Ventilator Associated Pneumonia Clinical Trial
Official title:
The Impact of Simultaneous Presence of Viral and Bacterial Pathogens on Therapy and Course of Severe Pneumonia
The purpose of the study is to determine if the clinical course of pneumonia is more severe when both, bacterial and viral pathogens are find as possible causative agent and how does it affect treatment.
Basic demographic data of the patients (age, gender), data on concomitant diseases and
epidemiological circumstances will be collected
Severity of illness will be assessed by APACHE II (at day 1) and SOFA (at day 1,2,3 and 7)
scoring system
Following laboratory tests will be performed at day 1, 2,3 and 7.:
- blood count analysis
- differential blood count
- C- reactive protein, procalcitonin
- glucose, urea, potassium, sodium, chloride, magnesium, creatinine, bilirubin, protein,
albumin, alkaline phosphatase, aspartate aminotransferase, alanine transaminase,
gamma-glutamyl transpeptidase , alpha-amylase, lipase, creatine kinase, lactate
dehydrogenase, myoglobin
- arterial blood gas analysis
- tests of hemostasis.
Additional 2 mL of blood will be taken at day 1 and day 21 (or later), due to paired
serologic testing
To establish the presence of potential pathogens we will perform following microbiological
investigations:
- cultivation of 2 pairs of blood cultures in all patients
- cultivation of sputum or quantitative cultivation of tracheal aspirate in nonintubated
patients
- quantitative cultivation of tracheal aspirate or bronchoalveolar lavage in intubated
patients
- testing the presence of soluble Legionella antigen in urine in all patients
- testing the presence of genetic material of respiratory viruses (influenza A, influenza
B, respiratory syncytial virus , adenovirus, bocavirus, coronavirus, metapneumovirus,
parainfluenza virus, rhinovirus) by qualitative polymerase chain reaction (PCR) in
nasopharyngeal swabs in all patients, in the tracheal aspirate in nonintubated patients
and in tracheal aspirate or bronchoalveolar lavage fluid in intubated patients
- testing the presence of mycoplasmal, legionella and chlamydial DNA by qualitative PCR
in nasopharyngeal smears in all patients, in the tracheal aspirate in nonintubated
patients and in bronchoalveolar lavage fluid or in tracheal aspirate in intubated
patients
;
Observational Model: Cohort, Time Perspective: Prospective
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