Trial Outcomes & Findings for Implementing a Combination of Clinical Parameters, Biomarkers and SoCs for the Etiology Diagnoses of Pneumonia in Pediatric Patients (NCT NCT03366454)

NCT ID: NCT03366454

Last Updated: 2025-06-04

Results Overview

The area under the receiver operating curve (AUROC) for WBC and ANC count at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.

Recruitment status

COMPLETED

Target enrollment

188 participants

Primary outcome timeframe

Total length of time the subject will be in the study is one month after enrollment.

Results posted on

2025-06-04

Participant Flow

Recruitment period was done from July 2017 to September 2019

From total target 275 subjects only achieved 188 subjects enrolled

Participant milestones

Participant milestones
Measure
Hospitalized Pediatric Participants With Pneumonia
Hospitalized pediatric patients with pneumonia at acute episode.
Overall Study
STARTED
188
Overall Study
COMPLETED
188
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Implementing a Combination of Clinical Parameters, Biomarkers and SoCs for the Etiology Diagnoses of Pneumonia in Pediatric Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Hospitalized Pediatric Participants With Pneumonia
n=188 Participants
Hospitalized pediatric patients with pneumonia at acute episode
Age, Categorical
<=18 years
188 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
Age, Continuous
9 months
n=5 Participants
Sex: Female, Male
Female
85 Participants
n=5 Participants
Sex: Female, Male
Male
103 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
188 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
188 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
0 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
Indonesia
188 participants
n=5 Participants

PRIMARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects with confirmed etiology.

The area under the receiver operating curve (AUROC) for WBC and ANC count at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
White Blood Cells and Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
12.2 10^3 cells/microliter
6.15 10^3 cells/microliter

PRIMARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects with confirmed etiology.

The area under the receiver operating curve (AUROC) for NLR at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
Neutrophil Lymphocyte Ratio Cut-off for Distinguishing of Viral and Bacterial/Mixed Pathogens
1.34 ratio

PRIMARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects with confirmed etiology.

The area under the receiver operating curve (AUROC) for CRP at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
CRP Cut-off for Distinguishing of Viral and Bacterial/Mixed Pathogens
5.70 mg/dL

PRIMARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects with confirmed etiology.

The area under the receiver operating curve (AUROC) for PCT at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
Procalcitonin Cut-off for Distinguishing of Viral and Bacterial/Mixed Pathogens
0.141 ng/mL

SECONDARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All participants who have specimens to be tested

Any pathogens identified as a cause of pneumonia based on laboratory tests such as culture, serology, and molecular assays.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=188 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
The Etiologies of Pneumonia in Children Expressed in Percentages of Enrolled Subjects.
Bacterial
48 Participants
The Etiologies of Pneumonia in Children Expressed in Percentages of Enrolled Subjects.
Viruses
31 Participants
The Etiologies of Pneumonia in Children Expressed in Percentages of Enrolled Subjects.
Mixed pathogens
76 Participants
The Etiologies of Pneumonia in Children Expressed in Percentages of Enrolled Subjects.
Unidentified pathogens
33 Participants

SECONDARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects enrolled with clinical data.

Data and specimens were collected at enrollment and 14 days after enrollment. A telephone interview was done on day 30 to assess the clinical outcome. The outcome report was expressed in percentages of enrolled subjects and the proportions of subjects within each category defined by cured and death.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=48 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=31 Participants
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
n=76 Participants
Identified etiology based on laboratory testing
Unidentified Pathogens
n=33 Participants
Identified etiology based on laboratory testing
The Clinical Outcome in Pneumonia Pediatric Subjects
Cured
41 Participants
29 Participants
71 Participants
28 Participants
The Clinical Outcome in Pneumonia Pediatric Subjects
Death
7 Participants
2 Participants
5 Participants
5 Participants

SECONDARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects with confirmed etiology.

The percentage of sign and symptom of SoC procedure of pneumonia pediatric subjects expressed in percentages of identified pathogens. The proportion of subjects within each category is defined by bacterial or mixed infections and viral infections. We analyzed only 155 subjects with confirmed etiology for this secondary outcome.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=124 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=31 Participants
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
The Percentage of Sign and Symptom of SoC Procedure
Skin rash
6 Participants
2 Participants
The Percentage of Sign and Symptom of SoC Procedure
Cough
116 Participants
27 Participants
The Percentage of Sign and Symptom of SoC Procedure
Shortness of breath
116 Participants
28 Participants
The Percentage of Sign and Symptom of SoC Procedure
Fever
105 Participants
22 Participants
The Percentage of Sign and Symptom of SoC Procedure
Decreased consciousness
6 Participants
0 Participants
The Percentage of Sign and Symptom of SoC Procedure
Inability to drink
10 Participants
2 Participants
The Percentage of Sign and Symptom of SoC Procedure
Diarrhea
30 Participants
1 Participants
The Percentage of Sign and Symptom of SoC Procedure
Vomiting
9 Participants
2 Participants
The Percentage of Sign and Symptom of SoC Procedure
Seizure
5 Participants
1 Participants
The Percentage of Sign and Symptom of SoC Procedure
Tachypnea
54 Participants
13 Participants
The Percentage of Sign and Symptom of SoC Procedure
Intercostal retraction
112 Participants
27 Participants
The Percentage of Sign and Symptom of SoC Procedure
Ronchi
115 Participants
25 Participants
The Percentage of Sign and Symptom of SoC Procedure
Wheezing
20 Participants
2 Participants
The Percentage of Sign and Symptom of SoC Procedure
Nasal Flaring
49 Participants
11 Participants
The Percentage of Sign and Symptom of SoC Procedure
Chest indrawing
85 Participants
18 Participants
The Percentage of Sign and Symptom of SoC Procedure
Head bobbing
7 Participants
2 Participants
The Percentage of Sign and Symptom of SoC Procedure
SpO2 <90%
29 Participants
6 Participants
The Percentage of Sign and Symptom of SoC Procedure
Severe/ very severe pneumonia (WHO classification 2014)
55 Participants
16 Participants
The Percentage of Sign and Symptom of SoC Procedure
Chest X-ray Pleural effusion
3 Participants
1 Participants
The Percentage of Sign and Symptom of SoC Procedure
Chest X-ray- Interstitial infiltrate
93 Participants
19 Participants
The Percentage of Sign and Symptom of SoC Procedure
Chest X-ray-Alveolar infiltrate
86 Participants
19 Participants

SECONDARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects with confirmed etiology.

We explored the combination of significant factors/variables in the multivariate analysis for their overall sensitivity and specificity for discriminating bacterial/mixed and viral infection. The combination variables were CRP ≥5.70 mg/L + fever, CRP ≥5.70 mg/L + dry season, and CRP ≥5.70 mg/L + fever + dry season. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
n=155 Participants
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
Performance of Combined Factors in Differentiating Viral and Bacterial Infections
Sensitivity
62.28 percentage of participants
40.35 percentage of participants
35.09 percentage of participants
Performance of Combined Factors in Differentiating Viral and Bacterial Infections
Specificity
65.52 percentage of participants
82.76 percentage of participants
86.21 percentage of participants
Performance of Combined Factors in Differentiating Viral and Bacterial Infections
PPV
87.65 percentage of participants
90.19 percentage of participants
90.91 percentage of participants
Performance of Combined Factors in Differentiating Viral and Bacterial Infections
NPV
30.64 percentage of participants
26.09 percentage of participants
25.25 percentage of participants

SECONDARY outcome

Timeframe: Total length of time the subject will be in the study is one month after enrollment.

Population: All subjects with confirmed etiology.

Any pathogens identified as a cause of pneumonia based on laboratory tests such as culture, serology, and molecular assays. We analyzed only 155 subjects with confirmed etiology for this secondary outcome.

Outcome measures

Outcome measures
Measure
White Blood Cells Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
n=155 Participants
The WBC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Absolute Neutrophil Count Cut-off Levels for Distinguishing of Viral and Bacterial/Mixed Pathogens
The ANC count data at enrolment was used to characterize their utility for discriminating bacterial/mixed and viral pathogens and for determining the best cut-off values. For this analysis, a total of 155 subjects with confirmed bacterial/mixed or viral infections were included.
Mixed Pathogens
Identified etiology based on laboratory testing
Unidentified Pathogens
Identified etiology based on laboratory testing
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Streptococcus pneumoniae
29 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Staphylococcus aureus
20 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Streptococcus mitis
4 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Streptococcus pyogenes
1 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Moraxella catarrhalis
2 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Haemophilus influenzae non type B
73 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Klebsiella pneumoniae
43 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Bordetella pertussis
7 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Escherichia coli
5 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Pseudomonas aeruginosa
4 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Acinetobacter baumannii
3 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Haemophilus influenzae type B
2 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Neisseria meningitidis
1 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Chlamydia pneumoniae
5 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Mycoplasma pneumonia
5 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Legionella pneumophila
1 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
RSV A
15 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
RSV B
36 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Influenza
25 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Influenza A (H1N1)
7 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Influenza A (H3N2)
3 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Influenza B
14 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
PIV 1
5 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
PIV 3
11 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
PIV 4
1 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
hMPV
11 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Rhinovirus
10 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Enterovirus
5 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
Bocavirus
3 participants
Number of Strains of Circulating Respiratory Viruses and Pathogens in Pediatric Pneumonia Subjects
hCoV-NL63
2 participants

Adverse Events

Obervational

Serious events: 0 serious events
Other events: 1 other events
Deaths: 19 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Obervational
n=188 participants at risk
Hospitalized pediatric participants with pneumonia
Skin and subcutaneous tissue disorders
Hematoma
0.53%
1/188 • Number of events 1 • 2 years, 2 months
Any untoward or unfavorable medical occurrence in a human subject that occurs within 48 hours of a study-related specimen collection that is possibly, probably, or definitely related to the blood draw or induced sputum. Any event outside of this 48 hour window period will not be considered an AE for this study.

Additional Information

Publication Division

INA-RESPOND

Phone: +62214208693

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place