MALDITOF Versus Routine Clinical Microbiology for Identifying Pathogens; a Randomized Diagnostic Trial (MALDITOF)
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|ClinicalTrials.gov Identifier: NCT02306330|
Recruitment Status : Completed
First Posted : December 3, 2014
Last Update Posted : November 15, 2016
|Condition or disease||Intervention/treatment||Phase|
|Bacterial Infections Fungal Infections||Device: Malditof Other: Routine clinical microbiology||Not Applicable|
When an eligible specimen from a patient shows pathogen growth, the pathogen identification will be randomized to either MaldiTof or routine diagnostics ('diagnostic pipelines'). Randomization to MaldiTof or routine diagnostics will be 1:1 with stratification by hospital and specimen type (blood vs. other). Isolates grown from all eligible specimens of the same patient will be assigned to the same diagnostic pipeline as the first randomized specimen of that patient.
Allocation to diagnostic arm will be assigned by a web based randomization program. When a pathogen is isolated from a positive eligible specimen, the laboratory technician will log onto the secure randomization program and enter the patient and specimen code. The random diagnostic pipeline allocation will then be generated, informed to the laboratory technician and logged in the study database. In the case of multiple specimens with pathogen growth for a single patient, the unique patient code will trigger the randomization program to generate the same diagnostic arm allocation as the previous sample(s).
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||802 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Outcomes Assessor)|
|Official Title:||Assessing Time to Reporting and Clinical Management of Patients With Severe Bacterial and Fungal Infections Between Two Diagnostic Approaches: Matrix-assisted Laser Desorption Ionization-time of Flight Mass Spectrometry Versus Routine Clinical Microbiology for Identifying Pathogens; a Randomized Diagnostic Trial|
|Study Start Date :||December 2014|
|Actual Primary Completion Date :||January 2016|
|Actual Study Completion Date :||January 2016|
Specimens of patients (diagnostic aspirates from normally sterile sites: cerebrospinal fluid (CSF), deep abscesses, joint fluid, peritoneal fluid, and pleural fluid, deep tissue biopsies) in Malditof arm will be performed by Malditof instrument to identify the pathogens. It takes 20 minutes for Malditof to identify the pathogens. Then patients will be treated based on these results.
Malditof MS system is applied for Malditof group for identifying pathogens. It takes 20 minutes to give the results.
Active Comparator: Routine clinical microbiology
Specimens of patients (diagnostic aspirates from normally sterile sites: cerebrospinal fluid (CSF), deep abscesses, joint fluid, peritoneal fluid, and pleural fluid, deep tissue biopsies) in routine clinical microbiology arm will be conducted by the routine clinical microbiologies and followed the treatment process of the hospital.
Other: Routine clinical microbiology
Pathogens will be identified by the routine clinical microbiology of the hospital.
- Proportion of patients on optimal antibiotic treatment [ Time Frame: Within 24 hours of positive culture (first growth of an eligible specimen). ]Optimal antibiotic treatment is defined as an antibiotic treatment for at least 48 hours since positive culture, targeted to the identified pathogen and later found to cover the organisms antimicrobial resistance profile, while avoiding unnecessary broad spectrum antibiotics (e.g. avoid carbapenems or multiple agents where other agents or single agents would provide sufficient coverage). This study aims to determine The proportion of patients on optimal antibiotic treatment within 24 hours of positive culture (first growth of an eligible specimen).
- The total duration of antibiotic treatment [ Time Frame: During treatment course, estimated to be 7-10 days. ]
- The total number of antibiotic switches [ Time Frame: During treatment course, estimated to be 7-10 days. ]
- Length of ICU stay [ Time Frame: During ICU admission, estimated to be 7 days ]
- Length of hospital stay [ Time Frame: During hospital admission, estimated to be 12 days ]
- Patient outcome: death, palliative discharge, survived with sequelae, recovered [ Time Frame: On or before discharge, estimated to be at 12 days ]
- Costs of microbiological testing [ Time Frame: On or before discharge, estimated to be at 12 days ]
- Treatment and hospital costs [ Time Frame: On or before discharge, estimated to be at 12 days ]
- Time from first growth of an eligible specimen to optimal antibiotic treatment. [ Time Frame: During hospital admission, estimated to be 0-48 hours ]
- Time from specimen collection of positive eligible specimen to optimal antibiotic treatment [ Time Frame: During hospital admission, estimated to be 0-48 hours ]
- The time from first recognition of isolate growth to issue of pathogen identification report [ Time Frame: Estimated 0-12 hours ]
- The time from specimen collection to issue of pathogen identification report [ Time Frame: Estimated 24-48 hours ]
- Time from first specimen collection to discharge [ Time Frame: Estimated to be 12 days ]
- Time from first pathogen identification to discharge [ Time Frame: Estimated to be 10 days ]
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02306330
|National Hospital for Tropical Diseases|
|Ha Noi, Vietnam|
|Hospital for Tropical Diseases|
|Ho CHi Minh City, Vietnam|
|Principal Investigator:||Heiman Wertheim, MD, PhD||Oxford University of Clinical Research|