by Esther Segal
, Tel-Aviv University
The ECMM has established biennial one day educational events (Workshops) that take place between the TIMM meetings and are generally in conjunction with other scientific meetings. The 1st Workshop was held in 2008 in Istanbul, Turkey with the IUMS Congress.
The 2nd workshop took place September 25, 2010 in Milan, Italy, following the two day (September 23- 24) 10th Congress of Italian Society of Mycologists (FIMUA).
The workshop was held at the historic site of the University of Milan, at the Ospedale Maggiore Complex. The Ospedale Maggiore Complex was founded in the 15th Century by Francesco Sforza, Duke of Milan, and provided medical care to the city’s citizens during several centuries.
This huge complex is an impressive architectural Renaissance structure and it gave a special atmosphere to the Workshop.
The Workshop was headed by the Scientific Committee of Dr Giulia Morace, Dr Anna Maria Tortorano and Dr Maria Anna Viviani, and organized by Nadirex International,
who accomplished to bring-about an interesting educational program and a socially enjoyable event, for which they should be complimented.
The Workshop was attended by 202 participants from 15 different countries, with majority, naturally, from Italy.
The general theme of the Workshop was “Pathogenesis and Antifungal Management of Opportunistic Fungal Diseases”. The program included three sessions. One devoted to “Advances in the Understanding of the Pathogenesis of Opportunistic Fungal Diseases” Chaired by Jacques Meis and Esther Segal from The Netherlands and Israel, respectively. The two others: “Therapy 1” and “Therapy 2” focused on the “Management of Opportunistic Fungal Diseases” were chaired by Emanuel Roilides from Greece & Cornelia Lass-Floerl from Austria (Therapy 1) and by Bertrand Dupont & Katrien Lagrou, from France and Belgium, respectively (Therapy 2).
The session on pathogenesis included four review lectures on the four major opportunistic infections: Candidosis, Cryptococcosis, Aspergillosis and Zygomycosis, presented by Esther Segal
(Israel), Olivier Lortholary (France), Luigina Romani (Italy) and George Petrikkos (Greece).
The presentation on Candidosis overviewed the state of art of the pathogenesis of this complex infection. It highlighted specific fungal virulence factors, models for studying pathogenesis, epidemiologic and demographic aspects of Candida species
distribution and intra-species genotyping in relation to clinical entity. Dr Lortholary
focused on Cryptococcosis in solid organ transplant recipients. This lecture summarized the current knowledge on this infection in solid organ recipients and highlighted areas for future research aiming to improve the outcome in these patients. Dr Romani’s
lecture concentrated on the Immunology of Aspergillus and Aspergillosis. Her presentation emphasized the current understanding of the pathophysiology underlying Aspergillus infections. Dr Petrikkos
reviewed various aspects of Zygomycosis, including clinical facets of the infection and difficulties of diagnosis.
Session Therapy 1, included the following presentations on: 1). systemic antifungals currently available on the market, by Georg Maschmeyer (Germany), including the pharmacologist’s remarks by Andrea Novelli (Italy); 2). the clinical impact of antifungal drug resistance, by Francesco Barchiesi
(Italy); 3). the most reliable detection method of antifungal drug resistance, by Cornelia Lass-Floerl
and Dr Novelli
surveyed the currently available major classes of antifungals for treatment of invasive mycoses, indicating “first-line” and “second-line” treatment regimens and pointing –out the pharmacodynamics and pharmacokinetics of the drugs. Dr Barchiesi indicated the lack of sufficient data on the correlation between specific fungi and resistance to specific antifungal drugs in the context of impact in clinical management. Dr Lass-Floerl reported on the methodology used to assess antifungal drug resistance.
In the second session dealing with antifungals – Therapy 2, were lectures on: 1). can diagnosis improve therapy? by Maiken Arendrup
(Denmark); 2). how can we prevent invasive fungal disease? by Chris Kibbler
(United Kingdom); 3).strategies in antifungal therapy of neutropenic patients, by Claudio Viscoli
(Italy); 4). strategies in antifungal therapy of ICU patients, by Oscar Marchetti
(Switzerland). The overview of Dr Arendrup highlighted how optimal use and interpretation of the results of diagnostics may help the clinician to optimize the treatment. The presentation of Dr Kibbler reviewed the recent antifungal prophylaxis studies and guidelines for appropriate approaches. Dr Viscoli and Dr Marchetti, reviewed the state of art of antifungal treatments for neutropenic and ICU patients, respectively. Pros and contras of empirical vs pre-emptive therapy in the neutropenic patient were presented and discussed. The improvement in the management of ICU patients with candidosis has been pointed out by Dr Marchietti.
The social day activity of the workshop was concentrated around the coffee breaks and lunch in the corridor facing the architecturally magnificent “cortile”, where speakers and attendees mingled and exchanged friendly conversations. In the evening prior to the workshop an elegant and enjoyable dinner took place in the Museo della Scienza e della Tecnologia (the Leonardo da Vinci Museum), where participants had also the opportunity to visit the exhibits in Leonardo’s Gallery.
In summary, the 2nd ECMM Workshop in Milan was a successful event both educationally and socially, for which the organizers should be greatly appreciated.
Esther Segal, Tel-Aviv University