None listed
Conditions
Brief summary
Community acquired pneumonia (CAP) is an infection of the lungs where the lungs become inflamed. CAP is most commonly caused by bacterial infections however during the seasonal ‘flu epidemics and novel pandemics such as COVID-19, viral infections may predominate. Severe CAP requires treatment in an intensive care unit (ICU) and often support of breathing with a ventilator. In Australia pneumonia is the most common infection treated in ICU and unfortunately often proves fatal. Additionally, there is a large economic cost and survivors are often left with significant reductions in their quality of life. The body’s immune responses in the lung is designed to kill and eliminate the bacteria or viruses causing the infection but can also cause collateral damage to the lung through inflammation and injury. the lung has specialised immune cells called Tissue Resident Memory T-cells, (TRM)that play a crucial role in protecting the lung against bacteria and viruses. As the name suggests this specialised type of immune cells are ‘resident’ in the lung tissues and are not detected in the circulating blood. In this preliminary study we will evaluate a system to collect and study TRM -cells in mechanically ventilated patients with severe CAP. We will compare the immune responses of patients with severe CAP caused by COVID-19, other viral infections and bacterial infections. We will also compare patients with severe CAP to two different control groups. The first control group will be mechanically ventilated patients with lung injury not caused by infection. The second control group will be mechanically ventilated patients without evidence of lung injury. Studying the local immune response in this way will offer insights into how severe CAP occurs, may help identify which patients are going to need to most support and may identify new treatments for this important condition.
Interventions
We will analyse tissue samples (blood and bronchial washings) of patients with severe community acquired pneumonia (CAP) and compare these with patients without CAP. Samples will be collected during the intensive care admission by an appropriately trained intensive care doctor or nurse within 72 hours of intubation. Bronchial washings will be collected via a formal bronchoscope if clinically indicated or by passing a catheter through an endotracheal tube and introducing and aspirating a small am
We will analyse tissue samples (blood and bronchial washings) of patients with severe community acquired pneumonia (CAP) and compare these with patients without CAP. Samples will be collected during the intensive care admission by an appropriately trained intensive care doctor or nurse within 72 hours of intubation. Bronchial washings will be collected via a formal bronchoscope if clinically indicated or by passing a catheter through an endotracheal tube and introducing and aspirating a small amount of sterile saline solution (10-20ml). Blood samples will be collected via a central line, arterial line or via venesection when clinically indicated. Outcomes will be assessed at discharge from hospital via the electronic patient record with no further participant involvement post discharge.
Sponsors
The George Institute for Global Health
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Admitted to a critical care setting • A diagnosis of community acquired pneumonia has been made by the treating physicians based on the following criteria; - Symptoms and/or signs consistent with a lower respiratory tract infection - Radiological evidence of new onset consolidation on a chest x-ray or CT scan • Mechanically ventilated for less than 72 hours • Age equal to or greater than 18 years old • Participant consent or person responsible consent • Patients with confirmed COVID-19 disease meeting the criteria for CAP will be included in the study
Exclusion criteria
Previously included in the study
Outcome results
None listed