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M-ROSE Combined With mNGS in Severe Hospital-acquired Pneumonia

19. april 2022 opdateret af: wang kaifei, Chinese PLA General Hospital

A Multi-center Prospective Clinical Study of M-ROSE Combined With mNGS to Guide the Individualized Anti-infection Treatment, Prevention and Control of Drug-resistant Bacteria in Severe Hospital-acquired Pneumonia

The purpose of this study is to determine the value of M-ROSE(microbiological rapid on-site evaluation)in severe hospital-acquired pneumonia.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Severe hospital acquired pneumonia (SHAP) is the critical risk factor leading to the death of nosocomial infection patients. Rapid identification of pathogens, guidance of individualized treatment and rational application of antibiotics can not only improve the administration of antibiotics, but also reduce the production of multi drug resistant bacteria. Metagenomic second-generation sequencing (mNGS) is an important tool to quickly identify the pathogen in ICU. However, due to the low qualified rate of lower respiratory tract specimens in patients with SHAP, easily polluted, and the difficulty to determine whether microorganisms are infectious, colonizated or polluted, the value of mNGS was limited in the etiological diagnosis of SHAP. The bedside M-ROSE system established by our research team can determine whether the lower respiratory tract specimen is qualified, whether infection exists and the pathogen of infection within half an hour. Based on the previous work, this project plans to conduct a prospective multicenter, single blind, randomized controlled study under the guidance of M-ROSE and mNGS in the individualized anti-infection strategy of SHAP, to reduce the mortality of patients with SHAP; Combined with the third-generation sequencing, the standard analysis framework for the traceability and prevention and control of drug-resistant bacteria was established to clarify the transmission route of drug-resistant bacteria, so as to provide a new solution for the prevention and control of clinical multidrug-resistant bacteria.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

166

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Beijing
      • Beijing, Beijing, Kina, 100083
        • Rekruttering
        • Yi Tao
        • Kontakt:
          • Yi Tao
          • Telefonnummer: 17797708263

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Clinical diagnosis of severe hospital-acquired pneumonia
  • Must have undergone bronchoalveolar lavage

Exclusion Criteria:

  • BALF samples were not sent for mNGS examination
  • Age < 18 years old
  • The hospitalization days ≤ 3
  • The clinical data are incomplete
  • Mechanical ventilation time > 60 days

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Diagnostisk
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: M-ROSE combined with mNGS group
The bronchoalveolar lavage fluid (BALF) of patients undergoes M-ROSE analysis and decide whether the samples are qualified, whether they indicate bacterial infection and identify pathogens, and the qualified samples are sent for mNGS analysis. The individualized anti-infection treatment is comprehensively guided according to the results of M-ROSE, mNGS and clinical examinations.

The M-ROSE analysis process consists of 3 procudures.

  1. Specimen quality assessment. The BALF undergoes the process of smear, diff-quik stain, gram stain and are analyzed by experts to report the cytoloy and pathogen patterns to determine whether the sample is qualified according to the cell proportions. The qualified BALF samples are: squamous epithelial cell proportion<1%, columnar epithelial cell proportion <5% .
  2. Distinguish infection and colonization. According to the cytoloy pattern, the proportion of neutrophils > 50% often strongly suggests pulmonary bacterial infection; Neutrophil phagocytosis proportion> 5% indicates infection, and phagocytosis of bacteria is the pathogen. Besides, fungal and hyphae can be found under the microscope.
  3. Preliminary identification of infectious pathogens. Identify the infected bacteria and fungi, and the results are gram-positive cocci, gram-positive bacilli, gram-negative cocci, gram-negative bacilli, yeasts and molds.
Ingen indgriben: mNGS group
BALF samples were directly sent for mNGS analysis, and anti-infective treatment was guided according to clinical examinations.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
mortality
Tidsramme: During the intervention.
Alive or Dead.
During the intervention.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Blood leukocyte ratio tread
Tidsramme: During the intervention.
The changing of blood leukocyte ratio
During the intervention.
28 day outcome
Tidsramme: 28 days after admission
Live or dead.
28 days after admission
Blood neutriphil ratio tread
Tidsramme: During the intervention.
The changing of blood neutriphil ratio tread
During the intervention.
Blood interleukin 6 tread
Tidsramme: During the intervention.
The changing of blood interleukin 6 tread
During the intervention.
Blood C-reactive protein
Tidsramme: During the intervention.
The changing of blood C-reactive protein
During the intervention.
Blood procalcitonin tread
Tidsramme: During the intervention.
The changing of blood procalcitonin tread
During the intervention.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Lixin Xie, Ph.D, Chinese PLA General Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Forventet)

1. maj 2022

Primær færdiggørelse (Forventet)

31. december 2024

Studieafslutning (Forventet)

31. december 2024

Datoer for studieregistrering

Først indsendt

8. marts 2022

Først indsendt, der opfyldte QC-kriterier

25. marts 2022

Først opslået (Faktiske)

29. marts 2022

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

26. april 2022

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. april 2022

Sidst verificeret

1. april 2022

Mere information

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