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PNEUMONIA
Coordinator
Dr. Antoni Torres
Multidisciplinary translational research in respiratory tract
infections.
Severe acute respiratory infection (SARI) is the leading global cause of morbidity and mortality from infectious diseases . Under this term, we include severe community-acquired pneumonia (sCAP) and other community-acquired infections requiring 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 nosocomial 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 reported to produce an excess cost of more than $40,000 per patient . Incidence increases 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 prevention measures, rapid diagnosis techniques and adequate clinical management tools and treatment . Our group intends to perform activities that will allow us to better understand the current epidemiology, patterns of care and treatment, and patient outcomes . Furthermore we plan to undertake studies to improve the diagnosis 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 investigating 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 proteins fulfil this requirement, they are attractive targets for the treatment of pneumococcal diseases . Furthermore, we have done an initial screening of the Prestwick Chemical Library finding six hits (not including known antibiotics) that appear to inhibit the growth of S . pneumoniae at submillimolar concentrations . If the antimicrobial activity of all these compounds is confirmed, these hits would be tested using in vitro (planktonic or biofilm) and in vivo (animal models of infection)
We also plan to approach emerging pathogens causing severe respiratory infections or those that seem to complicate existing respiratory co-morbidities, such as C. difficile .
Finally, since this is major problem, we want to place a major emphasis on prevention and patient safety by investigating care-bundles in VARI .
Aims and objectives
The principal aims of this programme are: 1 . To study the risk, and prognosis factors of severe acute community-acquired and ICU-
acquired respiratory infections in Spain, including biomarkers and genetic factors . 2 . To study risk, and prognosis of community-acquired and hospital acquired respiratory
infections in patients not admitted to the ICU in Spain, also including biomarkers.
3 . To study in depth the microbial etiology and resistances of all the populations mentioned above . In this objective we will include the investigation of new rapid molecular techniques .
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