About this trial
Multicenter, randomized, controlled, open-label trial to assess if semiquantitative multiplex PCR assay, as compared to conventional microbiology, can reduce the percentage of patients without microbiological diagnosis in the first 24 hours from HAP/VAP suspicion, thus allowing early de-escalation.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Suspicion of HAP/VAP (clinical/radiological/laboratory criteria);
Availability to perform tracheal aspirates or broncoalveolar lavage within 1 hour from clinical suspicion
Life expectancy ≥ 48 hours
Signed written informed consent.
Disqualifiers
Pregnancy,
Concomitant participating in other interventional trial
Refusal to sign informed consent
Trial design
Parallel
Treatments tested in this trial
Lower tract respiratory samples
Procedure/SurgeryWithin 1 hour from HAP or VAP suspicion, quantitative tracheal aspirate or bronchoalveolar lavage will be performed to confirm the diagnosis. Clinicians will be encouraged to perform BAL whenever possible
Multiplex PCR assay (Film-array Pneumonia Panel Plus)
Diagnostic testThe lower tract respiratory samples will be analyzed with Multiplex PCR assay (Film-array Pneumonia Plus).
Lower respiratory tract standard culture
Diagnostic testThe lower tract respiratory samples will be analyzed using convention microbiological methods (including conventional Gram stain and semiquantitative culture on both selective/differential and screening agar media)
Blood sample standard culture
Diagnostic testWhen HAP or VAP are suspected, blood samples from peripheral vein will be collected and analyzed with conventional microbiological methods
Treatment groups
Trial outcomes
Primary outcomes
Proportion of patients without microbiological diagnosis of HAP/VAP within the first 24 hours
Proportion of patients where a microbiological diagnosis of HAP/VAP is not avaiable within the first 24 hours
Secondary outcomes
Rate of antibiotic de-escalation as a consequence of microbiological results
Proportion of patients in which antibiotic therapy has been modified from broad-spectrum empirical to targeted, due to microbiological results
Time to antibiotic de-escalation and optimal therapy
Period of time from empirical antibiotic therapy initiation to modification due to microbiological results
Mechanical Ventilation free-days
Number of days from enrollment in which the patients is not mechanically ventilated
Rate of MDR infection
Proportion of patients who suffered from infection caused by multidrug resistant germ
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Lead sponsor
Catholic University of the Sacred Heart
Collaborator