- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01695499
Diagnostic Study of Biomarkers in BAL of ICU Patients With Lung Infiltrates
Open, Prospective, Multicenter Trial to Evaluate the Clinical Significance of Combined Serological (Galactomannan ELISA, Beta D Glucan Assay) and Molecular (Nested Aspergillus PCR Assay, Real-time qPCR Assay, Multifungal DNA Microarray) Diagnostic Assays to Detect and Characterize Fungal Pathogens in Bronchoalveolar Lavage (BAL)and Blood Samples of Intensive Care Unit Patients With Pulmonary Infiltrates
The aim of this project is therefore to explore on the clinical significance of analyzing surrogate markers combined with conventional diagnostics in the ICU setting. BAL, blood and biopsy samples will be subjected to a combined analysis of GM, BDG, Aspergillus specific PCR assays in addition to conventional diagnostics (Microscopy, Culture,Histology) for ICU pts with pulmonary infiltrates.
As GM and BDG are not species-specific, three established and repeatedly published species specific PCR-based assays (nested PCR, real time PCR assay, multifungal DNA Array)developed by our group will be investigated in combination with the serological tests in a multicenter prospective clinical diagnostic trial.
Study Overview
Status
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
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Mannheim, Germany, 68167
- Mannheim University Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Immunocompromised patients on the intensive care unit with lun infiltrates and one of the following underlying conditions:
- Underlying malignancy
- Antineoplastic chemotherapy
- Neutropenia
- Allogeneic hematopoietic stem cell transplantation
- Solid organ transplantation
- Retransplantation
- Acute or chronic immunological rejection or graft-versus-host-disease
- Treatment with immunosuppressive agents (calcineurin inhibitors, OKT3, etc)
- Profound systemic corticosteroid therapy prior to ICU admission
- COPD Gold III/IV
- Advanced liver cirrhosis and ICU treatment for more than 7 days
- Hemodialysis, renal failure
- CMV infection
- HIV infection; CD4 cellcount
- Post splenectomy
- Post cardiac surgery
- Diabetes mellitus
- mechanical ventilation for more than 21 days
- ICU-based steroid therapy and corticosteroid treatment for more than 7 days
- Malnutrition
- Severe burn wounds
Description
Inclusion Criteria:
- underlying conditions (see above)
- being on mechanical ventilation
- lung infiltrates
Exclusion Criteria:
- immunocompetent patients (not fulfilling the criteria above)
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Immunosuppressed ICU Patients with lung infiltrates
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Control Group
BAL and blood aliquots of 20 immunocompetent pts (suffering from lung diseases) will be collected and tested identically as a control population.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Diagnostic accuracy of combined biomarker testing in BAL fluid in relation to diagnostic certainty
Time Frame: 6 weeks
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Evaluation of diagnostic accuracy of the combined biomarker approach
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6 weeks
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Collaborators and Investigators
Sponsor
Collaborators
Publications and helpful links
General Publications
- Reinwald M, Hummel M, Kovalevskaya E, Spiess B, Heinz WJ, Vehreschild JJ, Schultheis B, Krause SW, Claus B, Suedhoff T, Schwerdtfeger R, Reuter S, Kiehl MG, Hofmann WK, Buchheidt D. Therapy with antifungals decreases the diagnostic performance of PCR for diagnosing invasive aspergillosis in bronchoalveolar lavage samples of patients with haematological malignancies. J Antimicrob Chemother. 2012 Sep;67(9):2260-7. doi: 10.1093/jac/dks208. Epub 2012 Jun 27.
- Reinwald M, Spiess B, Heinz WJ, Vehreschild JJ, Lass-Florl C, Kiehl M, Schultheis B, Krause SW, Wolf HH, Bertz H, Maschmeyer G, Hofmann WK, Buchheidt D. Diagnosing pulmonary aspergillosis in patients with hematological malignancies: a multicenter prospective evaluation of an Aspergillus PCR assay and a galactomannan ELISA in bronchoalveolar lavage samples. Eur J Haematol. 2012 Aug;89(2):120-7. doi: 10.1111/j.1600-0609.2012.01806.x. Epub 2012 Jun 22.
- Spiess B, Seifarth W, Merker N, Howard SJ, Reinwald M, Dietz A, Hofmann WK, Buchheidt D. Development of novel PCR assays to detect azole resistance-mediating mutations of the Aspergillus fumigatus cyp51A gene in primary clinical samples from neutropenic patients. Antimicrob Agents Chemother. 2012 Jul;56(7):3905-10. doi: 10.1128/AAC.05902-11. Epub 2012 Apr 23.
- Boch T, Reinwald M, Spiess B, Liebregts T, Schellongowski P, Meybohm P, Rath PM, Steinmann J, Trinkmann F, Britsch S, Michels JD, Jabbour C, Hofmann WK, Buchheidt D. Detection of invasive pulmonary aspergillosis in critically ill patients by combined use of conventional culture, galactomannan, 1-3-beta-D-glucan and Aspergillus specific nested polymerase chain reaction in a prospective pilot study. J Crit Care. 2018 Oct;47:198-203. doi: 10.1016/j.jcrc.2018.07.001. Epub 2018 Jul 4.
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BAL-Biomarker-ICU Study
- Grant Pfizer ASPIRE Award (Other Grant/Funding Number: Pfizer Grant # WS 2274964)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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