Immunocompromised-host Pneumonia
Conditions
Interventions
Precision-guided group:Treatment is administered according to the precision-guided antimicrobial strategy model based on Phase I phenotypes.
Empirical group:Antimicrobial therapy guided by the clinician's expertise in patient management
Sponsors
The First Affiliated Hospital of Xi'an Jiaotong University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Phase I Inclusion Criteria: Inclusion of a proportion of samples based on admission diagnoses and medical history fields: a. Patients with explicit admission diagnoses in the database, such as: "immunocompromised," "immunodeficiency," "pneumonia," "pulmonary infection," etc. b. Patients meeting pneumonia-related diagnoses (e.g., pneumonia, pulmonary infection, community-acquired pneumonia, hospital-acquired pneumonia, severe pneumonia) AND having documented histories of: Malignancy Chemotherapy use Post-solid organ transplantation Post-hematopoietic stem cell transplantation Rheumatic/autoimmune diseases under treatment HIV infection Corticosteroid therapy Immunosuppressant use Chronic kidney disease Type 2 diabetes mellitus; 2. Inclusion of a proportion of samples based on post-admission diagnostic findings: Patients with confirmed pneumonia (supported by imaging evidence) AND meeting laboratory diagnostic criteria for immunosuppression. 3. Integration of samples from criteria 1 and 2. 4.Phase II Inclusion Criteria: Patients admitted to the Intensive Care Unit (ICU) of the First Affiliated Hospital of Xi’an Jiaotong University during the 3-month period starting from Phase II initiation, meeting both of the following: Confirmed pneumonia-related diagnosis (supported by symptoms, clinical signs, disease course, and/or imaging evidence). Immunocompromised status, defined as meeting: Laboratory diagnostic criteria for immunosuppression AND/OR At least one of the following: a) Active malignancy; b) Current cancer chemotherapy; c) Post-solid organ transplantation (SOT); d) Hematopoietic stem cell transplantation (HSCT); e) HIV/AIDS (CD4+ T-cell count = 200 mg/day for >14 consecutive days, or cumulative dose >600 mg); g) Treatment with biological agents; h) Use of disease-modifying antirheumatic drugs (DMARDs) or immunosuppressants. 5.For community-acquired pneumonia cases: CURB-65 score >= 3.
Exclusion criteria
Exclusion criteria: 1.Phase I exclusion criteria:? Patients aged = 1 critical clinical data items: Chest imaging not completed within 48 hours post-admission; Initial laboratory screening not completed within 24 hours post-enrollment; 13. Protocol violations, non-compliance, loss to follow-up, or investigator-determined exclusion during the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Precision Anti-Infective Treatment Strategies: A Comparative Analysis of Divergence and Consistency;Pathogen detection concordance rate; | — |
Secondary
| Measure | Time frame |
|---|---|
| In-hospital/28-day/90-day/180-day all-cause mortality rate?ICU length of stay; | — |
Countries
China
Contacts
Public ContactQin-Dong Shi
The First Affiliated Hospital of Xi'an Jiaotong University
Outcome results
None listed