Prospective Study of Multi-centers Exploring the Difference of Clinical Impact by Using Respiratory Pathogen ID/AMR Panel (RPIP) Versus Untarget Metagenomic Next-generation Sequencing (mNGS) and Multiplex PCR in Pathogen Identification of Pneumonia Patients in Intensive Care Unit

Condition(s) studied

Study summary

Pneumonia, pathogen involved to lower respiratory tract and leading lung parenchyma infection, is one of the three most common infectious diseases in the world. Rapidly and correctly diagnosis and prescription could reduce the complication, length of hospitalization and mortality rate, especially for the critically patients in intensive care unit. Among the current microbiological diagnostic methods, the current traditional culture combined with biochemical identification method is easily affected by the drug using and different species, and time consuming. Although other diagnostic methods like MALDI-TOF MS、multiplex PCR also common and available in clinically, but owing some limitations like lower resolution, inability to afford the drug sensitivity of pathogen. Whole genome sequencing is one of the potential developing tools in pathogen identification, especially the next-general sequencing. The advantage of Metagenomic NGS (mNGS) in the application of clinical microbial detection is that it can identify various species and provide drug resistance gene information at the same time. However, background DNA from non-pathogens can highly affect the sensitivity of next-generation sequencing (untargeted mNGS). The Respiratory Pathogen ID/AMR Panel (RPIP) is a targeted mNGS developed by Illumina, which can provide the detection results of pathogen type and resistant gene. This study is a prospective multi-centers study to explore using the new diagnostic tool of " RPIP " and the different detection methods of next-generation sequencing and multiplex PCR in patients with pneumonia in ICU. Further compare the difference of pathogen identification and clinical impact by different diagnostic methods.

Eligibility

Primary outcome measure(s)

• The expected outcomes to validate the effectiveness of RPIP application in the treatment of pneumonia patients in intensive care units, and to evaluate the value of this method in pathogen identification and clinical treatment decision-making. — After obtaining informed consent, samples will be collected from ICU patients with severe pneumonia at that hospitalization.
  The turnaround time between RPIP results and the final report of the standard test is compared to evaluate the time saved by using RPIP. The proportion of clinical treatment strategy adjustments prompted by RPIP results is analyzed, as well as the proportion of inappropriate empirical treatments. It also analyzes whether adjustments in treatment strategies have an impact on mortality.

Trial sites (1)

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