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.
調査の概要
状態
研究の種類
入学 (予想される)
連絡先と場所
研究場所
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Mannheim、ドイツ、68167
- Mannheim University Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
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
説明
Inclusion Criteria:
- underlying conditions (see above)
- being on mechanical ventilation
- lung infiltrates
Exclusion Criteria:
- immunocompetent patients (not fulfilling the criteria above)
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
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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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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Diagnostic accuracy of combined biomarker testing in BAL fluid in relation to diagnostic certainty
時間枠: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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協力者と研究者
スポンサー
協力者
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- BAL-Biomarker-ICU Study
- Grant Pfizer ASPIRE Award (その他の助成金/資金番号:Pfizer Grant # WS 2274964)
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