Post eccmid 2019

Lo que me traigo de ECCMID 2019
(Selección de sesiones y comunicaciones)
José Ramón Paño-Pardo
Servicio de Enfermedades Infecciosas
Hospital Clínico Universitario
Zaragoza
17 de mayo de 2019

Esquema
• Entendiendo ECCMID 2019: Estructura y cifras
• Cómo afrontar un ECCMID: ¿?
• Selección de sesiones y comunicaciones: (por temas)
- Infectología clínica (casa)
- Antimicrobial Stewardship / PROA
- Patógenos
- Temas estrella

Entendiendo ECCMID 2019: Estructura y cifras
ECCMID Programme Director

Ranking de países por número de abstracts aceptados*
Orden País Número abstracts
1 España 388
2 USA 323
3 Francia 314
4 Reino Unido 280
5 Italia 243
6 Alemania 205
7 Holanda 199
* + 5.000 abstracts aceptados

Hasta ¡¡¡14!!! actividades simultáneas

Tipos de actividades
Encuentro con el experto (ME): 60 ‘ (2 ponencias)
Simposio 60-120‘ (2-4 ponencias)
Taller educativo 2-4 h
Comunicaciones orales 1-2h‘ (8-16 comunicaciones)
Simposio patrocinado 60-120‘
Posters 60‘
Key note / Awards 60’

Cómo afrontar un ECCMID: ¿?
Pre-ECCMID ECCMID Post-ECCMID

Temas
Temas Estrella (3)
Patógenos / Microorganismos
PROA
Infectología clínica (Revisar en casa)

Temas estrella
1. Inmunoterapia
2. Inteligencia artificial y nuevas
tecnologías
3. Secuenciación masiva / Microbioma

Temas estrella: inmunomodulación
SY073 - Possible impact of new immunomodulators on
infection and infection management
• #S0402 Immune checkpoint inhibitors and infections
• #S0403 mTOR inhibitors as broad-spectrum
therapeutics: relevance for infection

#S0402 Immune checkpoint inhibitors and infections
Rao M. International Journal of Infectious Diseases 56 (2017) 221–228

Los ICI son un cambio en el paradigma del tratamiento del cáncer

Los ICI están cambiando la historia natural de algunos tumores

El infectólogo y los ICI: ayuda en el manejo de la toxicidad

El infectólogo y los ICI (2): infecciones asociadas

El infectólogo y los ICI (3): reconstitución inmune

El infectólogo y los ICI (3): Reconstitución inmune (TB)

El infectólogo y los ICI (4): ¿Nuevos antimicrobianos?

El infectólogo y los ICI: Conclusiones
• Los ICI se asocian a complicaciones inmunomediadas
(amplio diagnóstico diferencial)
• Los pacientes con complicaciones inmunomediadas tienen riesgo
elevado de infección (relacionadas con tto inmunosupresor)
• Los ICI pueden desencadenar IRIS
• El uso óptimo de ICI pasa por un trabajo multidisciplinar
• Potencial uso en el tratamiento de infecciones crónicas

#K0538 Collaborating with the innate immune system to treat
antibiotic-resistant superbugs (Victor Nizet)

#K0538 Collaborating with the innate immune system to treat
antibiotic-resistant superbugs (Victor Nizet)
• Efecto balancín (seesaw): La pérdida de la sensibilidad a dapto y
vanco se asocia a una recuperación de la sensibildad a meticilina
• Efecto antimicrobiano de azitromicina
• Efecto antimicrobiano de avibactam
a) Interacción de antimicrobiano con péptidos antimicrobianos
b) Efecto antimicrobiano de fármacos* no antimicrobianos
• Estatinas y Tamoxifeno -> NET (Neutrophils Extracellular Traps)
• *Hypoxia inducible factor
• Tricagelor y S. aureus bloquea toxina estafilocócica antiplaquetaria

SY131 - Host-directed therapies for infectious diseases
•#S0651 Host-directed therapies as adjunct treatment
options for sepsis
•#S0652 Host-directed therapies as adjunct treatment
options for viral infections
•#S0653 Adoptive immunotherapy: the time has come?
•#S0654 Combatting infection in immunotherapy and
immunocompromised hosts

#S0653 Adoptive immunotherapy: the time has come?

Temas estrella: IA y NN.TT.
SY118 - Information technology and innovation
• #S0617 Machine learning for infectious diseases
• #S0618 Multi-omics approaches: towards
understanding host-microbiome interactions
• #S0619 Implementation of machine learning for
routine microbiology diagnostics
• #S0620 Applying artificial intelligence to improve
empiric antibiotic treatment

#S0620 Applying artificial intelligence to improve
empiric antibiotic treatment (Carol García-Vidal)

SY011 - Automation and artificial intelligence in
nosocomial infection prevention
#S0071 Automation in hand hygiene surveillance and
improvement
#S0072 Computer vision monitoring of infection prevention
practices
#S0073 Fully automated healthcare-associated infection
surveillance: how do we get there?
#S0074 Prediction for prevention: applied machine learning
to identify risk of healthcare-associated infections

#S0071 Automation in hand hygiene surveillance and
improvement (F. Fitzpatrick)

#S0072 Computer vision monitoring of infection
prevention practices (P. Polgreen)

#S0072 Computer vision monitoring of infection
prevention practices
Mask detection

SY133 - @mobilemicrobiologylaboratory
• #S0659 Portable diagnostic instruments in
microbiology: current status
• #S0660 Smart phones as mobile microbiological
laboratories
• #S0661 Drones as mobile microbiological
laboratories
• #S0662 Use of sniffing animals in diagnostic
microbiology

#S0660 Smart phones as mobile microbiological laboratories
Smartphone como herramienta para POC (point-
of-care test)
• Microscopía / lector
• Integración con sistemas LAMP (loop-mediated
isothermal amplification)
11 ejemplos

#S0660 Smart phones as mobile microbiological laboratories

#S0661 Drones as mobile microbiological laboratories

#S0662 Use of sniffing animals in diagnostic microbiology

Temas estrella: Secuencación masiva
SY012 - Microbiology by DNA: moving towards
clinical metagenomics
• #S0075 Promises and hurdles of metagenomics
• #S0076 Clinical metagenomics in bone and joint infections
• #S0078 Clinical metagenomics in the field: outbreak investigation
in limited-resource settings
• #S0077 Metagenomics to unveil undetected microorganisms

#S0075 Promises and hurdles of metagenomics

Aportaciones
1. Diagnóstico de infecciones de causa desconocida
N Engl J Med 2014;370:2408-17

Aportaciones
1. Diagnóstico de infecciones de causa desconocida
2. Identificación de subpoblaciones (Resistencia)
3. Epidemiología de las infecciones (Relación)

Limitaciones

Limitaciones
1. Cuantificación
2. Dificultad para inferir un fenotipo (antibiograma)
3. Contaminaciones (identificación / eliminación)
4. Implementación: coste, falta de automatización…

Patógenos: Cambios en taxonomía
#SY076 - Year in Clinical Microbiology
FORMER NAME REVISED NAME
Streptococcus tigurinus Streptococcus oralis subsp. tigurinus
Propionibacterium acnes Cutibacterium acnes
Clostridium difficile Clostridioides difficile (fam.
Peptostreptococcaceae)
Klebsiella pneumoniae ATCC 700603 K. quasipneumoniae subsp. similipneumoniae
Enterobacter aerogenes Klebsiella aerogenes (AmpC+)
Borrelia burgdorferi Borreliella burgdorferi
Family Enterobacteriaceae Order Enterobacterales (7 families):
- Enterobacteriaceae, Erwiniaceae, Pectobacteriaceae,
Yersiniaceae, Hafniaceae, Morganellaceae, Budviciaceae
J Clin Microbiol. 2019; 57(2): e01181-18
Update on Taxonomy: bacteriology

Patógenos: S. aureus
SY067 - Monotherapy or antibiotic combination therapy for
Staphylococcus aureus infection: time for a change?
#S0369 Do we have convincing preclinical data on mono- versus
combination therapy?
#S0370 What did and didn’t we learn from clinical trials of
combination therapy?
#S0371 Which trial designs are needed to address optimised
therapy of S. aureus bloodstream infection?
#S0372 Using genomics to understand the interplay between
pathogenicity, virulence and antibiotic resistance

#S0370 What did and didn’t we learn from clinical trials of
combination therapy? (M. Pujol)

therapy of S. aureus bloodstream infection? (SYC Tong)
“Randomized care* better than random care”

therapy of S. aureus bloodstream infection? (SYC Tong)

L0014 Combination antibiotic therapy for methicillin-resistant S.
aureus bacteraemia: the CAMERA2 Randomized clinical trial (SYC Tong)
• Ensayo clínico aleatorizado no enmascarado: 27 centros de 4 países
• Pacientes adultos con bacteriemia por SARM (≤72h): N= 344
• Estándar: vanco o dapto (N=170) vs
Intervención: estándar + BL (flu /cloxa / cefazolina) (N=174)
• Variable resultado:
Primaria: Combo: mortalidad a 90d + bacteriemia
prolongada + recidiva + fracaso microbiológico
Secundarias: Insuficiencia renal (aumento creat > 1,5 veces)

Entrevista SYC Tong

#L0012 Exebacase (Lysin CF-301) improved clinical responder rates
in methicillin-resistant Staphylococcus aureus bacteraemia including
endocarditis compared to standard of care antibiotics alone in a
first-in patient Phase 2 study (V. Fowler)
#L0013 Efficacy and Safety Profile of Suvratoxumab, a Novel Anti-
Staphylococcus aureus Monoclonal Antibody: Results of the
SAATELLITE Study in Mechanically Ventilated Intensive Care Unit
Patients (B. Francoise)

Presentación y pronóstico
#P0256 Clinical outcome of C. difficile infection in relation to
positive vs negative faecal free toxins: an 8-year prospective study
• Cohorte prospectiva unicétrica: (2011-2018)
• 521 pacientes: 106 formas graves
• No diferencias entre toxina + y toxina -
#O0164 The relationship between strain type and mortality
in Clostridioides difficile infection: a meta-analysis
• ¿Influye el tipo de cepa (NAP1/BI/027 o R027) en la mortalida
• Mortalidad a 14d (027): 11.6 (IC95% 7.6-17.3 )
• Mortalidad a 30d (027 o NAP1): 22.9 (IC95% 18.6-27. 2)
Patógenos: Clostridioides difficile

Tratamiento
EW213 - Changing perspectives in the treatment of C. difficile
infection (CDI)
#W1092 Recent changes in CDI treatment guidelines
#W1093 Various forms of faecal microbiota transplantation
for recurrent CDI
#W1094 What is the target group for antitoxin treatment
to prevent CDI?

#W1094 What is the target group for antitoxin treatment
to prevent CDI? (Dra. Tanya M Monaghan)

SY139 - Hot topics in antimicrobial stewardship
PROA: Implementación
#S0686 How leadership can influence antimicrobial
stewardship (AH Homes)
#S0687 Resources required for effective stewardship -
dreams, consensus, reality (M. Hulscher)

PROA: Implementación
#S0687 Resources required for effective stewardship -
dreams, consensus, reality (M. Hulscher)

PROA: Intervenciones
ME002 - How to deal with antimicrobial drug and
vaccine shortages?
SY089* - Rapid diagnostic tests in respiratory
infections: do they really help clinicians reduce
unnecessary antibiotic prescribing?
*Debate

#L0006 The safety and effectiveness of an antibiotic
stewardship intervention in hospitalized patients with
community-acquired pneumonia: a stepped wedge cluster
randomized trial (I van Heijl / M Bonten)

#L0006 The safety and effectiveness of an antibiotic stewardship intervention in hospitalized
patients with community-acquired pneumonia: a stepped wedge cluster randomized trial

Infectología clínica: revisar en casa
SY068 - Addressing burning questions in the management of
community-acquired pneumonia (CAP)
• #S0373 Gaps in rapid diagnosis of CAP pathogens (K Templeton)
• #S0374 What are the predictors of treatment failure
and how should the non-responding patient be
approached? (R Menendez)
• #S0375 Antibiotic therapy: how long is enough? (T File)
• #S0376 How great is the burden of acute cardiac events in
pneumonia patients and how can they be prevented? (J Carratala)

Infectología clínica: revisar en casa
SY010 - Management of chronic bone and joint infections
EW163 - Progress in Infective Endocarditis (IE)
EW160 - Device-related central nervous system (CNS) infections
ME186 - How to manage immunocompromised patients with
central nervous system infection?
SY088 - Year in Infectious Diseases
SY195 - Individualised antimicrobial therapy for the future
SY094 - Pro/con: optimised dosing according to PK/PD principles
in patients - does it improve the efficacy of antibiotics?

Post eccmid 2019

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