Journal of Clinical Microbiology, 52(5), 1 May 2014, pp 1741-44, doi: 10.1128/JCM.03614-13
Intensive Care Medicine, 40(4), 1 April 2014, pp 564–571, doi: 10.1007/s00134-014-3225-8
Expert Opinion on Therapeutic Targets, 18(8), 1 August 2014, pp 851-61, doi: 10.1517/14728222.2014.925881

Expected results & advances

R-GNOSIS will provide new and vital evidence for controlling infections and spread of MDR-GNB in the community and within hospital settings. The core of R-GNOSIS is formed by five clinical studies that all progress well beyond the state-of-the-art by their design, innovative methods and strategies tested. All trials are connected with highly innovative supportive studies in the fields of microbiology and mathematical modelling.

R-GNOSIS will identify the most effective measures for controlling selection and transmission of MDR-GNB and their genes and for reducing infections caused by MDR-GNB in relevant patient populations in the community and healthcare settings, will optimize treatment and prophylaxis strategies to avoid the detrimental consequences of these bacteria on patient outcome and investigate the critical molecular aspects for persistence and transfer of resistance genes in the human gut.

The European Centre for Disease Prevention and Control and the European Medicines Agency estimated that 193,300 patients were infected with MDR-GNB in 2007, and that these infections caused 18,200 excess deaths and 1,375,000 additional hospital days in EU Member States, Iceland and Norway. Moreover, the rate of infections caused by MDR-GNB is still increasing. Today, ‘more of the same’ research is therefore no longer an option. An “out-of-the-box” conceptual step-change is necessary. Evidence base needs to be optimised for “well known but inadequately researched” infection prevention strategies through innovative and state-of-the-art study designs. Counterintuitive and highly innovative, solutions need to be identified and rigorously evaluated.

The R-GNOSIS programme will concentrate on

  • the reduction of the prescription of antibiotics by family practitioners;
  • preventive administration of antibiotics to IC patients;
  • the usefulness of isolating patients who are carriers of ESBL bacteria and
  • the prevention of infections following abdominal operations.