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This trial is aimed to study the immunological and pathological characteristics of influenza versus non-influenza severe community-acquired pneumonia patients in ICU.
This trial is aimed to study the immunological and pathological characteristics of influenza versus non-influenza severe community-acquired pneumonia patients in ICU, and correlate findings with occurrence of secondary invasive pulmonary aspergillosis infection.
All consecutive patients aged 18 or older admitted to ICU during the inclusion period with respiratory distress due to influenza positive/negative community acquired pneumonia (CAP) will be included.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Influenza positive CAPIV | All consecutive patients older than 18 years, admitted to the ICU with respiratory distress with microbiologically confirmed diagnosis of influenza | ||
| Influenza negative CAPIV | All consecutive patients older than 18 years, admitted to the ICU for respiratory distress due to community-acquired pneumonia (CAP) and with a microbiologically confirmed absence of influenza |
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| Measure | Description | Time Frame |
|---|---|---|
| Difference in immune cell profile in blood between influenza and non-influenza CAPIV patients at ICU. | Immunophenotyping of blood will be performed to determine number of neutrophils, T- and B-cell subsets, NK cell and myeloid cell subsets. Difference in influenza positive and influenza negative patients is expected. | through study completion, after 3 influenza seasons (3 years) |
| Difference in cytokine production of mononuclear cells to fungal stimulation in blood between influenza and non-influenza CAPIV patients at ICU. | Key cytokine reaction of mononuclear cells (PBMC) after fungal stimulation will be performed. Difference in influenza positive and influenza negative patients is expected. | through study completion, after 3 influenza seasons (3 years) |
| Difference in function of blood neutrophils between influenza and non-influenza CAPIV patients at ICU. | Functional analysis by killing assay will be performed. | through study completion, after 3 influenza seasons (3 years) |
| Difference in in immune cell profile in BAL fluid between influenza and non-influenza CAPIV patients at ICU. | Immunophenotyping of BAL fluid will be performed to determine number of neutrophils, T- and B-cell subsets, NK cell and myeloid cell subsets. Difference in influenza positive and influenza negative patients is expected. | through study completion, after 3 influenza seasons (3 years) |
| Difference in cytokine production of mononuclear cells to fungal stimulation in BAL fluid between influenza and non-influenza CAPIV patients at ICU. | Key cytokine reaction of mononuclear BAL fluid cells after fungal stimulation will be performed. Difference in influenza positive and influenza negative patients is expected. |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in longitudinal alterations in phagocytic cell and mononuclear inflammatory cell subsets in blood and BAL fluid and their response to fungal stimulation between the main study arms. | Longitudinal alterations in advanced immunophenotyping results and (fungal) cell stimulation will be analysed and compared between groups. | through study completion, after 3 influenza seasons (3 years) |
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Inclusion Criteria:
Exclusion Criteria:
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Critically ill community-acquired pneumonia patients
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Joost Wauters, PhD | Contact | 16344275 | +32 | joost.wauters@uzleuven.be |
| Lore Vanderbeke, MD | Contact | 16344275 | +32 | lore.vanderbeke@uzleuven.be |
| Name | Affiliation | Role |
|---|---|---|
| Joost Wauters, PhD | UZ Leuven | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitaire Ziekenhuizen Leuven | Recruiting | Leuven | 3000 | Belgium |
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| ID | Term |
|---|---|
| D055744 | Invasive Pulmonary Aspergillosis |
| D007251 | Influenza, Human |
| ID | Term |
|---|---|
| D055732 | Pulmonary Aspergillosis |
| D001228 | Aspergillosis |
| D009181 | Mycoses |
| D001423 | Bacterial Infections and Mycoses |
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whole blood, serum, white cells, broncho-alveolar lavage fluid, lung tissue
| through study completion, after 3 influenza seasons (3 years) |
| Difference in function of BAL fluid neutrophils between influenza and non-influenza CAPIV patients at ICU. | Functional analysis by killing assay will be performed. | through study completion, after 3 influenza seasons (3 years) |
| Difference in pathological hallmarks between influenza and non-influenza CAPIV patients at ICU. | Biopsies of respiratory tract tissue will be compared between two groups. | through study completion, after 3 influenza seasons (3 years) |
| Longitudinal differences in anatomopathological characteristics of the respiratory tract in CAPIV +/- influenza | Respiratory tract biopsies will be compared longitudinally throughout the disease course. | through study completion, after 3 influenza seasons (3 years) |
| Correlation of findings with invasive pulmonary aspergillosis incidence | All data will be compared within each group between patients that develop IPA vs no development of IPA. | through study completion, after 3 influenza seasons (3 years) |
| Correlation of findings with outcome | All data will be compared to outcome measures (length of ICU stay, mortality, etc) to find hallmarks of severe disease. | through study completion, after 3 influenza seasons (3 years) |
| D007239 |
| Infections |
| D000072742 | Invasive Fungal Infections |
| D008172 | Lung Diseases, Fungal |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012141 | Respiratory Tract Infections |
| D009976 | Orthomyxoviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |