- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04125654
Metagenomic Next-Generation Sequencing for Diagnosis of Ascites Infection in End-stage Liver Diseases
Clinical Metagenomic Next-Generation Sequencing for Diagnosis of Ascites Infection in End-stage Liver Diseases
Ascites is the most common complication of cirrhosis, and its development is associated with substantially increased mortality. Ascites infection including spontaneous bacterial peritonitis (SBP), bacterascites and fungal infections. SBP is one of the most feared complications of ascites. The EASL guidelines recommend that diagnostic criteria of SBP is defined on the ascitic fluid polymorphonuclear leucocytes (PMN) count ≥250 cell/μl, with or without ascites fluid positive culture. However, in clinical practice. Up to 30% of hospitalized patients are considered as suspicious SBP, and treated as SBP without a laboratory-confirmed cause of infection. and is present in 10-30% of all hospitalized patients with ascites. Besides, fungal infection in ascites was aslo related to high mortality in cirrhosis patients.
Thus, to diagnose ascites infection promptly is the key step to prevent the complication. Since, the sensitivity of bacterial culture is limited even if ascites is directly injected into blood culture bottles at the besides. New method to identified the pathogen is needed.
Here, we aim to use metagenomic next-generation sequencing(mNGS) to provide the first-ever demonstration of precision medicine for the diagnosis of ascites infection in hospitalized patients, with immediate impact on clinical care and patients outcomes. The method of mNGS is undertaken by BGI Genomics Company which is a licensed clinical diagnostic laboratory in China. In this multicenter and prospective clinical study, we are planning to detect ascites sample by mNGS and compare the performance of mNGS and routine microbiological testing. Ultimately, we aim to improve the diagnosis of ascites infection and improve patients' outcomes.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The study is divided into 2 parts:
Firstly, the study will test 3 types of sample by means of mNGS, including ascites fluid, peritoneal dialysis fluid and postoperative drainage fluid and evaluate the sensitivity and specificity of NGS.
Secondly, the clinical validation of mNGS will be performed in multicenters for ascites infection in cirrhosis patients. Furthermore, the study will collect the paired plasma sample for NGS testing at the same time to evaluate the protential sources of microorganisms in ascites.The aim of the study is to observe the performance of mNGS in ascites infection diagosis and the protential clinical effect in cirrhsis patients.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Jinjun Chen
- Phone Number: 0086-18588531001
- Email: chjj@smu.edu.cn
Study Contact Backup
- Name: Beiling Li
- Phone Number: 0086-13570541527
- Email: lbling123@163.com
Study Locations
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Guangdong
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Guangzhou, Guangdong, China, 510515
- Recruiting
- Nanfang Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Hospitalization cirrhotic patients;
- Age >18 years old;
- Paitents with ascites at hospital admission.
Exclusion Criteria:
- Pregnant women;
- Hepatic tumor or extrahepatic related cancer;
- Identified secondary peritonitis;
- Ascites not related to portal hypertension;
- Not provide written consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patients with ascites enrolled for mNGS testing
Patients with ascites will be enrolled in this study in order to analyze the clinical utility of mNGS for pathogen detection.
There is no control group for this study (Investigators will identify historical controls by retrospective clinical documents).
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This assay is a metagenomic test undertaken by BGI Genomics Co., Ltd. for comprehensive detection of viruses, bacteria, fungi, and parasites in clinical samples.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical mNGS assay performance (mNGS positive number and the pathogenics species)
Time Frame: within 1 month of patient enrollment in study
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mNGS positive number and the pathogenics species in ascites
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within 1 month of patient enrollment in study
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Classification of ascites infection based on mNGS result.
Time Frame: within 1 month of patient enrollment in study.
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Proportion of spontaneous bacterial peritonitis, bacterascites, neutrocytic ascites and sterile ascites based on mNGS result.
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within 1 month of patient enrollment in study.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The proportion of acute kindey injury.
Time Frame: within 1 month of patient enrollment in study.
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The proportion of acute kindey injury between ascites NGS positive and negative groups.
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within 1 month of patient enrollment in study.
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90-day mortality
Time Frame: within 90 days of patient enrollment in study
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within 90 days of patient enrollment in study
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The proportion of new-onset spontaneous bacterial peritonitis.
Time Frame: within 1 month of patient enrollment in study.
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within 1 month of patient enrollment in study.
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Collaborators and Investigators
Collaborators
Investigators
- Study Director: Aishan Su, Nanfang Hospital Guangzhou, Guangdong, China, 510515
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 010
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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