Prospective Study of Multi-centers Exploring the Difference of Clinical Impact by Using Respiratory Pathogen ID/AMR Panel (RPIP) Versus Untarget Metagenomic Next-generation Sequencing (mNGS) and Multiplex PCR in Pathogen Identification of Pneumonia Patients in Intensive Care Unit

May 29, 2026 updated by: Yu-Chao Lin, China Medical University Hospital

h Can Provide the Detection Results of Pathogen Type and Resistant Gene. This Study is a Prospective Multi Centers Study to Explore Using the New Diagnostic Tool of " RPIP " and the Different Detection Methods of Next Generation Sequencing and Multiplex PC R in Patients With Pneumonia in ICU. Further Compare the Difference of Pathogen Identification and Clinical Impact by Different Diagnostic Methods.

Pneumonia, pathogen involved to lower respiratory tract and leading lung parenchyma infection, is one of the three most common infectious diseases in the world. Rapidly and correctly diagnosis and prescription could reduce the complication, length of hospitalization and mortality rate, especially for the critically patients in intensive care unit. Among the current microbiological diagnostic methods, the current traditional culture combined with biochemical identification method is easily affected by the drug using and different species, and time consuming. Although other diagnostic methods like MALDI-TOF MS、multiplex PCR also common and available in clinically, but owing some limitations like lower resolution, inability to afford the drug sensitivity of pathogen. Whole genome sequencing is one of the potential developing tools in pathogen identification, especially the next-general sequencing. The advantage of Metagenomic NGS (mNGS) in the application of clinical microbial detection is that it can identify various species and provide drug resistance gene information at the same time. However, background DNA from non-pathogens can highly affect the sensitivity of next-generation sequencing (untargeted mNGS). The Respiratory Pathogen ID/AMR Panel (RPIP) is a targeted mNGS developed by Illumina, which can provide the detection results of pathogen type and resistant gene. This study is a prospective multi-centers study to explore using the new diagnostic tool of " RPIP " and the different detection methods of next-generation sequencing and multiplex PCR in patients with pneumonia in ICU. Further compare the difference of pathogen identification and clinical impact by different diagnostic methods.

Study Overview

Status

Enrolling by invitation

Conditions

Study Type

Observational

Enrollment (Estimated)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
      • Taichung, Taiwan, 40447
        • Biomedical Technology R&D Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

ICU pneumonia patients

Description

Inclusion Criteria:

  • Patients admitted to the intensive care unit who meet the diagnosis of pneumonia

Exclusion Criteria:

  • Under 18 years old

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
ICU pneumonia patient

Standard-of-care test: Bacterial and fungal testing: BAL and ETA or sputum specimens are subjected to Gram staining, and aerobic, anaerobic, and fungal cultures are performed. Mycobacterium culture is performed, and PCR is used to detect mycobacterial DNA. Other tests included atypical pathogen, aspergillus and virus survey.

FilmArray PP can detect 15 bacterial species, 3 atypical bacteria, 8 viruses, and detect 7 antimicrobial resistance genes.

Respiratory Pathogen ID/AMR enrichment (RPIP): According to the manufacturer's instructions, the workflow includes nucleic acid extraction, cDNA synthesis, sequencing library construction, target amplification, library quality testing, sequencing, and analysis.

Untargeted mNGS: The sample is outsourced to a biotechnology company for mNGS analysis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The expected outcomes to validate the effectiveness of RPIP application in the treatment of pneumonia patients in intensive care units, and to evaluate the value of this method in pathogen identification and clinical treatment decision-making.
Time Frame: After obtaining informed consent, samples will be collected from ICU patients with severe pneumonia at that hospitalization.
The turnaround time between RPIP results and the final report of the standard test is compared to evaluate the time saved by using RPIP. The proportion of clinical treatment strategy adjustments prompted by RPIP results is analyzed, as well as the proportion of inappropriate empirical treatments. It also analyzes whether adjustments in treatment strategies have an impact on mortality.
After obtaining informed consent, samples will be collected from ICU patients with severe pneumonia at that hospitalization.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Generalization medical information
Time Frame: Collect data admission period, 28-day and 90-day mortality.
The data will collect from the medical records of patients, which contained demographic data (age, gender, smoking status, alcohol consumption, source of admission, and type of ICU and supportive care), comorbidities (malignancy, liver disease, including chronic hepatitis or cirrhosis, heart failure, hypertension, cerebral vascular disease, neurodegenerative disorder, chronic kidney disease, chronic lung disease, diabetes mellitus, immunocompromised due to long-term use of steroid or other immunosuppressants, autoimmune disease), clinical manifestations, laboratory findings, severity of illness on the day of pneumonia diagnosis evaluated by the Acute Physiology and Chronic Health Evaluation (APACHE) II score and SOFA score, microbiological profile, antimicrobial therapy, and other outcome measures included 90-day mortality, clinical cure/improvement, and microbiological eradication at day 14 following pneumonia diagnosis evaluation.
Collect data admission period, 28-day and 90-day mortality.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

China Medical University Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 20, 2023

Primary Completion (Estimated)

April 9, 2028

Study Completion (Estimated)

April 9, 2028

Study Registration Dates

First Submitted

May 21, 2026

First Submitted That Met QC Criteria

May 29, 2026

First Posted (Actual)

June 4, 2026

Study Record Updates

Last Update Posted (Actual)

June 4, 2026

Last Update Submitted That Met QC Criteria

May 29, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • CMUH112-REC1-087

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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