de Carvalho F. B., Buhot C., Bukharie H., Cabie A., Calandra T., Caniaux I., Canica M., Canton R., Carenco P., Carlet C., Carlet F., Carlet R., Cars O., Cassiano-Neves M., Castan B., Castellan V., Cazenave-Roblot F., Ceretti A. -M., Chakarian J. -C., Chalumeau-Lemoine L., Chandy J., Chanfreau B., Chastre J., Chausset R., Chavanet P., Cheadle W., Chiche J. -D., Chidiac C., Chosidow O., Chueca N., Cohen J., Cohen R., Collignon P., Collot F., Coloby P., Conly J., Cordero C., Cordonnier C., Corso A., Cosgrove S., Courcol R., Crane S., Craven D., Crespin A., Cyrillo M., Danin P. -E., Waele J. D., Dellamonica P., Patchen Dellinger E., Dellinger P., Delmont J., Denes E., Dimopoulos G., Drekonja D., Mansilla A. D., Druais P. -L., Dufour-Pierrat S., Dumartin C., Dunser M., Dupont M., Durlach R., Dyar O., Echaniz G., Edelstein P., Eggimann P., Elghonemi M., Elmdaghri N., Elsaid R., Elsokari R., Engelhard D., Fabry J., Farmer C., Fernandez J., Finfer S., Finn P., Fjeldsted K., Floret D., Flozaro F., Foegle J., Forceville X., Fournier S., Frachon I., Friedrich A., Funuel P., Gaillard D., Gaillat J., Galperine T., Gambarotto K., Garo B., Garrouste-Orgeas M., Gastemeier P., Gauchot J. -Y., Gauzit R., Gavazzi G., Gazagne L., Gerberding J., Ghafur A., Giamarellos-Bourboulis E., Giamarellou E., Giard M., Gilchrist M., Gilquin J., Gilsanz F., Gniadkowski M., Gogos C., Goldman D., Gordon F., Gottlieb T., Gould I., Gouveia J., Grant J., Grason L., Greder A., Grundman H., Guaguere E., Gueroult-Locher G., Guery B., Guidet B., Guignabert C., Gupta P., Gupta S., Gurjar M., Guzman M., Hajjar J., Hammad N., Hammerum A., Hanberger H., Hanke R., Harbarth S., Harel A., Heisbourg E., Hermes I., Hermet J. -P., Hirschel B., Hoen B., Hollis A., Honghong X., Hooper D., Horcajada J. P., Housset B., Hryniewicz W., Hsu L. Y., Huang S., Hughes J., Hunault J. -L., Jakobsen L., Jalil N., Jansens H., Jarlier V., Jarvis W., Jean D., Jereb M., Johnson J., Joly-Guillou M. -L., Jonquet O., Kac G., Kaddu-Mulindwa D., Kaku M., Kilani B., Kim E. -C., Gazard D. K., Klugman K., Klutts S., Kluytmans J., Kollef M., Koulenti D., Kresken M., Lacoin F., Lajonchere J. -P., Landgraf N., Larroussinie G., Laterre P. -F., Lavenaire A. -M., Lavigne T., Laxminarayan R., Le T. A. T., Leblanc-Jouffre F., Lee N. Y., Lehiani O., Lelouet H., Lemanach-Kergueris F., Lepape A., Leroy J., Lescure X., Levy M., Levy-Hara G., Lin L. M., Lipman J., Livartowski J., Looke D., Cardozo F. L. L., Medrano F. L., Lotthe A., Lucet J. C., Lupande D., Madec J. -Y., Mainardi J. -L., Maiylagan S., Mancebo J., Mansour-Adeoti F., Maravi E., Marchou B., Marciniuk D., Marshall J., Martin C., Martin D., Martinez-Martinez L., Martinot A., Maseda E., Matamis D., Matheron S., Matos R., Matthews M., May T., Mayet T., McGowan J., Mehtar S., Teles J. M. M., Mendelson M., Michelet C., Mifsud A., Mikaszewska-Sokolewicz M., Minion J., Miquel C., Mira J. -P., Miro J., Misset B., Monot J. -J., Montravers P., Mootien J., Moreno R., Morris A., Moulin G., Mourlan C., Mouthon G., Mowafy W., Muhl E., Muruganathan A., Mushira E., N'Doye B., Nana A., Niederman M., Nitenberg G., Nordman P., Novira A., Nowak C., Okeke I., Olaechea P. M., Omar A., Opal S., Leyba C. O., Oudega B., Oziol E., Page B., Paiva J. A., Palmer L., Palomar-Martinez M., Parneix P., de la Garanderie D. P., Perencevich E., Perl T., Perronne C., Peters G., Peters M., Peyramond D., Philippart F., Pittet D., Pittet J. -F., Plesiat P., Pletz M., Ploy M. -C., Pospisil F., Pouedras P., Poulakou G., Poursinoff A., Pronovost P., Pulcini C., Puoti M., Puvanendiram S., Quintel M., Rabaud C., Rambaud C., Ramos H., Rassla O., Raymond J., Regnier B., Reinhart K., Condomines J. R., Revil J. -C., Riche A., Richman P., Richmann R., Rodriguez V., Rodriguez-Bano J., Romain O., Romand K., Rossines E., Rothan-Tondeur M. I., Rousselot J. -F., Rubinstein E., Rudnov V., Saini N., Salmon D., Salomao R., Garcia M. S., Santos-Bouza A., Saux M. -C., Savey A., Saxinger L., Schlemmer B., Schmit J. -L., Schneider D., Schoemaker J., Singh S., Sole-Violan J., Soto S., Stahl J. -P., Stoclin A., Tabah A., Tabut J. -P., Tambyah P. A., Tamion F., Tarr P., Tattevin P., Tenover F., Terzi N., Lecompte M. T., Theodore J., Thevenin D., Thevenot P., Thiriet L., Thompson C., Thurn J., Tillotson G., Tiouiri H., Torres A., Tremolieres F., Troadec M., Umar R., Upham G., Urban C., Vaarten J., Valla D., Van Der Mee-Marquet N., Van der Meer J., Van Der Poll T., Vancel J., Vanhems P., Varin R., Varon E., Vaughan D., Veilly M., Vijayakumar K., Villanueva A., Vincent J. -L., Vitrat V., Voss A., Wachter R., Walsh T., Wark P., Waterer G., Wegener H. C., Weinbreck P., Weinstein R., Weissman S., Wiener-Kronish J., Wilmer A., Wyplosz B., Yacoub-Agha I., Young M., Yusuf I., Zein E., Zhanel G., Zinner S., Zoungrana J., and Zubareva N.

Abstract

We must change how antibiotics are used and adopt proactive strategies, similar to those used to save endangered species. Preservation of the efficacy of antibiotics and to stabilization of antibiotic-susceptible bacterial ecosystems should be global goals. (C) 2014 Elsevier Espana, S.L.U. and SEMICYUC. All rights reserved.

Published
2015

41. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2016: the Influenza Complications Alert Network (FluCAN).

Author

Cooley L., Kelly P., Bowler S., Upham J., Simpson G., Kotsimbos T., Wark P., Brady S., Friedman N.D., Cheng A.C., Holmes M., Dwyer D.E., Irving L., Korman T., Senenayake S., Macartney K., Blyth C., Brown S., Waterer G., Cooley L., Kelly P., Bowler S., Upham J., Simpson G., Kotsimbos T., Wark P., Brady S., Friedman N.D., Cheng A.C., Holmes M., Dwyer D.E., Irving L., Korman T., Senenayake S., Macartney K., Blyth C., Brown S., and Waterer G.

Abstract

During the period 1 April to 30 October 2016 (the 2016 influenza season), 1,952 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 46% were elderly (e65 years), 18% were children (<16 years), 5% were Aboriginal and Torres Strait Islander peoples, 3% were pregnant and 76% had chronic co-morbidities.Copyright This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that r

Published
2018

42. Bacteriology and clinical outcomes of patients with culture-positive pleural infection in Western Australia: A 6-year analysis

Author

Brims, Fraser, Popowicz, N., Rosenstengel, A., Hart, J., Yogendran, A., Read, C., Lee, F., Shrestha, R., Franke, A., Lewis, J., Kay, I., Waterer, G., Lee, Y., Brims, Fraser, Popowicz, N., Rosenstengel, A., Hart, J., Yogendran, A., Read, C., Lee, F., Shrestha, R., Franke, A., Lewis, J., Kay, I., Waterer, G., and Lee, Y.

Abstract

© 2018 Asian Pacific Society of Respirology Background and objective: Pleural infection is a clinical challenge; its microbiology can be complex. Epidemiological and outcome data of pleural infection in adult Australians are lacking. We describe the bacteriology and clinical outcomes of Australian adults with culture-positive pleural infection (CPPI) over a 6-year period. Methods: Cases with CPPI were identified through Western Australian public hospitals electronic record. Culture isolates, admission dates, vital status, co-morbidities, radiology, blood and pleural fluid tests were extracted. Results: In total, 601 cases (71.4% males; median age: 63 years (IQR: 50–74); median hospital stay 13 days) involving 894 bacterial isolates were identified. Hospital-acquired (HA)-CPPI was defined in 398 (66.2%) cases, community-acquired (CA)-CPPI in 164 (27.3%) cases and the remaining classified as oesophageal rupture/leak. Co-morbidities, most frequently cancer, were common (65.2%). Radiological evidence of pneumonia was present in only 43.8% of CA-CPPI and 27.3% of HA-CPPI. Of the 153 different bacterial strains cultured, Streptococcus species (32.9%) especially viridans streptococci group were most common in CA-CPPI, whereas HA-CPPI was most often associated with Staphylococcus aureus (11.6%) and Gram-negative (31.9%) infections. Mortality was high during hospitalization (CA-CPPI 13.4% vs HA-CPPI 16.6%; P = 0.417) and at 1 year (CA-CPPI 32.4% vs HA-CPPI 45.5%; P = 0.006). Conclusion: This is the first large multicentre epidemiological study of pleural infection in Australian adults and includes the largest cohort of HA-CPPI published to date. CPPI is caused by a diverse range of organisms which vary between CA and HA sources. CPPI is a poor prognostic indicator both in the short term and in the subsequent 12 months.

Published
2018

43. Anemia in hospitalized patients: an overlooked risk in medical care

Author

Krishnasivam, D., Trentino, K., Burrows, S., Farmer, Shannon, Picardo, S., Leahy, M., Halder, A., Chamberlain, J., Swain, S., Muthucumarana, K., Waterer, G., Krishnasivam, D., Trentino, K., Burrows, S., Farmer, Shannon, Picardo, S., Leahy, M., Halder, A., Chamberlain, J., Swain, S., Muthucumarana, K., and Waterer, G.

Abstract

© 2018 AABB BACKGROUND: This study investigated the association between nadir anemia and mortality and length of stay (LOS) in a general population of hospitalized patients. STUDY DESIGN AND METHODS: A retrospective cohort study of tertiary hospital admissions in Western Australia between July 2010 and June 2015. Outcome measures were in-hospital mortality and LOS. RESULTS: Of 80,765 inpatients, 45,675 (56.55%) had anemia during admission. Mild and moderate/severe anemia were independently associated with increased in-hospital mortality (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.36-1.86, p = 0.001; OR 2.77, 95% CI 2.32-3.30, p < 0.001, respectively). Anemia was also associated with increased LOS, demonstrating a larger effect in emergency (mild anemia—incident rate ratio [IRR] 1.52, 95% CI 1.48-1.56, p < 0.001; moderate/severe anemia—IRR 2.18, 95% CI 2.11-2.26, p < 0.001) compared to elective admissions (mild anemia—IRR 1.30, 95% CI 1.21-1.41, p < 0.001; moderate/severe anemia—IRR 1.69, 95% CI 1.55-1.83, p < 0.001). LOS was longer in patients who developed anemia during admission compared to those who had anemia on admission (IRR 1.13, 95% CI 1.10-1.17, p < 0.001). Red cell transfusion was independently associated with 2.23 times higher odds of in-hospital mortality (95% CI 1.89-2.64, p < 0.001) and 1.31 times longer LOS (95% CI 1.25-1.37, p < 0.001). CONCLUSION: More than one-third of patients not anemic on admission developed anemia during admission. Even mild anemia is independently associated with increased mortality and LOS; however, transfusion to treat anemia is an independent and additive risk factor.

Published
2018

44. Adjunctive and Supportive Measures for Community-Acquired Pneumonia

Author

Waterer, G. W. and Wunderink, R. G.

Subjects
Noninvasive Ventilation, Partial Liquid Ventilation, Extracorporeal Life Support, Article, Acute Respiratory Failure, Miliary Tuberculosis
Abstract

The widespread introduction of penicillin in the 1940s resulted in a substantial reduction in mortality from community-acquired pneumonia (CAP). However, despite significant advances in medical science, only a small improvement has occurred since, particularly in patients with bacteremic pneumococcal pneumonia [1, 2]. Even modern intensive care has only made a small difference to the mortality in patients with severe pneumonia [3, 4]. While the aging population, increased number of patients with severe co-morbid illnesses, and the human immunodeficiency virus (HIV) epidemic have certainly contributed to the persistently high mortality rate [2, 5, 6], apparently healthy, immunocompetent patients continue to die from CAP. Disturbingly, a recent British Thoracic Society study concluded that no available therapy could substantially reduce the mortality rate from severe CAP in young adults [7].

Published
2010

45. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2015: the Influenza Complications Alert Network.

Author

Bowler S.D., Kelly P.M., Upham J., Lessing A., Kotsimbos T., Cheng A.C., Holmes M., Dwyer D.E., Irving L.B., Korman T.M., Senenayake S., Macartney K.K., Blyth C.C., Brown S., Waterer G., Hewer R., Friedman N.D., Wark P.A., Simpson G., Bowler S.D., Kelly P.M., Upham J., Lessing A., Kotsimbos T., Cheng A.C., Holmes M., Dwyer D.E., Irving L.B., Korman T.M., Senenayake S., Macartney K.K., Blyth C.C., Brown S., Waterer G., Hewer R., Friedman N.D., Wark P.A., and Simpson G.

Abstract

The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all states and territories in Australia. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2015 influenza season. In this observational study, cases were defined as patients admitted to one of the sentinel hospitals with an acute respiratory illness with influenza confirmed by nucleic acid detection. During the period 1 April to 30 October 2015 (the 2015 influenza season), 2,070 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 46% were elderly (>= 65 years), 15% were children (< 16 years), 5% were Indigenous Australians, 2.1% were pregnant and 75% had chronic co-morbidities. A high proportion were due to influenza B (51%). There were a large number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2015 with case numbers similar to that reported in 2014. The national immunisation program is estimated to avert 46% of admissions from confirmed influenza across all at-risk groups, but more complete vaccination coverage in target groups could further reduce influenza admissions by as much as 14%.

Published
2017

46. The australasian bronchiectasis registry-Early steps in mapping the impact of bronchiectasis in australia and new zealand.

Author

Visser S., Allan H., Burr L., Hunter C., Jackson D., King P., Maguire G., Middleton P., Smith D., Thomson R., Waterer G., Wong C., Morgan L., Holmes-Liew C.-L., Chang A., Visser S., Allan H., Burr L., Hunter C., Jackson D., King P., Maguire G., Middleton P., Smith D., Thomson R., Waterer G., Wong C., Morgan L., Holmes-Liew C.-L., and Chang A.

Abstract

Introduction/Aim: Despite a growing worldwide recognition of bronchiectasis as a cause of substantial morbidity and healthcare utilisation, little is known about the prevalence or burden of disease for Australians and New Zealanders. The Australasian Bronchiectasis Registry (ABR) was established to fill this gap and to promote international collaborative research. Method(s): A comprehensive Registry has been developed by the Australasian Bronchiectasis Consortium with the support of Lung Foundation Australia (LFA), the European (EMBARC) and US Bronchiectasis Registries, with common data fields to ensure interoperability and future collaboration, and some unique data-fields to capture information specific to Australia and New Zealand. Investigators identify participants during episodes of care or from preexisting local databases. Patients are eligible if non-CF bronchiectasis is reported on high-resolution computed tomography chest scan. Patient demographics and clinical information are obtained at baseline, annual review and during clinical exacerbations. Linkage to Medicare and Pharmaceutical Benefits Scheme (PBS) information provides the opportunity to study health care resource utilisation. Result(s): As the first step towards a regional standardised registry, the project has been initiated at 15 hospitals, including adult, paediatric, metropolitan and regional sites. Enrolment commenced at the pilot site (Concord Hospital) in March 2016 and as of October 2016 is being undertaken at 10 sites, with the remainder awaiting research governance approvals. To date, 261 patients have been enrolled; females 166 (64%), mean age 64.7 +/- 19.4 years. Conclusion(s): The ABR is a secure, web-based platform to capture the first comprehensive longitudinal data set of patients with bronchiectasis in Australia and New Zealand. Unique features include the use of optout consent, collection of paediatric data and linkage to PBS/Medicare data which will allow for the first time, a to

Published
2017

47. Risk factors and antibiotic therapy in P. aeruginosa community-acquired pneumonia

Author

Sibila O., Laserna E., Maselli D.J., Fernandez J.F., Mortensen E.M., Anzueto A., Waterer G., and Restrepo M.I.

Subjects
retrospective study, heart failure, ICD-9-CM, meropenem, amikacin, piperacillin, antibiotic therapy, antibiotic agent, ceftazidime, artificial ventilation, clinical trial, cohort analysis, hypertensive factor, cerebrovascular disease, health survey, Anti-Bacterial Agents, antiinfective agent, Community-Acquired Infections, aged, female, priority journal, risk factor, peripheral vascular disease, diabetes mellitus, Pseudomonas aeruginosa, Charlson Comorbidity Index, heart infarction, tobramycin, gentamicin, Article, length of stay, male, ciprofloxacin, cefepime, metastasis, pneumonia, controlled study, Pseudomonas Infections, human, levofloxacin, treatment duration, isolation and purification, practice guideline, microbiology, community acquired pneumonia, major clinical study, mortality, United States, multicenter study, incidence, disease duration, chronic obstructive lung disease, Huma, aztreonam, imipenem, dementia
Abstract

Background and objective Current guidelines recommend empirical treatment against Pseudomonas aeruginosa in community-acquired pneumonia (CAP) patients with specific risk factors. However, evidence to support these recommendations is limited. We evaluate the risk factors and the impact of antimicrobial therapy in patients hospitalized with CAP due to P. aeruginosa. Methods We performed a retrospective population-based study of >150 hospitals. Patients were included if they had a diagnosis of CAP and P. aeruginosa was identified as the causative pathogen. Univariate and multivariate analyses were performed using the presence of risk factors and 30-day mortality as the dependent measures. Results Seven hundred eighty-one patients with P. aeruginosa pneumonia were identified in a cohort of 62 689 patients with pneumonia (1.1%). Of these, 402 patients (0.6%) were included in the study and 379 (0.5%) were excluded due to health care-associated pneumonia or immunosuppression. In patients with CAP due to P. aeruginosa, 272 (67.8%) had no documented risk factors. These patients had higher rates of dementia and cerebrovascular disease. Empirical antibiotic therapy against P. aeruginosa within the first 48 h of presentation was independently associated with lower 30-day mortality in patients with CAP due to P. aeruginosa (hazard ratio (HR) 0.42, 95% confidence interval (CI): 0.23-0.76) and in patients without risk factors for P. aeruginosa CAP (HR 0.40, 95% CI: 0.21-0.76). Conclusions Risk factor recommended by current guidelines only detect one third of the patients admitted with CAP due to P. aeruginosa. Risk factors did not define the whole benefit observed due to empirical therapy covering P. aeruginosa. Risk factors recommended by current guidelines only detect one third of the patients admitted with CAP due to P. aeruginosa. Not administrating antibiotics active against P. aeruginosa in the first 48 h increases 30-day mortality. © Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Published
2015
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48. Influenza vaccine effectiveness against hospitalisation with influenza in adults in Australia in 2014.

Author

Irving L., Waterer G., Dwyer D.E., Macartney K., Blyth C., Kotsimbos T., Kelly P.M., Wark P., Hunter C., Hewagama S., Friedman N.D., Korman T.M., Simpson G., Upham J.W., Bowler S., Senenayake S.-J., Holmes M., Brown S.G.A., Cheng A.C., Irving L., Waterer G., Dwyer D.E., Macartney K., Blyth C., Kotsimbos T., Kelly P.M., Wark P., Hunter C., Hewagama S., Friedman N.D., Korman T.M., Simpson G., Upham J.W., Bowler S., Senenayake S.-J., Holmes M., Brown S.G.A., and Cheng A.C.

Abstract

We provide estimates of the influenza vaccine protection against hospitalisation with laboratory-confirmed influenza in the 2014 Australian season where the A/H1N1/pdm09 strain predominated. This was performed using a case-test negative study design as part of a national sentinel surveillance system in Australia. Vaccine effectiveness was estimated as (1-OR). x. 100% where the odds ratio of vaccination in cases vs test negative participants was estimated from a conditional logistic regression. Between April and November, 1692 adult patients were admitted with laboratory-confirmed influenza. Vaccine effectiveness was estimated from 1283 patients with influenza and 1116 test negative patients where vaccination status was ascertained. Vaccination was associated with a reduction in the risk of hospitalisation with influenza of 51.5% (95% CI: 41.6%, 59.7%) in all patients, and a reduction of 50.7% (95% CI: 40.1%, 59.3%) in the target population for vaccination. We estimate that the influenza vaccine was moderately protective against hospitalisation with laboratory-confirmed influenza during the 2014 influenza season in Australia.Copyright © 2015 Elsevier Ltd.

Published
2016

49. Influenza epidemiology in adults admitted to sentinel Australian hospitals in 2014: the Influenza Complications Alert Network (FluCAN).

Author

Cheng A.C., Holmes M., Senenayake S., Dwyer D.E., Hewagama S., Korman T., Irving L., Brown S., Waterer G., Hunter C., Friedman N.D., Wark P., Simpson G., Upman J., Bowler S., Macartney K., Blyth C., Kotsimbos T., Kelly P., Cheng A.C., Holmes M., Senenayake S., Dwyer D.E., Hewagama S., Korman T., Irving L., Brown S., Waterer G., Hunter C., Friedman N.D., Wark P., Simpson G., Upman J., Bowler S., Macartney K., Blyth C., Kotsimbos T., and Kelly P.

Abstract

The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all states and territories in Australia. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2014 influenza season. In this observational study, cases were defined as patients admitted to one of the sentinel hospitals with an acute respiratory illness with influenza confirmed by nucleic acid detection. During the period 3 April to 31 October 2014 (the 2014 influenza season), 1,692 adult patients (>16 years) were admitted with confirmed influenza to one of 15 of 17 FluCAN sentinel hospitals (excluding 2 paediatric hospitals). Of these, 47% were over 65 years of age, 10% were Indigenous Australians, 3.3% were pregnant and 85% had chronic co-morbidities. The majority of cases were due to influenza A. Influenza B was detected in 7% of patients. There were a large number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2014. These are estimated to represent a national annual burden of around 15,000 admissions and almost 100,000 bed-days nationally.

Published
2016

50. Endothelial adhesion molecules and multiple organ failure in patients with severe sepsis

Author

Universitat Rovira i Virgili, Amalakuhan B., Habib S., Mangat M., Reyes L., Rodriguez A., Hinojosa C., Soni N., Gilley R., Bustamante C., Anzueto A., Levine S., Peters J., Aliberti S., Sibila O., Chalmers J., Torres A., Waterer G., Martin-Loeches I., Bordon J., Blanquer J., Sanz F., Marcos P., Rello J., Ramirez J., Solé-Violán J., Luna C., Feldman C., Witzenrath M., Wunderink R., Stolz D., Wiemken T., Shindo Y., Dela Cruz C., Orihuela C., Restrepo M., Universitat Rovira i Virgili, and Amalakuhan B., Habib S., Mangat M., Reyes L., Rodriguez A., Hinojosa C., Soni N., Gilley R., Bustamante C., Anzueto A., Levine S., Peters J., Aliberti S., Sibila O., Chalmers J., Torres A., Waterer G., Martin-Loeches I., Bordon J., Blanquer J., Sanz F., Marcos P., Rello J., Ramirez J., Solé-Violán J., Luna C., Feldman C., Witzenrath M., Wunderink R., Stolz D., Wiemken T., Shindo Y., Dela Cruz C., Orihuela C., Restrepo M.

Abstract

To determine if serum levels of endothelial adhesion molecules were associated with the development of multiple organ failure (MOF) and in-hospital mortality in adult patients with severe sepsis.This study was a secondary data analysis of a prospective cohort study.Patients were admitted to two tertiary intensive care units in San Antonio, TX, between 2007 and 2012.Patients with severe sepsis at the time of intensive care unit (ICU) admission were enrolled. Inclusion criteria were consistent with previously published criteria for severe sepsis or septic shock in adults. Exclusion criteria included immunosuppressive medications or conditions.None.Baseline serum levels of the following endothelial cell adhesion molecules were measured within the first 72h of ICU admission: Intracellular Adhesion Molecule 1 (ICAM-1), Vascular Cell Adhesion Molecule-1 (VCAM-1), and Vascular Endothelial Growth Factor (VEGF). The primary and secondary outcomes were development of MOF (?2 organ dysfunction) and in-hospital mortality, respectively.Forty-eight patients were enrolled in this study, of which 29 (60%) developed MOF. Patients that developed MOF had higher levels of VCAM-1 (p=0.01) and ICAM-1 (p=0.01), but not VEGF (p=0.70) compared with patients without MOF (single organ failure only). The area under the curve (AUC) to predict MOF according to VCAM-1, ICAM-1 and VEGF was 0.71, 0.73, and 0.54, respectively. Only increased VCAM-1 levels were associated with in-hospital mortality (p=0.03). These associations were maintained even after adjusting for APACHE and SOFA scores using logistic regression.High levels of serum ICAM-1 was associated with the development of MOF. High levels of VCAM-1 was associated with both MOF and in-hospital mortality.Published by Elsevier Ltd.

Published
2016

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