SIRS and Bacterial Sepsis Discrimination by Biomarkers in ICU (Captain)
Aim of the study : The primary aim of the investigators study is to highlight the presence of biomarkers (biological indicators of the presence of inflammation or infection) of infectious processes during the systemic inflammatory response (SIRS) allowing, first to discriminate non-infectious inflammation from infectious processes and secondary to determine the microbial pathogen responsive of the infection. For this purpose the investigators will conduct a combinatorial approach of several blood markers including usual markers of inflammation and other blood and cells markers. Expression of small pieces of RNA (miRNA) known to inhibit determined gene expression, will also be analysed in monocytes (a specific group of white blood cells involved in the fist line of defences against microbes.
Study design : For this purpose the investigators will include 300 patients admitted to the intensive care unit with suspicion of infection. Serial blood sample will be take for biological parameters analysis. Efficiency of each single parameters and of different combinations of different markers to determine the presence or absence of infection responsive of clinical inflammation will be studied.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Early Detection and Diagnostic Performance of Bio-markers During Bacterial Sepsis: Multicentre Cohort Study in Intensive Care|
- Combination of biomarkers in sepsis [ Time Frame: 3 days ( from D0 to D2) ]
The primary endpoint is to determine the ability of each individual parameter and of the different combination to discriminate between sepsis and noninfectious inflammation.
Each biomarker will be isolatelly studied to determine existence of a cut-off value allowing discrimination between SIRS and sepsis.
Each positive biomarker (biomarker for which such a cut-off can be determined), will be include in a second study involving all or part of the positive biomarkers to determine the possibility of increasing AUC for discrimination of SIRS and sepsis patients
- Pathogen in human fluids (Blood, BAL, CSF, Urin) [ Time Frame: D0 ]A partnership with Biomerieux laboratory was estabished to allow microbial detection at D0 by a new system of microbial DNA amplification, which is at the moment under development
- mRNA expression during inflammatory process in white blood cells [ Time Frame: D0 to D3 ]Study of modification of mRNA expression between SIRS and sepsis during inflammatory process in white blood cells. Study of the expression of whole mRNA in whole blood and of its modification during the 3 fist days of SIRS to determine a potential specific profil during infectious processes
Biospecimen Retention: Samples Without DNA
|Actual Study Start Date:||January 1, 2011|
|Study Completion Date:||June 1, 2013|
|Primary Completion Date:||January 1, 2013 (Final data collection date for primary outcome measure)|
Every patient, without exclusion criteria, presenting with SIRS during an hospitalization in ICU.
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01378169
|Groupe hospitalier Paris Saint Joseph|
|Paris, France, 75014|
|Principal Investigator:||François J Philippart, MD; PhD||Groupe Hospitalier Paris Saint Joseph|