Universität zu Köln

Garnacho-Montero, Jose ORCID: 0000-0003-2542-7601, Dimopoulos, George ORCID: 0000-0002-3784-3103, Poulakou, Garyphallia, Akova, Murat, Miguel Cisneros, Jose, De Waele, Jan, Petrosillo, Nicola, Seifert, Harald, Timsit, Jean Francois, Vila, Jordi ORCID: 0000-0002-8025-3926, Zahar, Jean-Ralph and Bassetti, Matteo (2015). Task force on management and prevention of Acinetobacter baumannii infections in the ICU. Intensive Care Med., 41 (12). S. 2057 - 2076. NEW YORK: SPRINGER. ISSN 1432-1238

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Abstract

Acinetobacter baumannii constitutes a dreadful problem in many ICUs worldwide. The very limited therapeutic options available for these organisms are a matter of great concern. No specific guidelines exist addressing the prevention and management of A. baumannii infections in the critical care setting. Clinical microbiologists, infectious disease specialists and intensive care physicians were invited by the Chair of the Infection Section of the ESICM to participate in a multidisciplinary expert panel. After the selection of clinically relevant questions, this document provides recommendations about the use of microbiological techniques for identification of A. baumannii in clinical laboratories, antibiotic therapy for severe infections and recommendations to control this pathogen in outbreaks and endemic situations. Evidence supporting each statement was graded according to the European Society of Clinical Microbiology and Infection Diseases (ESCMID) grading system. Empirical coverage of A. baumannii is recommended in severe infections (severe sepsis or septic shock) occurring during an A. baumannii outbreak, in an endemic setting, or in a previously colonized patient. For these cases, a polymyxin is suggested as part of the empirical treatment in cases of a high suspicion of a carbapenem-resistant (CR) A. baumannii strain. An institutional program including staff education, promotion of hand hygiene, strict contact and isolation precautions, environmental cleaning, targeted active surveillance, and antimicrobial stewardship should be instituted and maintained to combat outbreaks and endemic situations. Specific recommendations about prevention and management of A. baumannii infections in the ICU were elaborated by this multidisciplinary panel. The paucity of randomized controlled trials is noteworthy, so these recommendations are mainly based on observational studies and pharmacodynamics modeling.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Garnacho-Montero, Jose UNSPECIFIED orcid.org/0000-0003-2542-7601 UNSPECIFIED Dimopoulos, George UNSPECIFIED orcid.org/0000-0002-3784-3103 UNSPECIFIED Poulakou, Garyphallia UNSPECIFIED UNSPECIFIED UNSPECIFIED Akova, Murat UNSPECIFIED UNSPECIFIED UNSPECIFIED Miguel Cisneros, Jose UNSPECIFIED UNSPECIFIED UNSPECIFIED De Waele, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrosillo, Nicola UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Timsit, Jean Francois UNSPECIFIED UNSPECIFIED UNSPECIFIED Vila, Jordi UNSPECIFIED orcid.org/0000-0002-8025-3926 UNSPECIFIED Zahar, Jean-Ralph UNSPECIFIED UNSPECIFIED UNSPECIFIED Bassetti, Matteo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-386043
DOI:	10.1007/s00134-015-4079-4
Journal or Publication Title:	Intensive Care Med.
Volume:	41
Number:	12
Page Range:	S. 2057 - 2076
Date:	2015
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1238
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VENTILATOR-ASSOCIATED PNEUMONIA; CRITICALLY-ILL PATIENTS; EXTENSIVELY DRUG-RESISTANT; IN-VITRO ACTIVITY; INTENSIVE-CARE-UNIT; ANTIMICROBIAL SURVEILLANCE PROGRAM; BLOOD-STREAM INFECTIONS; INTRAVENOUS POLYMYXIN-B; HYDROGEN-PEROXIDE VAPOR; GRAM-NEGATIVE BACTERIA Multiple languages Critical Care Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38604