NCT06157372

Brief Summary

It is difficult to determine the pathogens in the early stage of infection in critically ill patients, and empirical use of broad-spectrum antibiotics for a long time is often necessary, leading to antibiotics drug resistance. Targeted next generation sequencing (tNGS) can provide faster results for pathogen and related antibiotic resistant diagnosis. But it lacks sufficient clinical evidence. Evidence regarding the clinical diagnostic accuracy and drug resistance is needed to comprehensively evaluate targeted next generation sequencing (tNGS) for diagnosis of patients in ICU who and will be critical to inform national policy.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
20

participants targeted

Target at below P25 for all trials

Timeline
Completed

Started Dec 2023

Shorter than P25 for all trials

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 19, 2023

Completed
2 months until next milestone

First Posted

Study publicly available on registry

December 5, 2023

Completed
15 days until next milestone

Study Start

First participant enrolled

December 20, 2023

Completed
8 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 10, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 10, 2024

Completed
Last Updated

December 5, 2023

Status Verified

November 1, 2023

Enrollment Period

8 months

First QC Date

October 19, 2023

Last Update Submit

November 27, 2023

Conditions

Keywords

Targeted Next-generation sequencingICUinfectionsNext-generation sequencing

Outcome Measures

Primary Outcomes (2)

  • Sensitivity

    The probability of being positive in clinical composite diagnosis, the probability that etiological culture, mNGS, and tNGS tests are also positive, which is also known as the true positive rate.

    1 year

  • Specificity

    It refers to the probability that cultures, mNGS, and tNGS tests are also negative in the presence of non-infection confirmed by the gold standard.

    1 year

Secondary Outcomes (6)

  • False-positive rate

    1 year

  • False-negative rate

    1 year

  • Positive predictive value

    1 year

  • Negative predictive value

    1 year

  • Kappa values

    1 year

  • +1 more secondary outcomes

Study Arms (2)

Non-Infection group

Participants received traditional etiological culture of suspected site of infection.

Diagnostic Test: targeted next-generation sequencing (tNGS)

Infection group

Participants received traditional etiological culture, metagenomic next-generation sequencing of infectious sites.

Diagnostic Test: targeted next-generation sequencing (tNGS)

Interventions

To provide rapid etiological diagnosis of patients by means of targeted next-generation sequencing.

Infection groupNon-Infection group

Eligibility Criteria

Age18 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients in ICU truly have infected disease and non-infected disease diagnosed by two ICU physicians determining whether the patient have an infectious etiology and identifying the pathogen through existing clinical guidelines, clinical features, laboratory tests, microbiological tests, chest imaging, and treatment response.

You may qualify if:

  • The presence of an infection or clearly excluded the presence of infection.
  • Etiological culture and/or metagenomic next-generation sequencing detection of specimens sent for testing.

You may not qualify if:

  • Suspected infection.
  • Participation in other clinical trials in the past 2 months.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (6)

  • Chiu CY, Miller SA. Clinical metagenomics. Nat Rev Genet. 2019 Jun;20(6):341-355. doi: 10.1038/s41576-019-0113-7.

    PMID: 30918369BACKGROUND
  • Diao Z, Han D, Zhang R, Li J. Metagenomics next-generation sequencing tests take the stage in the diagnosis of lower respiratory tract infections. J Adv Res. 2021 Sep 29;38:201-212. doi: 10.1016/j.jare.2021.09.012. eCollection 2022 May.

    PMID: 35572406BACKGROUND
  • Miao Q, Ma Y, Wang Q, Pan J, Zhang Y, Jin W, Yao Y, Su Y, Huang Y, Wang M, Li B, Li H, Zhou C, Li C, Ye M, Xu X, Li Y, Hu B. Microbiological Diagnostic Performance of Metagenomic Next-generation Sequencing When Applied to Clinical Practice. Clin Infect Dis. 2018 Nov 13;67(suppl_2):S231-S240. doi: 10.1093/cid/ciy693.

    PMID: 30423048BACKGROUND
  • Pei XM, Yeung MHY, Wong ANN, Tsang HF, Yu ACS, Yim AKY, Wong SCC. Targeted Sequencing Approach and Its Clinical Applications for the Molecular Diagnosis of Human Diseases. Cells. 2023 Feb 2;12(3):493. doi: 10.3390/cells12030493.

    PMID: 36766834BACKGROUND
  • Li S, Tong J, Liu Y, Shen W, Hu P. Targeted next generation sequencing is comparable with metagenomic next generation sequencing in adults with pneumonia for pathogenic microorganism detection. J Infect. 2022 Nov;85(5):e127-e129. doi: 10.1016/j.jinf.2022.08.022. Epub 2022 Aug 26. No abstract available.

    PMID: 36031154BACKGROUND
  • Gaston DC, Miller HB, Fissel JA, Jacobs E, Gough E, Wu J, Klein EY, Carroll KC, Simner PJ. Evaluation of Metagenomic and Targeted Next-Generation Sequencing Workflows for Detection of Respiratory Pathogens from Bronchoalveolar Lavage Fluid Specimens. J Clin Microbiol. 2022 Jul 20;60(7):e0052622. doi: 10.1128/jcm.00526-22. Epub 2022 Jun 13.

    PMID: 35695488BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Blood samples and qualified lower respiratory tract specimens (LRS), including bronchoalveolar lavage fluid (BALF), pleural/peritoneal effusion, lymph node tissue and other suspected infected tissues are obtained from patients after including and preferred to be collected before the antimicrobial therapy began.

MeSH Terms

Conditions

InfectionsCritical IllnessDisease

Condition Hierarchy (Ancestors)

Disease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Zhijie He

    Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

    STUDY DIRECTOR

Central Study Contacts

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 19, 2023

First Posted

December 5, 2023

Study Start

December 20, 2023

Primary Completion

August 10, 2024

Study Completion

August 10, 2024

Last Updated

December 5, 2023

Record last verified: 2023-11

Data Sharing

IPD Sharing
Will not share