Mycoses Clinical Trial
Official title:
Invasive Mould Infections in Indian ICUs - Descriptive Epidemiology, Management and Outcome
Verified date | February 2018 |
Source | Fungal Infection Study Forum |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Invasive mould infections are emerging causes of morbidity and mortality in ICU patients.
This is attributed to prolonged ICU stay of critically ill patients with many co-morbidities.
Modern medicine and multiple intervention make the patients susceptible to these prevalent
moulds in the environment. In India the high frequency of IMIs in general has been attributed
to environmental and host factors prevalent in this region. Additionally sub-optimal hospital
care practice, frequent demolition and construction activities in the hospital make the
patients susceptible to IMIs. There is no multicentric study available in India describing
the epidemiology of IMIs in India. However, single center studies have reported distinct
epidemiology of IMIs in India. High incidence, different spectrum and risk factors are
possible unique features of IMIs in India.Early diagnosis and optimal therapy improve the
outcome of these patients. The conventional diagnosis including histopathology and culture
has limitations. The tests are of low sensitivity and long turnaround time. The major
challenge is collection of sample from deep tissue. Therefore majority of the patients in
ICUs of India are managed empirically against invasive fungal diseases. The galactomannan
test has improved the diagnosis of invasive aspergillosis. However, galactomannan test is not
well standardized in non-neutropenic patients. Beta-glucan test is used for early diagnosis
of invasive fungal infections other than mucormycosis. But the test is cumbersome for routine
laboratories and expensive. Both tests are not available in majority of Institutions of
India. PCR assay is not standardized and not performed routinely in any Institution.
Due these limitations in diagnosis, there is no uniform management protocol in ICUs of India.
To develop optimal management protocol, we need to know the epidemiology, the right patient
to treat, antifungal drug resistance, optimal drug and duration of therapy etc. The present
study will provide descriptive epidemiology, present status of diagnosis and management
practiced in India to treat IMIs in ICUs. This will help to find the suitable intervention
strategies to improve outcome of IMIs in India.This descriptive observational prospective
study will document the epidemiologic and clinical characteristics, as well as treatment and
outcome data, of patients with IMIs in ICUs in India over one year.
Status | Completed |
Enrollment | 420 |
Est. completion date | September 30, 2017 |
Est. primary completion date | September 30, 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A and older |
Eligibility |
Inclusion criteria: Proven: Histopathology/cytology/culture/direct microscopy demonstrating septate hyphae invading tissue or aspirate from sterile sites Probable: - Host criteria of EORTC - Host with COPD satisfying definitions by Bulpa P, et al Eur Resp J 2007 - Host in ICU satisfying clinical algorithm by Blot SI, et al Am J Resp Crit Care Med 2012 Exclusion criteria: - Endemic mycoses (histoplasmosis, sporotrichosis, penicilliosis) - Yeast infections - Allergic fungal diseases like allergic bronchopulmonary aspergillosis - Infection limited to the skin only |
Country | Name | City | State |
---|---|---|---|
India | Sterling Hospital | Ahmedabad | Gujarat |
India | St.Johns Medical College | Bangalore | Karnataka |
India | Chirayu Medical College | Bhopal | Madhya Pradeh |
India | PGIMER | Chandigarh | |
India | Sri Ramchandra Medical university | Chennai | Tamil Nadu |
India | Nizams Institute Of Medical Sciences | Hyderabad | Telengana |
India | AMRI Hospital | Kolkata | West Bengal |
India | Tata Memorial Hospital | Mumbai | Maharashtra |
India | Indraprastha Apollo Hospitals | New Delhi | Delhi |
India | Sir Gangaram Hospital | New Delhi | Delhi |
India | Christian Medical College | Vellore | Tamil Nadu |
Lead Sponsor | Collaborator |
---|---|
Fungal Infection Study Forum | Merck Sharp & Dohme Corp. |
India,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Incidence of Invasive mould infections (IMIs) in Indian ICUs (Number of patients with IMI per 1000 ICU admissions) | Three months from the date of admission | ||
Secondary | Incidence in specific population (Number of patients with IMI in specific population per 1000 ICU admissions) | six months after the completion of the study | ||
Secondary | Mortality (number of deaths per 1000 ICU admissions) | six months after the completion of the study |
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