Infectious Disease of Lung, Molecular Diagnosis, Pneumonia
Conditions
Brief summary
The objective of the research is to ascertain the influence of a syndromic mutiplex PCR assay (FilmArray) on the management of patients hospitalised in the ICU for severe respiratory disease. The diagnostic process for pneumonia has become significantly more intricate over the past decade due to the interference of the biological, radiological, and clinical criteria of patients hospitalised in the intensive care unit with the conventional criteria for the diagnosis of severe respiratory diseases. Additionally, patients who are hospitalised in the ICU are at a heightened risk of contracting other associated infections. Consequently, patients are frequently administered antibiotics, whether or not they are effective, as it is challenging to promptly determine the aetiology of their symptoms using conventional methods. To enhance the diagnostic and therapeutic aspects of their treatment, we implemented a novel syndromic molecular test in our laboratories. This test is designed to expedite and enhance the management of pneumonia and the stewardship of antibiotics. This research will include 80 to 100 adult patients hospitalized in ICU between Feb 2025 and Feb 2027. It will take place within the Siriraj Hospital, Bangkok, Thailand.
Detailed description
Not provided
Interventions
DIAGNOSTIC_TESTPneumonia Panel by FilmArray
The Pneumonia Panel comprehensively identifies 33 potential pathogen targets from sputum-like (including endotracheal aspirate) and bronchoalveolar lavage (BAL)-like (including mini-BAL) samples. For 15 of the bacteria, the Pneumonia Panel provides semi-quantitative results, which may help determine whether an organism is a colonizer or a pathogen.
Sponsors
Mahidol University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who have received complete information about the research and who have not objected to the use of its data * Patients with suspected pneumonia infection
Exclusion criteria
Patients with following conditions; * Active immediate life-threatening cardiac arrhythmia, defined as ventricular tachycardia and ventricular fibrillation * Acute cerebral vascular event, including both acute ischemic stroke or intracranial hemorrhage Acute coronary syndrome * Cardiogenic shock * Life-threatening gastrointestinal hemorrhage * Drug overdose * Advanced-stage cancer with predicted survival less than 1 year
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Therapeutic decision [Time Frame: 24 hours following the FilmArray results] | 24 hours following the FilmArray results | Antibiotic prescription modification following the FilmArray results as: No prescription No change in antibiotic utilization Antibiotic initiation Antibiotic escalation Antibiotic de-escalation Antibiotic discontinuation |
Countries
Thailand
Contacts
Primary ContactAdhiratha Boonyasiri, MD, MSc, PhD
Outcome results
None listed