Page 38 - MemoriaES-Eng

RESEARCH PROGRAMMES

Pneumonia

MULTIDISCIPLINARY TRANSLATIONAL RESEARCH IN
Coordinator
RESPIRATORY TRACT INFECTIONS.
Dr. Antoni Torres
Severe acute respiratory infection (SARI) is the leading global cause of morbidity and

mortality from infectious diseases. Under this term, we include severe communi-

ty-acquired pneumonia (sCAP) and other community-acquired infections re-
quiring admission to intensive care unit. Severe community-acquired pneumonia

(sCAP) is a current major health concern. Despite the introduction of antibiotic agents

(1950s), the outcome of sCAP has shown little improvement in the past 3 decades and
remains between 25% and 40% in patients admitted to the intensive care unit (ICU).

Hospital-acquired pneumonia (HAP) is currently the second most common noso-

comial infection, and is associated with high mortality and morbidity. The presence of
HAP increases hospital stay by an average of 7 to 9 days per patient and has been re-

ported to produce an excess cost of more than $40,000 per patient. Incidence increa-

ses by as much as 6- to 20-fold in mechanically ventilated patients, and in this case
we call these Ventilator-associated respiratory infections (VARI) such as pneumonia,

tracheobronchitis and other bronchopulmonary infections.

At present, the emphasis in the field of SARI and VARI should be on effective preven-

tion measures, rapid diagnosis techniques and adequate clinical management tools
and treatment. Our group intends to perform activities that will allow us to bet-

ter understand the current epidemiology, patterns of care and treatment, and
patient outcomes. Furthermore we plan to undertake studies to improve the diagno-

sis of SARI/VARI (focusing on rapid tests and using biomarkers as selective predictors

of respiratory infection) and in terms of treatment we will prioritize optimizing
the dosage of currently used antibiotics for respiratory infections and inves-

tigating the value of biomarkers for enhancing therapy in SARI/VARI as well as

finding new targets for S. pneumoniae. As DNA topoisomerases and choline-binding 13
proteins fulfil this requirement, they are attractive targets for the treatment of pneu- 20
T
mococcal diseases. Furthermore, we have done an initial screening of the Prestwick R
Chemical Library finding six hits (not including known antibiotics) that appear to PO
E
inhibit the growth of S. pneumoniae at submillimolar concentrations. If the antimicro- L R
A
bial activity of all these compounds is confirmed, these hits would be tested using in NU
vitro (planktonic or biofilm) and in vivo (animal models of infection)
N
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We also plan to approach emerging pathogens causing severe respiratory in- /
ES
fections or those that seem to complicate existing respiratory co-morbidities, such as ER
B
C. difficile.
CI
Finally, since this is major problem, we want to place a major emphasis on prevention

and patient safety by investigating care-bundles in VARI.
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