Evaluating a Host-response Based Diagnostic for Distinguishing Between Bacterial and Viral Etiology in Patients With Lower Respiratory Tract Infection (LRTI) (OBSERVER)
A Multi-center, Prospective, Validation Study to Assess the Accuracy of a Host-response Based Diagnostic for Distinguishing Between Bacterial and Viral Etiology in Adult Patients With Lower Respiratory Tract Infections
Study Overview
Status
Status
Conditions
Conditions
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
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Haifa, Israel, 3109601
- Rambam Health Care Campus
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients aged 18 years and older who agree (or their legal guardian agree) to sign an informed consent will be eligible for inclusion.
The LRTI cohorts should also fulfill the following criteria:
- Peak measured (not tactile, self-reported acceptable) temperature ≥ 37.8°C (100°F) within the last 7 days (AND)
- Symptoms duration ≤7 days (AND)
- Clinical suspicion of LRTI or pneumonia
Exclusion Criteria:
- Oral/intravenous/intramuscular antibiotic treatment of over 48/12/12 hours' duration at time of enrollment (respectively), unless temperature ≥ 37.8°C was measured within the last 2 days
- Another episode of an acute infection during the last 2 weeks
- Congenital immune deficiency (CID)
- A proven or suspected human immunodeficiency virus (HIV)-1, hepatitis B virus (HBV), or hepatitis C virus (HCV) infection
- Active malignancy
- Pregnancy
Current treatment with immune-suppressive or immune-modulating therapies including without limitations:
- Use of high dose steroids >1 mg/kg/day prednisone or equivalent in the past two weeks
- Monoclonal antibodies
- Intravenous immunoglobulin (IVIG)
- Cyclosporine, Cyclophosphamide, Tacrolimus
- Granulocyte/Monocyte colony stimulating factor (G/GM-CSF)
- Anti-Tumor Necrosis Factor (TNF) agents
- Interferon (of all kinds)
Other severe illnesses that affect life expectancy and quality of life such as:
- Moderate to severe psychomotor retardation
- Post-transplant patients (including solid organs, allogeneic/autologous stem cell transplantation)
- Moderate to severe congenital metabolic disorder
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
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LRTI patients
Patients with suspicion of LRTI, excluding episodes of COPD exacerbations
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Non-infectious patients
Afebrile patients with no apparent infectious disease
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LRTI patients with COPD
Patients with suspicion of LRTI in a sub-group of patients with COPD
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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To externally validate the diagnostic accuracy of a host-response based diagnostic tool called ImmunoXpert™, for differentiating between bacterial and viral etiologies in adult patients aged 18 years and older with clinical suspicion of LRTI
Time Frame: 0-6 days after the initiation of symptoms
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0-6 days after the initiation of symptoms
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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To compare the diagnostic accuracy of ImmunoXpert™ to currently available lab measures (WBC, ANC, PCT, CRP), using sensitivity and specificity measures and predetermined cutoffs
Time Frame: 0-6 days after the initiation of symptoms
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0-6 days after the initiation of symptoms
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To compare ImmunoXpert™ results with the physician suspected diagnosis at time of patient recruitment and compared to the reference standard diagnosis
Time Frame: 0-6 days after the initiation of symptoms
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0-6 days after the initiation of symptoms
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To estimate the potential improvement in health and economic outcomes following the usage of ImmunoXpert™ compared to current practice
Time Frame: 0-6 days after the initiation of symptoms
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0-6 days after the initiation of symptoms
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To estimate the diagnostic accuracy of ImmunoXpert™ in differentiating between infectious vs non-infectious patients
Time Frame: 0-6 days after the initiation of symptoms
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0-6 days after the initiation of symptoms
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Mical Paul, MD, Rambam Health Care Campus
Publications and helpful links
General Publications
- Oved K, Cohen A, Boico O, Navon R, Friedman T, Etshtein L, Kriger O, Bamberger E, Fonar Y, Yacobov R, Wolchinsky R, Denkberg G, Dotan Y, Hochberg A, Reiter Y, Grupper M, Srugo I, Feigin P, Gorfine M, Chistyakov I, Dagan R, Klein A, Potasman I, Eden E. A novel host-proteome signature for distinguishing between acute bacterial and viral infections. PLoS One. 2015 Mar 18;10(3):e0120012. doi: 10.1371/journal.pone.0120012. eCollection 2015.
- Eden E, Srugo I, Gottlieb T, Navon R, Boico O, Cohen A, Bamberger E, Klein A, Oved K. Diagnostic accuracy of a TRAIL, IP-10 and CRP combination for discriminating bacterial and viral etiologies at the Emergency Department. J Infect. 2016 Aug;73(2):177-80. doi: 10.1016/j.jinf.2016.05.002. Epub 2016 May 30. No abstract available.
- van Houten CB, de Groot JAH, Klein A, Srugo I, Chistyakov I, de Waal W, Meijssen CB, Avis W, Wolfs TFW, Shachor-Meyouhas Y, Stein M, Sanders EAM, Bont LJ. A host-protein based assay to differentiate between bacterial and viral infections in preschool children (OPPORTUNITY): a double-blind, multicentre, validation study. Lancet Infect Dis. 2017 Apr;17(4):431-440. doi: 10.1016/S1473-3099(16)30519-9. Epub 2016 Dec 22.
Helpful Links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- MM-1005-OB
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