The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates) receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015. Hospitals were classified as primary, secondary, tertiary (including infectious diseases hospitals), and paediatric hospitals. Five main ward types were defined: medical wards, surgical wards, intensive-care units, haematology oncology wards, and medical transplantation (bone marrow or solid transplants) wards. Data recorded included patient characteristics, antimicrobials received, diagnosis, therapeutic indication according to predefined lists, and markers of prescribing quality (eg, whether a stop or review date were recorded, and whether local prescribing guidelines existed and were adhered to). We report findings for adult inpatients. The Global-PPS for 2015 included adult data from 303 hospitals in 53 countries, including eight lower-middle-income and 17 upper-middle-income countries. 86 776 inpatients were admitted to 3315 adult wards, of whom 29 891 (34·4%) received at least one antimicrobial. 41 213 antimicrobial prescriptions were issued, of which 36 792 (89·3%) were antibacterial agents for systemic use. The top three antibiotics prescribed worldwide were penicillins with β-lactamase inhibitors, third-generation cephalosporins, and fluoroquinolones. Carbapenems were most frequently prescribed in Latin America and west and central Asia. Of patients who received at least one antimicrobial, 5926 (19·8%) received a targeted antibacterial treatment for systemic use, and 1769 (5·9%) received a treatment targeting at least one multidrug-resistant organism. The frequency of health-care-associated infections was highest in Latin America (1518 [11·9%]) and east and south Asia (5363 [10·1%]). Overall, the reason for treatment was recorded in 31 694 (76·9%) of antimicrobial prescriptions, and a stop or review date in 15 778 (38·3%). Local antibiotic guidelines were missing for 7050 (19·2%) of the 36 792 antibiotic prescriptions, and guideline compliance was 77·4%. The Global-PPS showed that worldwide surveillance can be accomplished with voluntary participation. It provided quantifiable measures to assess and compare the quantity and quality of antibiotic prescribing and resistance in hospital patients worldwide. These data will help to improve the quality of antibiotic prescribing through education and practice changes, particularly in low-income and middle-income countries that have no tools to monitor antibiotic prescribing in hospitals. bioMérieux.

Community-acquired pneumonia is one of the most common acute infectious diseases that has a significant share in the structure of mortality from respiratory diseases. It is extremely important to select rational antibiotic therapy which ensures optimal clinical efficacy, improved outcome, reduced rate of antibiotic resistance selection, and minimization of side effects.Methods. The target audience of these clinical recommendations are therapists, general practitioners, pulmonologists, anesthesiologist-resuscitators, and clinical pharmacologists. Each thesis-recommendation about diagnostic and therapeutic procedures has been scored according to the scale of classes of recommendations from 1 to 5 and A, B, C scale of the levels of evidence. The clinical recommendations also contain comments and explanations to these theses, algorithms for the diagnosis and treatment, and reference materials on the use of antibacterial drugs and microbiological (culture) tests.Conclusion. The presented clinical guidelines cover current information about the etiology, clinical manifestations, diagnosis and treatment tactics for community-acquired pneumonia. The presented clinical guidelines have been approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation in 2021.

Primary ciliary dyskinesia (PCD) is a rare hereditary disease from the group of ciliopathies, which is based on a defect in the cilia ultrastructure of the respiratory epithelium and similar structures (sperm flagella, villi of the fallopian tubes, ventricular ependyma, etc.), leading to motor function impairment. The prevalence of the disease varies significantly around the world and is not known reliably in the Russian Federation.The aim of the review was to analyze literature data on modern approaches to the diagnosis and treatment of PCD.Methodology. The data of 90 articles and the opinions of experts providing care to patients with PCD were used.Results. The classic manifestations of PCD depend on age. The leading manifestations of the disease in patients with PCD are recurrent inflammatory diseases of the upper and lower respiratory tract (bronchitis, pneumonia), with the formation of bronchiectasis, damage to the ENT organs (chronic rhinitis, rhinosinusitis, nasal polyposis, repeated otitis media, progressive hearing loss). Currently, there is no single method which could serve as a “gold” standard for diagnosing PCD. The diagnosis of PCD is based on the characteristic clinical picture in combination with the results of special tests (nitric oxide in exhaled air, DNA diagnostics, high-speed video microscopy, transmission electron microscopy). The genetic diagnostics has not been developed sufficiently in the global practice yet and is unavailable in our country. The approach to the treatment of a patient with PCD should be multidisciplinary due to multiple organ lesions. According to the European consensus, the goal of PCD therapy is to restore or maintain normal lung function. There have been no randomized trials of treatment for PCD, and therefore all treatment recommendations are based on very low-level evidence or extrapolated from cystic fibrosis guidelines. Recommendations on mucolytic, antibacterial and anti-inflammatory therapy of PCD are given with consideration for the international and domestic experience.Conclusion. The development of a new version of clinical guidelines containing up-to-date relevant information will improve the diagnosis and treatment of PCD in the Russian Federation.

ЦЕЛЬ Обновленных клинических рекомендаций состоит в представлении специалистам, в первую очередь анестезиологам-реаниматологам, современных, основанных на методах доказательной медицины данных по этиологии, эпидемиологии, способах диагностики, лечения и профилактики тяжелой внебольничной пневмонии у взрослых. При подготовке настоящего документа использованы и адаптированы научные исследования высокого уровня доказательности, систематические обзоры и метаанализы, рекомендации Американского общества инфекционных заболеваний/Американского торакального общества (IDSA/ATS), Европейского респираторного общества/Европейского общества интенсивной терапии/Европейского общества клинической микробиологии и инфекционным заболеваниям/Латиноамериканского торакального общества (ERS/ESICM/ESCMID/ALAT) и прочих ведущих профессиональных сообществ. Подробно представлены современные рекомендации по дифференцированной антибиотикотерапии пациентов с тяжелой внебольничной пневмонией (ТВП) в зависимости от наличия у них факторов риска инфицирования определенными микроорганизмами, приведены схемы этиотропной терапии при установленном возбудителе. Значительный раздел рекомендаций посвящен респираторной терапии при ТВП, сформулирован ступенчатый алгоритм лечения острой дыхательной недостаточности в зависимости от ее стадии. Детально охарактеризованы наиболее эффективные и безопасные режимы инвазивных и неинвазивных способов респираторной поддержки. В качестве методов адъювантной терапии названы глюкокортикостероиды при невозможности стабилизировать показатели гемодинамики на фоне адекватной гидратации и вазопрессорной поддержки, а также парентеральные антикоагулянты с целью предупреждения тромбоэмболических осложнений. Для профилактики ТВП у пациентов высокого риска предложены антипневмококковые и противогриппозные вакцины. Представлены критерии оценки качества медицинской помощи.

Antimicrobial resistance (AMR) is a pressing global concern, posing significant challenges to the effective treatment of infections, including pneumonia. This bibliometric analysis aims to investigate the research output on AMR among pneumonia pathogens from 2013 to 2023. Data were extracted from the Web of Science Core Collection (WOS-CC) using an inclusive search strategy. The analysis included 152 relevant studies published in 99 different sources, involving 988 authors and yielding an average of 16.33 citations per document over the past decade. The findings reveal a notable increase in research on AMR among pneumonia pathogens, indicating a growing awareness of this critical issue. Collaborative studies were prevalent, with the majority of authors engaging in joint research efforts. Bradford’s Law identified twelve core journals that were instrumental in disseminating research in this field, with “Medicine” emerging as the most prolific journal. The USA and China emerged as the leading contributors, while Germany displayed a strong inclination towards collaborative research. Intermountain Medical Center, Saitama Medical University, and Udice-French Research Universities were the most productive institutions, and Yayan J. and Rasche K. were the top authors. Furthermore, the analysis identified commonly encountered microorganisms such as Acinetobacter baumanii and Klebsiella pneumoniae in the context of AMR. Time-based analysis of keywords highlighted the significance of terms like “community-acquired pneumonia” and “ventilator-associated pneumonia”. Overall, this comprehensive study sheds light on the global research landscape of AMR among pneumonia pathogens. The insights gained from this analysis are essential for guiding future research priorities and collaborative efforts to combat AMR effectively and improve treatment outcomes for pneumonia and related infections. As the frequency of reports concerning resistance among pneumonia pathogens, notably A. baumannii and K. pneumoniae, continues to rise, there is an immediate requirement for pharmaceutical manufacturers and healthcare providers to respond proactively and ready themselves for the forthcoming implications of this matter. It also underscores the importance of knowledge dissemination and evidence-based interventions to address this growing public health challenge. However, the study acknowledges the limitations associated with using a single publication database and encourages the inclusion of data from other sources in future research.