[Antibiotic Stewardship in Nosocomial Pneumonia].

Pneumonia is one of the most important nosocomially acquired infections in Germany. Rational management strategies contribute to optimizing treatment and minimizing the development of resistance. The calculated antimicrobial therapy should take into account the severity, the risk of multi-resistant pathogens and as well as the local resistance situation.

[Antibiotic stewardship-an update : Ongoing development of an initiative].

The burden of disease caused by infections with antibiotic-resistant bacteria is increasing worldwide. The reason for this is the inappropriate use of antibiotics. In addition to the development of new antibiotics, their rational use is crucial to slowing down the development of resistance.

[Epidemiology, diagnosis and treatment of adult patients with nosocomial pneumonia].

Background:  Nosocomial pneumonia, encompassing hospital-acquired (HAP) and ventilator-associated pneumonia (VAP), remains a major cause of morbidity and mortality in hospitalized adults. In response to evolving pathogen profiles and emerging resistance patterns, this updated S3 guideline (AWMF Register No. 020-013) provides an evidence-based framework to enhance the diagnosis, risk stratification, and treatment of nosocomial pneumonia.

[Artificial intelligence and machine learning in auscultation: prospects of the project DigitaLung].

Auscultation is one of the key medical skills in physical examination. The main problem with auscultation is the lack of objectivity of the findings and great dependence on the experience of the examiner. Auscultation using machine learning and neural networks promises great potential for solving these problems in clinical practice.

[Management of adult bronchiectasis - Consensus-based Guidelines for the German Respiratory Society (DGP) e. V. (AWMF registration number 020-030)].

Bronchiectasis is an etiologically heterogeneous, chronic, and often progressive respiratory disease characterized by irreversible bronchial dilation. It is frequently associated with significant symptom burden, multiple complications, and reduced quality of life. For several years, there has been a marked global increase in the prevalence of bronchiectasis, which is linked to a substantial economic burden on healthcare systems.

Evaluation of treatment response with serial CT in patients with non-tuberculous mycobacterial pulmonary disease.

Objectives: In patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD), the response to treatment is evaluated based on microbiological, clinical, and radiological data. However, little is known about the dynamics of CT findings. The aim of this study was to evaluate CT changes in NTM-PD in order to define radiological criteria for treatment success.

Primary Ciliary Dyskinesia in Adult Bronchiectasis: Data from the German Bronchiectasis Registry PROGNOSIS.

Background: Primary ciliary dyskinesia (PCD) is a rare genetic disorder caused by the malfunction of motile cilia and a specific etiology of adult bronchiectasis of unknown prevalence. A better understanding of the clinical phenotype of adults with PCD is needed to identify individuals for referral to diagnostic testing.

Research Question: What is the frequency of PCD among adults with bronchiectasis; how do people with PCD differ from those with other etiologies; and which clinical characteristics are independently associated with PCD?

Study Design And Methods: We investigated the proportion of PCD among the participants of the Prospective German Non-CF-Bronchiectasis Registry (PROGNOSIS) study; applied multiple imputation to account for missing data in 64 (FEV), 58 (breathlessness), 26 (pulmonary exacerbations), and two patients (BMI), respectively; and identified predictive variables from baseline data using multivariate logistic regression analysis.

Clinical Features, Diagnostics, Etiology, and Outcomes of Hospitalized Solid Organ Recipients With Community-Acquired Pneumonia: A Retrospective Cohort Analysis.

Background: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Limited evidence is available on the most effective diagnostic approaches, management strategies, and long-term outcomes for CAP in patients who have undergone solid organ transplantation.

Research Question: What is the acute and long-term morbidity and mortality after CAP in organ transplant recipients?

Study Design And Methods: We retrospectively analyzed hospitalizations for CAP in solid organ recipients at the largest German transplant center.

Respiratory Syncytial Virus-Associated Respiratory Diseases in Children and Adults.

Background: Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infections (LRTI), particularly in neonates, infants and young children, with approximately 33 million infections worldwide each year. 1-2% of episodes lead to hospitalization. There are hardly any reliable epidemiological figures on hospital - ization in adults, whose burden of disease from RSV is probably markedly underestimated.

Factors influencing voriconazole plasma level in intensive care patients.

Background: In clinical routine, voriconazole plasma trough levels () out of target range are often observed with little knowledge about predisposing influences.

Objectives: To determine the distribution and influencing factors on voriconazole blood levels of patients treated on intensive- or intermediate care units (ICU/IMC).

Patients And Methods: Data were collected retrospectively from patients with at least one voriconazole trough plasma level on ICU/IMC ( = 153) to determine the proportion of sub-, supra- or therapeutic plasma levels.

Perioperative Antibiotic Prophylaxis—Indications and Modalities for the Prevention of Postoperative Wound Infection.

Background: Postoperative surgical site infections (SSI) account for almost 25% of all nosocomial infections in Germany and are a source of increased morbidity and mortality.

Methods: This review is based on pertinent publications retrieved by a selective search in PubMed and on national and international guidelines.

Results: The individual risk factors for SSI must be assessed before any surgical procedure.

Photon Counting Computed Tomography with the Radiation Dose of a Chest X-Ray: Feasibility and Diagnostic Yield.

Introduction: Photon counting (PC) detectors allow a reduction of the radiation dose in CT. Chest X-ray (CXR) is known to have a low sensitivity and specificity for detection of pneumonic infiltrates. The aims were to establish an ultra-low-dose CT (ULD-CT) protocol at a PC-CT with the radiation dose comparable to the dose of a CXR and to evaluate its clinical yield in patients with suspicion of pneumonia.

Association of respiratory infections and the impact of vaccinations on cardiovascular diseases.

Influenza, pneumococcal, severe acute respiratory syndrome coronavirus 2, and respiratory syncytial virus infections are important causes of high morbidity and mortality in the elderly. Beyond the burden of infectious diseases, they are also associated with several non-infectious complications like cardiovascular events. A growing body of evidence in prospective studies and meta-analyses has shown the impact of influenza and pneumococcal vaccines on types of cardiovascular outcomes in the general population.

The role of vaccination in COPD: influenza, SARS-CoV-2, pneumococcus, pertussis, RSV and varicella zoster virus.

Exacerbations of COPD are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression and death. At least 70% of COPD exacerbations are infectious in origin, with respiratory viruses identified in approximately 30% of cases. Despite long-standing recommendations to vaccinate patients with COPD, vaccination rates remain suboptimal in this population.

Optimal treatment of the underlying aetiology is the most effective antimicrobial stewardship for chronic respiratory disease: a lesson learned from cystic fibrosis.

https://bit.ly/3ptrmV8.

[Antibiotic treatment of community-acquired and hospital-acquired pneumonia].

Community-acquired and nosocomial bacterial pneumonia are among the most common infectious diseases in Germany. Knowledge of possible pathogens and therapeutic implications thereof are essential to be able to provide adequate, differentiated antimicrobial therapy with the appropriate drugs, form of application, dose, and duration. New diagnostics that include multiplex polymerase chain reaction, correct interpretation of the biomarker procalcitonin, and treatment of multidrug-resistant bacteria are becoming increasingly import.