Gernot Rohde

Publications (104) View all

• Article: [Epidemiology, diagnosis and treatment of adult patients with nosocomial pneumonia].

  K Dalhoff, M Abele-Horn, S Andreas, T Bauer, H von Baum, M Deja, S Ewig, P Gastmeier, S Gatermann, H Gerlach, [......], G Rohde, S Rosseau, B Schaaf, R Schaumann, D Schreiter, H Schütte, H Seifert, H Sitter, C Spies, T Welte
  [show abstract] [hide abstract]
  ABSTRACT: Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However infections on general wards are also increasing. A central issue are infections with multi drug resistant (MDR) pathogens which are difficult to treat particularly in the empirical setting potentially leading to inappropriate use of antimicrobial therapy.This guideline was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and therapy of HAP on the basis of quality of evidence and benefit/risk ratio.The guideline has two parts. First an update on epidemiology, spectrum of pathogens and antiinfectives is provided. In the second part recommendations for the management of diagnosis and treatment are given. Proper microbiologic work up is emphasized for knowledge of the local patterns of microbiology and drug susceptibility. Moreover this is the optimal basis for deescalation in the individual patient. The intensity of antimicrobial therapy is guided by the risk of infections with MDR. Structured deescalation concepts and strict limitation of treatment duration should lead to reduced selection pressure.
  Pneumologie 12/2012; 66(12):707-65.
• Article: The burden of pneumococcal pneumonia - experience of the German competence network CAPNETZ.

  M W Pletz, H von Baum, M van der Linden, G Rohde, H Schütte, N Suttorp, T Welte
  [show abstract] [hide abstract]
  ABSTRACT: Pneumococcal pneumonia is still an important cause of mortality. The objective of this study was to compare frequency, clinical presentation, outcome and vaccination status of patients with pneumococcal community-acquired pneumonia (CAP) to CAP due to other or no detected pathogen based on data of the German Network for community-acquired pneumonia (CAPNETZ). Demographic, clinical and diagnostic data were recorded using standardized web-based data acquisition. Standardized microbiological sampling and work-up were conducted in each patient. 7400 patients with CAP from twelve clinical centers throughout Germany were included. In 2259 patients (32 %) a pathogen was identified, Streptococcus pneumonia being the most frequent (n = 676, 30 % of all patients with identified pathogens). Compared to those with non-pneumococcal pneumonia, patients with pneumococcal pneumonia were more frequently admitted to hospital (80 % vs. 66 %, p < 0.001), had higher CURB score values on admission, had more frequently pleural effusion (19 % vs. 14 %, p = 0.001) and needed more frequently oxygen insufflation (58 % vs. 44 %, p < 0.001). There was no relevant difference in overall mortality. Pneumococcal pneumonia was associated with a more severe clinical course demanding more medical resources as compared to non-pneumococcal pneumonia.
  Pneumologie 08/2012; 66(8):470-5.
• Source

  Available from: Marcus Panning

  Article: Performance of a novel microarray multiplex PCR for the detection of 23 respiratory pathogens (SYMP-ARI study).

  S Bierbaum, N Königsfeld, N Besazza, K Blessing, G Rücker, U Kontny, R Berner, M Schumacher, J Forster, V Falcone, C van de Sand, A Essig, D Huzly, G Rohde, D Neumann-Haefelin, M Panning
  [show abstract] [hide abstract]
  ABSTRACT: Symptoms of acute febrile respiratory tract infection are often unspecific, but the rapid identification of pathogens allows optimised patient management. The objective of this study was to evaluate a novel multiplex polymerase chain reaction (PCR) suspension microarray which detects 19 viral and four atypical bacterial targets. A comprehensive set of sensitive monoplex real-time PCR assays was used for each pathogen as the gold standard. A panel of archived as well as 300 prospectively collected clinical samples was analysed by both methods. At least one target was detected in 165/300 (55 %) samples by monoplex PCR and in 140/300 (46 %) samples by multiplex PCR, respectively. The positivity rate was significantly higher in paediatric patients compared to adults [126/154 (82 %) vs. 39/146 (27 %) by monoplex and 114/154 (74 %) vs. 26/146 (18 %) by multiplex PCR, respectively]. Among all samples, 17/300 (5.6 %) were positive for atypical bacteria by monoplex and 8/300 (2.6 %) by multiplex PCR, respectively. Multiple detections were recorded in 35/300 (11.6 %) samples by monoplex and 26/300 (8.7 %) by multiplex PCR. For the most common pathogens, the sensitivity ranged from 57 to 93 % and the specificity ranged from 95 to 100 %. The overall concordance between both methods was 77 % [95 % confidence interval (CI) 72-81 %]. False-negative results by multiplex PCR were mainly due to the low target concentration. Compared to monoplex PCR, the novel microarray assay proved its principle but displayed overall lower sensitivities, potentially restricting its use to paediatric patients. For some targets, only small numbers of positive samples were available, requiring larger studies to firmly assess the sensitivity and specificity.
  European Journal of Clinical Microbiology 05/2012; 31(10):2851-61. · 2.86 Impact Factor
• Article: GRACE and the development of an education and training curriculum.

  R G Finch, F B Blasi, T J M Verheij, H Goossens, S Coenen, K Loens, G Rohde, H Saenz, M Akova
  [show abstract] [hide abstract]
  ABSTRACT: Antimicrobial resistance is a serious threat and compromises the management of infectious disease. This has particular significance in relation to infections of the respiratory tract, which are the lead cause of antibiotic prescribing. Education is fundamental to the correct use of antibiotics. A novel open access curriculum has been developed in the context of a European Union funded research project Genomics to combat Resistance against Antibiotics in Community-acquired lower respiratory tract infections in Europe (GRACE http://www.grace-lrti.org). The curriculum was developed in modular format and populated with clinical and scientific topics relevant to community-acquired lower respiratory tract infections. This curriculum informed the content of a series of postgraduate courses and workshops and permitted the creation of an open access e-Learning portal. A total of 153 presentations matching the topics within the curriculum together with slide material and handouts and 104 webcasts are available through the GRACE e-Learning portal, which is fully searchable using a 'mindmap' to navigate the contents. Metrics of access provided a means for assessing usage. The GRACE project has permitted the development of a unique on-line open access curriculum that comprehensively addresses the issues relevant to community-acquired lower respiratory tract infections and has provided a resource not only for personal learning, but also to support independent teaching activities such as lectures, workshops, seminars and course work.
  Clinical Microbiology and Infection 05/2012; 18(9):E308-13. · 4.54 Impact Factor
• Article: Infektion und Asthma

  G. Rohde, J. Rupp
  [show abstract] [hide abstract]
  ABSTRACT: Asthma ist eine chronisch entzündliche Erkrankung der Atemwege. Pathogenetisch steht die allergeninduzierte Atemwegsentzündung im Vordergrund. Infektionen spielen aber eine wesentliche Rolle als Auslöser akuter Exazerbationen und kommen auch in einer chronisch oder latenten Form als Verstärker der lokalen Entzündungsreaktion in Betracht. Ziel dieses Beitrags ist es, eine Übersicht über die unterschiedlichen Infektionserreger zu geben und den aktuellen Wissensstand zur Bedeutung von Atemwegsviren und atypischen Bakterien (C.pneumoniae und M.pneumoniae) in der Pathogenese von Asthma darzustellen. Asthma is a chronic inflammatory disorder of the airways. Allergen-induced airway inflammation plays a central role in the pathogenesis of the disease whereas infections are known to be important triggers of acute exacerbations. Chronic or latent infections may also influence and enhance the local inflammation. The aim of this review is to give an overview of the different pathogens and to present the current understanding of the role of respiratory viruses and atypical bacteria in the pathogenesis of the disease.
  Der Internist 04/2012; 49(11):1302-1310. · 0.30 Impact Factor