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Etiologic Diagnosis Algorithm in Infective Endocarditis

28. juni 2026 opdateret af: I.M. Sechenov First Moscow State Medical University

Development and Validation of An Algorithm of Etiological Diagnosis of Infective Endocarditis in Adults: An Open-Label Multicenter Randomized Clinical Trial

The goal of this study is to evaluate the impact of a diagnostic algorithm combining culture-based and molecular methods on the frequency of etiotropic antibiotic therapy prescription within 14 days of diagnosis of infective endocarditis

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is an open-label (with blinded endpoint assessment) multicenter randomized trial designed to evaluate the impact of an etiological diagnostic algorithm incorporating various laboratory methods (culture-based and molecular) on the frequency of etiological antibiotic therapy prescription within 14 days after the diagnosis of infective endocarditis. While molecular samples are collected from all participants, results are only disclosed to physicians in the intervention group to guide treatment, while remaining blinded in the control group.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

128

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

Studiesteder

  • Rusland
      • Moscow, Rusland
        • Ikke rekrutterer endnu
        • A.N. Bakulev National Medical Research Center for Cardiovascular Surgery of the Russian Ministry of Health
        • Kontakt:
          • Dmitry Popov, Prof
      • Moscow, Rusland
        • Rekruttering
        • City Clinical Hospital Named After S. S. Yudin
        • Kontakt:
      • Moscow, Rusland
        • Rekruttering
        • City Clinical Hospital №67 Named After L. A. Vorokhobova
        • Kontakt:
          • Svetlana Mirzakhamidova, Dr

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Informed consent,
  • Age ≥ 18,
  • IE (definite or possible per the 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis)

Exclusion Criteria:

  • Pregnancy/breastfeeding
  • Unconfirmed or rejected IE diagnosis,
  • Very high risk of death within 14 days due to severe complications of the main or concomitant disease(s), according to the physician's opinion;
  • Prior use of antibiotic therapy (except documented treatment failure).

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: Comprehensive Etiological Diagnosis Group
Patients receive standard diagnostics plus molecular test results (PCR, PCR with sequencing) to guide etiotropic therapy
Diagnostisk test: Molecular tests (PCR, sequencing)
PCR and PCR with consequent sequencing of the blood (or tissue) will be performed in addition to the cultural methods in the experimental study arm
Aktiv komparator: Standard Clinical Practice Group
Patients receive standard care; molecular test results are blinded for the treating physician
Diagnostisk test: Standard Clinical Practice
Patients receive standard care with analysis of microorganisms in at least 2 or more separate blood culture sets and from cardiac tissue (if surgical treatment is performed); molecular test results are blinded for the treating physician

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Frequency of etiotropic antibiotic therapy prescription
Tidsramme: 14 days from the date of diagnosis
Proportion of patients receiving specific ABT within 14 days of diagnosis
14 days from the date of diagnosis

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
IE Complications requiring surgical treatment
Tidsramme: At discharge (an average of 14 days)
Proportion of patients with IE-related complications (uncontrolled infection, heart failure, or embolic events) requiring surgical treatment during hospitalization
At discharge (an average of 14 days)
Acute Kidney Injury
Tidsramme: At discharge (an average of 14 days)

Proportion of patients with acute kidney injury during hospitalization, defined as:

increase in serum creatinine by ≥26.5 μmol/L within 48 hours, or increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days, or urine output <0.5 mL/kg/h for 6 hours.
At discharge (an average of 14 days)
ICU Transfer
Tidsramme: At discharge (an average of 14 days)
Proportion of patients requiring transfer to the intensive care unit (ICU) during hospitalization (for admissions to non-ICU departments) or requiring repeated transfer to the ICU (if initially admitted to the ICU)
At discharge (an average of 14 days)
Mortality
Tidsramme: 30 days after diagnosis
Probability of death within 30 days after diagnosis, estimated using the Kaplan-Meier method
30 days after diagnosis

Samarbejdspartnere og efterforskere

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

Sponsor

I.M. Sechenov First Moscow State Medical University

Samarbejdspartnere

Federal State Budgetary Institution of the Central Research Institute of Epidemiology of Rospotrebnadzor
City Clinical Hospital Named After S. S. Yudin, Moscow, Russian Federation
City Clinical Hospital №67 Named After L. A. Vorokhobova, Moscow, Russian Federation
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery of the Russian Ministry of Health, Moscow, Russian Federation

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 (Faktiske)

20. januar 2026

Primær færdiggørelse (Anslået)

4. februar 2027

Studieafslutning (Anslået)

20. februar 2027

Datoer for studieregistrering

Først indsendt

12. juni 2026

Først indsendt, der opfyldte QC-kriterier

28. juni 2026

Først opslået (Faktiske)

2. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

28. juni 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • IE-2026

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

There is no current plan to share individual participant data (IPD) because data protection requirements and consent procedures for this study do not allow external data sharing beyond the study team.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Kliniske forsøg med Infektiøs endokarditis

Kliniske forsøg med Molecular tests (PCR, sequencing)

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

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Narkotikainterventioner

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Betingelser

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Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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