Table 1

ERS syllabus for postgraduate training in respiratory infections

Module 1. Pathogens (respiratory microbiology)
1 Respiratory microbiology	Mandatory
1.1 Normal bacterial flora
1.2 Classification of respiratory microorganisms
2 Respiratory bacteria	Mandatory
2.1 Gram positive
2.2 Gram negative
2.3 Atypicals
3 Respiratory viruses	Mandatory
3.1 RNA viruses (seasonal and/or pandemic, emerging)
3.2 DNA viruses (seasonal and/or pandemic, emerging)
4 Respiratory fungi	Mandatory
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 Mycobacteria	Mandatory
5.1 Mycobacterium tuberculosis
5.2 Non-tuberculous mycobacteria (NTM)
6 Antimicrobial resistance	Mandatory
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 resistance	Optional
7 Microbiome	Optional
Module 2. Host respiratory defence mechanisms against infection
1 Natural barriers	Mandatory
1.1 Cilia/primary ciliary dyskinesia
2 Innate immune systems	Mandatory
2.1 Complement
2.2 Cells
2.3 Defensins
2.4 Cytokines
2.5 Inflammation process
3 Adaptive immune systems	Mandatory
3.1 Humoral immunity
3.2 Cellular immunity
4 Immune reconstitution inflammatory syndrome (IRIS)	Optional
5 Pathophysiology of respiratory infections	Mandatory
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 infections	Mandatory
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 transmission	Mandatory
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 specimens	Mandatory
1.1 Noninvasive (blood, urine, bronchoalveolar lavage, throat swabs)
1.2 Invasive (sputum, tracheal aspirate, thoracentesis, imaging-guided biopsy, transthoracic fine-needle biopsy)
2 Microscopy	Optional
3 Culture	Optional
4 Susceptibility testing	Optional
5 Immunological tests	Optional
5.1 Interferon-γ release assay (IGRA)
5.2 Tuberculin skin test
5.3 Serology
6 Molecular testing	Optional
7 Rapid point-of-care diagnostic tests for viral and bacterial respiratory tract infections	Optional
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 agents	Mandatory
1.1 Classification and activity (including pharmacokinetics/pharmacodynamics (PK/PD) principles)
2 Antiviral agents	Mandatory
2.1 Classification and activity (including PK/PD principles)
3 Antifungal agents	Mandatory
3.1 Classification and activity (including PK/PD principles)
4 Antimycobacterial agents	Mandatory
4.1 Classification and activity (including PK/PD principles)
5 Drug delivery or administration	Mandatory
5.1 Oral
5.2 Inhaled
5.3 Intravenous
5.4 Intramuscular
6 Drug–drug interaction	Mandatory
7 Antimicrobial adverse events	Mandatory
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 bronchitis	Mandatory
3 Bronchiolitis	Mandatory
4 Exacerbation of asthma	Mandatory
5 Exacerbation of chronic obstructive pulmonary disease (COPD)	Mandatory
6 Exacerbation of bronchiectasis	Mandatory
7 Community-acquired pneumonia, including nursing-home pneumonia	Mandatory
8 Nosocomial pneumonia, including ventilator-associated pneumonia	Mandatory
9 Aspiration pneumonia	Mandatory
10 Seasonal influenza	Mandatory
11 Extrapulmonary complications	Mandatory
Module 7. Other respiratory infections
1 Fungal pulmonary infections	Mandatory
2 Lung abscess	Mandatory
3 Nocardiosis	Mandatory
4 Actinomycosis	Mandatory
5 Parasitic pneumonia	Optional
6 Travel born respiratory infections	Mandatory
Module 8. Severe viral respiratory infections
1 Viruses	Mandatory
1.1 Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), H1N1, H5N1
2 Pandemics	Mandatory
2.1 Identification
2.2 Management
2.3 Public health policies
Module 9. Mycobacterial disease
1 Pulmonary tuberculosis	Mandatory
2 Extrapulmonary tuberculosis	Mandatory
3 Latent tuberculosis infection	Mandatory
4 Nontuberculous mycobacterial infections	Mandatory
Module 10. Chronic respiratory infections in patients with respiratory disease
1 Asthma	Mandatory
2 COPD	Mandatory
3 Bronchiectasis	Mandatory
4 Adult cystic fibrosis bronchiectasis	Mandatory
Module 11. Pulmonary infections in the immunocompromised host
1 Neutropenic patients	Mandatory
2 HIV-infected patients	Mandatory
3 Haematological disorders and malignancy	Mandatory
4 Lung and other solid organ transplant recipients	Mandatory
5 Haematopoietic cell transplant recipients	Mandatory
6 Secondary immunodeficiency induced by drugs and biologicals	Mandatory
7 Primary immune deficiency syndromes	Mandatory
Module 12. Pleural infections
1 Parapneumonic effusion and empyema	Mandatory
2 Pleuritis	Mandatory
2.1 tuberculosis, bacterial, etc.
Module 13. Sepsis
1 Sepsis, severe sepsis and septic shock	Mandatory
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 Vaccination	Mandatory
1.1 Influenza vaccination
1.2 Pneumococcal vaccination
1.3 Other vaccinations
2 Other prevention measures	Optional
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 control	Mandatory
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)