Medical News & Perspectives 

May 3, 2023

Artificial Intelligence, Emerging Threats, and Diagnostic Advances—Highlights From ECCMID, Europe’s Largest Infectious Disease Conference

Preeti Malani

JAMA. Published online May 3, 2023. doi:10.1001/jama.2023.6066

For more than 14 000 infectious diseases physicians, clinical microbiologists, and public health professionals, gathering in Copenhagen, Denmark, in April was a special occasion. The European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) was back on familiar, face-to-face footing after 3 years of disruptions due to COVID-19.

Jacob Moran-Gilad, MD, MPH

Thomas Ecke/European Society of Clinical Microbiology and Infectious Diseases

“This year I can definitely say that in many aspects, we returned to the pre-COVID era,” Jacob Moran-Gilad, MD, MPH, of Ben-Gurion University of the Negev in Israel, said during a recent interview with JAMA. “There were no restrictions, and we were very pleased to have attendees from all parts of the world—close to 150 countries,” noted Moran-Gilad, also director of clinical microbiology at Hadassah Medical Center in Jerusalem.

As the ECCMID program director since 2021, he oversees the scientific and organizational planning and delivery of the massive conference. In addition to the thousands who attended in person, another 2500 participated remotely in all sessions—18 parallel tracks—which were live-streamed. “[T]he pandemic really made us develop a hybrid format, and this hybrid format is here to stay,” Moran-Gilad noted.

During a conversation with JAMA Deputy Editor Preeti Malani, MD, MSJ, also a professor of medicine at the University of Michigan and an ECCMID planning committee member, Moran-Gilad discussed technological advances and diversity in microbiology and infectious diseases. The following interview has been edited for length and clarity.

Dr Malani:Let’s start with a basic description of ECCMID since many US-based clinicians may not be familiar with this meeting or even the concept of medical microbiologists.

Dr Moran-Gilad:ECCMID is the leading congress for ESCMID, which is the European Society for Clinical Microbiology and Infectious Diseases. It’s an annual event usually held in April, and it takes place across Europe. ECCMID started 33 years ago as a relatively small conference that was initiated by microbiologists, but nowadays it's one of the world's premier clinical microbiology and infectious disease congresses that attracts physicians, clinical microbiologists, public health professionals, and infection control and prevention personnel. It's a pretty diverse congress that covers the entire range of microbiology and infectious diseases.

Dr Malani:The ECCMID meeting had to be canceled in 2020 and in 2021 it was replaced with a series of virtual events. At last year’s meeting in Lisbon there were still travel restrictions and other limitations related to the COVID-19 pandemic. So what have you and the planning committee learned in the past 3 years in terms of organizing a meeting of this size during a pandemic?

Dr Moran-Gilad:The pandemic has been quite disruptive to medical congresses in general. As you mentioned, our April 2020 congress was canceled, but a few months later we had ECCVID [ESCMID Conference on Coronavirus Disease], which was developed ad hoc. This was our first experience with a fully online congress. We’ve made quite some progress since then. In 2021, I think we delivered a much better online experience to our attendees. And in 2022, the congress was hybrid. Attendees had to wear masks, but otherwise the congress went pretty well. This year, there were no restrictions and we were pleased to have attendees from close to 150 countries.

Dr Malani:The manner in which you and I might practice medicine and microbiology in the US and Israel is quite different than the clinical care resources available to our colleagues in many low- and middle-income countries. Yet the burden of infectious diseases and antimicrobial resistance disproportionately affects low- and middle-income countries. How does the planning committee make sure ECCMID provides an inclusive approach given so much variability across the world?

Dr Moran-Gilad:I agree that we are seeing a lot of disparities with respect to the epidemiology of infectious diseases, and also among health systems. We are trying to ensure that our congress is as diverse and inclusive as possible. Over 50% of our faculty, the invited speakers, and chairs are female. In addition, our abstract submitters are from over a hundred countries, and our faculty originates from close to 70 countries. So we try to keep the congress very diverse.

In addition to lower-resource countries, there are different regions which are not always very well represented. As an example, Eastern European countries tend to be underrepresented, and we are working very hard to encourage both attendance and scientific contributions from those countries. We also try to encourage attendance from lower-resource countries through grants. We have internal grants and grants from the ESCMID Trust Fund. Also, we received support from the Gates Foundation, and this allows us to support a growing number of representatives from those countries. The countries that we define as underrepresented currently comprise around 10% of our invited faculty and between 15% to 20% of abstract submitters.

Dr Malani:What are the major infectious disease–related concerns that you're thinking about these days?

Dr Moran-Gilad:We all share concerns with respect to several infectious disease threats. We are just coming out of a pandemic, and pandemic preparedness is very important. We have so many lessons learned from the COVID-19 pandemic. Some are global; some are regional or local. And those lessons should inform our preparedness for the next pandemic.

Just recently, we've seen the emergence of new or reemerging pathogens. Mpox is quite important. Poliovirus is now reemerging in many countries, including in the US and Israel. So all these emerging infections are very concerning. This ties in very well with the business of “One Health,” looking at human, animal, and environmental health and the links among those different areas and the movement of pathogens and potential exposures and transmissions. This is very important now, as is AMR, antimicrobial resistance. This is a global threat. During COVID, we had somewhat less attention to AMR, but we see alarming rates of resistance in health care institutions across the globe.

Dr Malani:The ECCMID meeting is always packed with research. What are some of the new studies and findings that you're most excited about?

Dr Moran-Gilad:Topics where there is significant advancement and a lot of exciting things going on are digital health and AI [artificial intelligence]. AI is explosive in medicine and health care, and we see that in microbiology and infectious diseases, both with respect to the use of AI in the analysis of medical data and health records and trying to predict patient course—high-risk outcome and so forth—but also in the application of AI in diagnostics to process data that arises from modalities such as proteomics and genomics. So we are seeing now the application of meta-genomics for clinical diagnosis, trying to crack difficult cases, and also trying to shorten the time to results. And at the same time, we saw not only many abstracts with results of clinical trials and clinical studies on COVID but also new vaccines and new drugs.

Dr Malani:There was a lot of attention paid at this meeting to diagnostics, much more than I've noted before at US-based meetings. Can you comment on the evolving role of medical diagnostics in infectious disease, and how ECCMID has developed partnerships with the makers of these diagnostics?

Dr Moran-Gilad:We are very happy to be able to attract both the clinicians and the colleagues who work on the diagnostic side and to facilitate a cross talk between them, which is very important to ensure that timely and accurate diagnostics are being implemented. And we have, as you say, a very notable presence of the industry. In addition to the commercial component, there are the integrated symposia. These are scientific symposia and not promotional in nature, being developed by the industry but also regulated by the program committee and having ESCMID-appointed chairs who moderate the sessions. This is a very good opportunity to generate an ongoing discussion among clinicians, laboratory personnel, and the industry. We see so many new developments related to next-generation sequencing, molecular diagnostics, and point-of-care diagnostics.

This is really a rapidly changing field, and to keep ourselves up to date, we need to bring everyone together and create this interaction. By the way, attendees from the US are comprising the second ranking country with respect to the number of faculties. This is amazing because it's so important for us to also have this ongoing discussion between colleagues from North America and Europe.

Dr Malani:Looking ahead, what do you see in terms of the future of ECCMID in 2024 and beyond?

Dr Moran-Gilad:ECCMID will continue being a hybrid congress. We will be looking to further enhance the user experience, so trying to make the congress more interactive, more immersive. We are looking at the personalization of the program. We took some first steps this year, with our online platform being able to provide recommendations for attendees—it's very difficult to choose [sessions] to go to when you have so many things happening in parallel. And we have a strategic plan to further augment this personalized experience.

ECCMID is also the main educational platform for the members of ESCMID. We have trainees, either medical residents or postdoctoral students, and we are constantly looking at how to ensure that ECCMID is not only a leading scientific venue but also promoting postgraduate education and ensuring cross-disciplinary work. We work hard to bring basic science and translational science together with medical professionals to ensure there really is an ongoing interaction that is beneficial to all of our attendees.