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ERS syllabus for postgraduate training in respiratory infections: a guide for comprehensive training

Stefano Aliberti, Amy Farr, Nathalie Tabin, Francesco Blasi, Antoni Torres, Mark Woodhead, Giovanni Battista Migliori, Giovanni Sotgiu, George Dimopoulos, James D. Chalmers, Felix C. Ringshausen, Michael R. Loebinger, Robert Read, Gernot Rohde
Breathe 2018 14: 269-275; DOI: 10.1183/20734735.026218
Stefano Aliberti
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Amy Farr
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Nathalie Tabin
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Francesco Blasi
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Antoni Torres
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Mark Woodhead
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Giovanni Battista Migliori
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Giovanni Sotgiu
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George Dimopoulos
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James D. Chalmers
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Felix C. Ringshausen
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Michael R. Loebinger
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Robert Read
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Gernot Rohde
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  • For correspondence: gernot.rohde@kgu.de
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    Overview of the Delphi process.

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    ERS syllabus for postgraduate training in respiratory infections

    Module 1. Pathogens (respiratory microbiology) 
     1 Respiratory microbiologyMandatory
      1.1 Normal bacterial flora 
      1.2 Classification of respiratory microorganisms 
     2 Respiratory bacteriaMandatory
      2.1 Gram positive 
      2.2 Gram negative 
      2.3 Atypicals 
     3 Respiratory virusesMandatory
      3.1 RNA viruses (seasonal and/or pandemic, emerging) 
      3.2 DNA viruses (seasonal and/or pandemic, emerging) 
     4 Respiratory fungiMandatory
      4.1 Candida spp. 
      4.2 Aspergillus spp. 
      4.3 Pneumocystis 
      4.4 Other fungi (including Mucor spp., Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Exophiala and Scedosporium)Optional
     5 MycobacteriaMandatory
      5.1 Mycobacterium tuberculosis 
      5.2 Non-tuberculous mycobacteria (NTM) 
     6 Antimicrobial resistanceMandatory
      6.1 Mechanisms of antibiotic resistance 
      6.2 Multidrug-resistant (MDR) bacteria 
      6.3 Risk factors for MDR bacteria 
      6.4 MDR/extensively drug-resistant (XDR) tuberculosis 
      6.5 Risk factors for MDR/XDR tuberculosis 
      6.6 NTM resistance 
      6.7 Resistance in other microorganisms (anti-fungal and anti-viral resistance)Optional
      6.8 Influenza resistanceOptional
     7 MicrobiomeOptional
    Module 2. Host respiratory defence mechanisms against infection 
     1 Natural barriersMandatory
      1.1 Cilia/primary ciliary dyskinesia 
     2 Innate immune systemsMandatory
      2.1 Complement 
      2.2 Cells 
      2.3 Defensins 
      2.4 Cytokines 
      2.5 Inflammation process 
     3 Adaptive immune systemsMandatory
      3.1 Humoral immunity 
      3.2 Cellular immunity 
     4 Immune reconstitution inflammatory syndrome (IRIS)Optional
     5 Pathophysiology of respiratory infectionsMandatory
      5.1 Transmission 
      5.2 Infection 
      5.3 Inflammation 
      5.4 Resolution 
    Module 3. Epidemiology, burden of disease and risk factors 
     1 Epidemiological burden of respiratory infectionsMandatory
      1.2 Bacterial infections 
      1.3 Viral infections 
      1.4 Fungal infections 
      1.5 Mycobacterial infections (tuberculosis and NTM) 
     2 Risk factors for respiratory infections and transmissionMandatory
      2.1 Environmental risk factors 
      2.2 Host risk factors (including other conditions leading to mild immunosuppression, e.g. diabetes mellitus) 
      2.3 Microbial risk factors 
    Module 4. Diagnostic techniques for respiratory infections 
     1 Indication and collection of biological specimensMandatory
      1.1 Noninvasive (blood, urine, bronchoalveolar lavage, throat swabs) 
      1.2 Invasive (sputum, tracheal aspirate, thoracentesis, imaging-guided biopsy, transthoracic fine-needle biopsy) 
     2 MicroscopyOptional
     3 CultureOptional
     4 Susceptibility testingOptional
     5 Immunological testsOptional
      5.1 Interferon-γ release assay (IGRA) 
      5.2 Tuberculin skin test 
      5.3 Serology 
     6 Molecular testingOptional
     7 Rapid point-of-care diagnostic tests for viral and bacterial respiratory tract infectionsOptional
     8 Imaging techniques in relation to infections (including chest radiography, computed tomography, lung ultrasounds and magnetic resonance imaging)Mandatory
    Module 5. General principles of antimicrobial therapy 
     1 Antibacterial agentsMandatory
      1.1 Classification and activity (including pharmacokinetics/pharmacodynamics (PK/PD) principles) 
     2 Antiviral agentsMandatory
      2.1 Classification and activity (including PK/PD principles) 
     3 Antifungal agentsMandatory
      3.1 Classification and activity (including PK/PD principles) 
     4 Antimycobacterial agentsMandatory
      4.1 Classification and activity (including PK/PD principles) 
     5 Drug delivery or administrationMandatory
      5.1 Oral 
      5.2 Inhaled 
      5.3 Intravenous 
      5.4 Intramuscular 
     6 Drug–drug interactionMandatory
     7 Antimicrobial adverse eventsMandatory
      7.1 Haematological side-effects 
      7.2 Nausea and vomiting 
      7.3 Diarrhoea including Clostridium difficile infection 
      7.4 Ototoxicity 
      7.5 Hepatic toxicity 
      7.6 Nephrotoxicity 
      7.7 Cardiovascular toxicity 
     8 Principles of antimicrobial stewardship (including prevention of infection, infection control, adequate and appropriate treatment)Mandatory
    Module 6. Common respiratory tract syndromes 
     1 Common upper respiratory tract syndromes (including acute infective rhinitis, sinusitis, pharyngitis, epiglottitis, laryngotracheitis)Mandatory
     2 Acute bronchitisMandatory
     3 BronchiolitisMandatory
     4 Exacerbation of asthmaMandatory
     5 Exacerbation of chronic obstructive pulmonary disease (COPD)Mandatory
     6 Exacerbation of bronchiectasisMandatory
     7 Community-acquired pneumonia, including nursing-home pneumoniaMandatory
     8 Nosocomial pneumonia, including ventilator-associated pneumoniaMandatory
     9 Aspiration pneumoniaMandatory
     10 Seasonal influenzaMandatory
     11 Extrapulmonary complicationsMandatory
    Module 7. Other respiratory infections 
     1 Fungal pulmonary infectionsMandatory
     2 Lung abscessMandatory
     3 NocardiosisMandatory
     4 ActinomycosisMandatory
     5 Parasitic pneumoniaOptional
     6 Travel born respiratory infectionsMandatory
    Module 8. Severe viral respiratory infections 
     1 VirusesMandatory
      1.1 Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), H1N1, H5N1 
     2 PandemicsMandatory
      2.1 Identification 
      2.2 Management 
      2.3 Public health policies 
    Module 9. Mycobacterial disease 
     1 Pulmonary tuberculosisMandatory
     2 Extrapulmonary tuberculosisMandatory
     3 Latent tuberculosis infectionMandatory
     4 Nontuberculous mycobacterial infectionsMandatory
    Module 10. Chronic respiratory infections in patients with respiratory disease 
     1 AsthmaMandatory
     2 COPDMandatory
     3 BronchiectasisMandatory
     4 Adult cystic fibrosis bronchiectasisMandatory
    Module 11. Pulmonary infections in the immunocompromised host 
     1 Neutropenic patientsMandatory
     2 HIV-infected patientsMandatory
     3 Haematological disorders and malignancyMandatory
     4 Lung and other solid organ transplant recipientsMandatory
     5 Haematopoietic cell transplant recipientsMandatory
     6 Secondary immunodeficiency induced by drugs and biologicalsMandatory
     7 Primary immune deficiency syndromesMandatory
    Module 12. Pleural infections 
     1 Parapneumonic effusion and empyemaMandatory
     2 PleuritisMandatory
      2.1 tuberculosis, bacterial, etc. 
    Module 13. Sepsis 
     1 Sepsis, severe sepsis and septic shockMandatory
      1.1 Virulence factors involved in sepsis 
      1.2 Early recognition and management 
      1.3 Additional therapies 
      1.4 Biomarkers 
      1.5 Clinical management 
    Module 14. Prevention of respiratory infections 
     1 VaccinationMandatory
      1.1 Influenza vaccination 
      1.2 Pneumococcal vaccination 
      1.3 Other vaccinations 
     2 Other prevention measuresOptional
      2.1 Smoking cessation 
      2.2 Specific preventive management 
      2.3 Prevention of community-acquired pneumonia 
      2.4 Dental care 
      2.5 Aspiration management 
     3 Infection controlMandatory
      3.1 Infection surveillance 
      3.2 Universal precautions 
      3.3 Isolation and reverse isolation, including specific microbes in cystic fibrosis and bronchiectasis (e.g. Pseudomonas) 
      3.4 Infectious risks to healthcare workers 
      3.5 Tuberculosis control and elimination, including Bacillus Calmette–Guérin (BCG) vaccine 
      3.6 Immunomodulants (synthetic and microbial) 
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ERS syllabus for postgraduate training in respiratory infections: a guide for comprehensive training
Stefano Aliberti, Amy Farr, Nathalie Tabin, Francesco Blasi, Antoni Torres, Mark Woodhead, Giovanni Battista Migliori, Giovanni Sotgiu, George Dimopoulos, James D. Chalmers, Felix C. Ringshausen, Michael R. Loebinger, Robert Read, Gernot Rohde
Breathe Dec 2018, 14 (4) 269-275; DOI: 10.1183/20734735.026218

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ERS syllabus for postgraduate training in respiratory infections: a guide for comprehensive training
Stefano Aliberti, Amy Farr, Nathalie Tabin, Francesco Blasi, Antoni Torres, Mark Woodhead, Giovanni Battista Migliori, Giovanni Sotgiu, George Dimopoulos, James D. Chalmers, Felix C. Ringshausen, Michael R. Loebinger, Robert Read, Gernot Rohde
Breathe Dec 2018, 14 (4) 269-275; DOI: 10.1183/20734735.026218
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