COVID19, Lower Respiratory Tract Infection, Ventilator Associated Pneumonia
Conditions
Brief summary
Lower Respiratory Tract infections are a common cause of admission to the intensive care unit. Children routinely receive antibiotics until the tests confirm whether the infection is bacterial or viral. The exclusion of bacterial infection may take 48 hours or longer for culture tests on biological samples to be completed. In many cases, the results may be inconclusive or negative if the patient has already received antibiotics prior to the sample being taken. A rapid assay to detect the most likely cause of infection could improve the speed with which antibiotic therapy is rationalised or curtailed. This study aims to assess whether a new genetic testing kit which can identify the presence of bacteria and viruses within hours rather than days is a feasible tool in improving antibiotic prescribing and rationalisation of therapy in critically ill children with suspected lower respiratory tract infection.
Interventions
DIAGNOSTIC_TESTRapid Pathogen Detection
Rapid assays for pathogen detection on bronchoalveolar lavage fluid
Sponsors
Cambridge University Hospitals NHS Foundation Trust
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Months to 16 Years
Healthy volunteers
No
Inclusion criteria
1. Aged \>37 weeks corrected gestation and ≤16 years old 2. Receiving mechanical ventilation 3. Commencing or already receiving antibiotic treatment for lower respiratory tract infection
Exclusion criteria
1\. Survival not expected/active medical treatment expected to be withdrawn/palliative care only
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Performance of the novel pathogen detection assay | 3 years | Performance of novel pathogen detection assays compared to standard microbiology, in regard to sensitivity, specificity and likelihood ratios |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to results | 3 years | Time to reportable test results |
| Negative cultures | 3 years | Where routine culture is negative, what proportion of tests have a positive detection using the novel assay? |
| Antibiotic therapy | 3 years | Duration of therapy and number of antibiotic classes during paediatric intensive care unit admission |
Other
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of COVID19 in children admitted to PICU | 2 years | Number of critically ill children requiring mechanical ventilation with COVID19 compared to those without |
| Prevalence of SARS-CoV-2 antigen in faecal samples following acute admission with COVID-19 related illness | 2 years | Faecal excretion of SARS-CoV-2 |
Countries
United Kingdom
Contacts
Primary ContactNazima Pathan, FRCPCH PhD
Outcome results
None listed