Roman Stets

Bio: Roman Stets is an academic researcher. The author has contributed to research in topics: Pneumonia & Internal medicine. The author has an hindex of 2, co-authored 2 publications receiving 101 citations.

Omadacycline for Community-Acquired Bacterial Pneumonia

Abstract: Background Omadacycline, a new once-daily aminomethylcycline antibiotic agent that can be administered intravenously or orally, reaches high concentrations in pulmonary tissues and is acti...

A Phase 3 Randomized, Double-blind, Multi-center Study to Compare the Safety and Efficacy of IV to Oral Omadacycline to Moxifloxacin for the Treatment of Adult Subjects with CABP (The OPTIC Study)

Abstract: FUNDING AND DISCLOSURES BACKGROUND METHODS A Phase 3, Randomized, Double-Blind, Multi-Center Study to Compare the Safety and Efficacy of IV to Oral Omadacycline to Moxifloxacin for the Treatment of Adult Patients With CABP (The OPTIC Study) Roman Stets, MD, PhD1; Monica Popescu, MD2; Joven Gonong, MD3; Ismail Mitha, MD4; William Nseir, MD5; Andrzej Madej, MD, PhD6; Courtney Kirsch, BS7; Anita Das, PhD7; Lynne Garrity-Ryan, PhD7; Judith N. Steenbergen, PhD7; Amy Manley, BS7; Paul B. Eckburg, MD7; Stephen Villano, MD7; Evan Tzanis, BA7; Paul McGovern, MD7; Evan Loh, MD7 Poster 1883

Etiology and efficacy of anti-microbial treatment for community-acquired pneumonia in adults requiring hospital admission in Ukraine

Abstract: Background and aim: Empiric therapy of community-acquired pneumonia (CAP) remains the standard care and guidelines are mostly based on published data from the United States or Europe. In this study, we determined the bacterial etiology of CAP and evaluated the clinical outcomes under antimicrobial treatment of CAP in Ukraine. Methods: A total of 98 adult subjects with CAP and PORT risk II-IV were recruited for the study. The sputum diagnostic samples were obtained from all patients for causative pathogen identification. Subjects were randomly assigned in a 1:1 ratio to receive delafloxacin 300 mg (n=51) or moxifloxacin 400 mg (n=47) with a blinding placebo. The switch to oral treatment was after a minimum of 6 IV doses according to clinical criteria. The total duration of antibacterial treatment was 5-10 days. In vitro susceptibility of pathogens to delafloxacin and other comparator antibiotics was determined. Results: The most frequently isolated pathogens in adults with CAP were S. pneumoniae – 19.5%, M. pneumoniae – 15.3%, H. influenzae – 13.2%, S. aureus – 10.5%, K. pneumoniae – 10.1%, and H. parainfluenzae – 6.4%. All isolates of S. pneumoniae, S. aureus, M. pneumoniae had sufficient susceptibility to appropriate antibiotics. 9.0% of H. influenzae strains were susceptible to azithromycin. 94.8 % of patients had a successful clinical response to delafloxacin at the end of treatment and 93.9 % – at test-of-cure. Conclusions: In Ukraine, the major bacterial agents that induced CAP in adults were S. pneumoniae, M. pneumoniae, H. influenzae, S. aureus, K. pneumoniae, H. parainfluenzae, E. cloacae, L. pneumophila. Delafloxacin is a promising effective antibiotic for monotherapy of CAP in adults and could be used in cases of antimicrobial-resistant strains. (www.actabiomedica.it)

Selection of a control system model of health care and labor safety of the enterprise, taking into account the requirements of international standards

Abstract: Article 43 of the Constitution of Ukraine guarantees proper, safe and healthy working conditions for every employee, according to Article 13 of the Law “On Labor Protection” the employer must ensure the functioning of the labor protection management system. Accordingly, the Concept approved by the Order of the Ministry of Labor dated 22.10. No. 432 of 2001, every enterprise, institution or organization (hereinafter – the enterprise) of any form of ownership, which uses the labor of employees in its activities, is obliged to comply with the necessary requirements established by the legislation of Ukraine, in order to guarantee the safety of work and the preservation of life, health and working capacity of employees in the process of work. In order to ensure healthy, safe and highly productive working conditions, improve working life, prevent injuries and occupational diseases, the company operates a health and safety management system, which is an integral part of the management system of the business entity. The occupational health and safety management system (OH&S) is a set of enterprise management bodies that, on the basis of a set of regulatory documentation, carry out purposeful, planned activities regarding the implementation of management tasks and functions in order to ensure healthy, safe and highly productive working conditions.To build an effective occupational safety management system, it is necessary to choose its optimal model. A scientific and applied problem is the choice of the most suitable system in the conditions of a particular enterprise. An analysis of the approaches available in international practice regarding the formation of health and safety management system models, taking into account quality management systems, environmental protection and social responsibility, was carried out. Recommendations aregiven for choosing a basic methodological approach that will contribute to the creation of an effective labor safety management system with the aim of ensuring safe and highly productive working conditions and creating a positive image of the enterprise.

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

Abstract: Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia.Methods: A multidisciplinary panel conducted pra...

Antimicrobial resistance in ESKAPE pathogens

Abstract: Antimicrobial-resistant ESKAPE ( Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens represent a global threat to human health. The acquisition of antimicrobial resistance genes by ESKAPE pathogens has reduced the treatment options for serious infections, increased the burden of disease, and increased death rates due to treatment failure and requires a coordinated global response for antimicrobial resistance surveillance. This looming health threat has restimulated interest in the development of new antimicrobial therapies, has demanded the need for better patient care, and has facilitated heightened governance over stewardship practices.

Considerations and Caveats in Combating ESKAPE Pathogens against Nosocomial Infections

Abstract: ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) are among the most common opportunistic pathogens in nosocomial infections. ESKAPE pathogens distinguish themselves from normal ones by developing a high level of antibiotic resistance that involves multiple mechanisms. Contemporary therapeutic strategies which are potential options in combating ESKAPE bacteria need further investigation. Herein, a broad overview of the antimicrobial research on ESKAPE pathogens over the past five years is provided with prospective clinical applications.

An open label trial of anakinra to prevent respiratory failure in COVID-19.

Abstract: People infected with the SARS-CoV-2 virus, which causes COVID-19, can develop severe respiratory failure and require a ventilator to keep breathing, but this does not happen to every infected individual. Measuring a blood protein called suPAR (soluble urokinase plasminogen activator receptor) may help identify patients at the greatest risk of developing severe respiratory failure and requiring a ventilator. Previous investigations have suggested that measuring suPAR can identify pneumonia patients at highest risk for developing respiratory failure. The protein can be measured by taking a blood sample, and its levels provide a snapshot of how the body’s immune system is reacting to infection, and of how it may respond to treatment. Anakinra is a drug that forms part of a class of medications called interleukin antagonists. It is commonly prescribed alone or in combination with other medications to reduce pain and swelling associated with rheumatoid arthritis. Kyriazopoulou et al. investigated whether treating COVID-19 patients who had developed pneumonia with anakinra could prevent the use of a ventilator and lower the risk of death. The findings show that treating COVID-19 patients with an injection of 100 milligrams of anakinra for ten days may be an effective approach because the drug combats inflammation. Kyriazopoulou et al. examined various markers of the immune response and discovered that anakinra was able to improve immune function, protecting a significant number of patients from going on a ventilator. The drug was also found to be safe and cause no significant adverse side effects. Administering anakinra decreased of the risk of progression into severe respiratory failure by 70%, and reduced death rates significantly. These results suggest that it may be beneficial to use suPAR as an early biomarker for identifying those individuals at highest risk for severe respiratory failure, and then treat them with anakinra. While the findings are promising, they must be validated in larger studies.

Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

Abstract: Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Despite important advances in prevention through vaccines, new rapid diagnostic tests and antibiotics, CAP management still has significant drawbacks. Mortality remains very high in severely ill patients presenting with respiratory failure or shock but is also high in the elderly. Even after a CAP episode, higher risk of death remains during a long period, a risk mainly driven by inflammation and patient-related co-morbidities. CAP microbiology has been altered by new molecular diagnostic tests that have turned viruses into the most identified pathogens, notwithstanding uncertainties about the specific role of each virus in CAP pathogenesis. Pneumococcal vaccines also impacted CAP etiology and thus had changed Streptococcus pneumoniae circulating serotypes. Pathogens from specific regions should also be kept in mind when treating CAP. New antibiotics for CAP treatment were not tested in severely ill patients and focused on multidrug-resistant pathogens that are unrelated to CAP, limiting their general use and indications for intensive care unit (ICU) patients. Similarly, CAP management could be personalized through the use of adjunctive therapies that showed outcome improvements in particular patient groups. Although pneumococcal vaccination was only convincingly shown to reduce invasive pneumococcal disease, with a less significant effect in pneumococcal CAP, it remains the best therapeutic intervention to prevent bacterial CAP. Further research in CAP is needed to reduce its population impact and improve individual outcomes.