Host RNA Profiles to Detect Infections in Young Infants

NCT ID: NCT04823026

Last Updated: 2022-12-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

152 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-05-15

Study Completion Date

2021-12-31

Brief Summary

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This study seeks to identify and test host RNA expression profiles as markers for infections in young infants. Preliminary studies have shown high sensitivity and specificity for the discrimination of bacterial from non-bacterial infections in children, but the method has only been investigated in a limited number of young infants. The study aims to include 65 young infants with serious bacterial infections. The samples will be analysed by RNA sequencing. New diagnostic tools may help reduce unnecessary antibiotic treatment, antibiotic resistance, side-effects, hospitalisation and invasive procedures.

Detailed Description

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Background:

Infections in young infants is a challenge as 1) it is often not possible to distinguish serious bacterial infection (SBI) from viral infection by clinical appearance alone, 2) a causative organism is often not identified and 3) due to relatively low sensitivity and specificity of current biomarkers. The consequence is overtreatment with antibiotics being prescribed to as many as 50% of febrile young infants presenting to emergency departments. However, the majority of these children does not have a bacterial infection. Host RNA expression profiling has shown high sensitivity and specificity for discriminating bacterial from non-bacterial infections in preliminary studies of febrile young infants.

Methods:

A prospective multicentre observational study including young infants admitted and evaluated due to suspected infection at the 4 paediatric acute care units in the Capital Region of Denmark (Rigshospitalet, Hvidovre Hospital, Herlev Hospital, Nordsjællands Hospital - Hillerød). Whole blood will be collected in PAXgene blood RNA tubes and analysed by RNA sequencing at the Centre for Genomic Medicine, Rigshospitalet. Host RNA expression profiles will be identified in a discovery cohort and the diagnostic performance will be tested in a validation cohort. A control group of healthy and afebrile young infants will be included.

Time frames:

Patient recruiting: May 15th 2020 to February 28th 2022. Sample analysis (RNA sequencing): March 1st 2022 to August 31st 2022.

Perspectives:

New molecular-based diagnostic tools complementary to conventional methods may optimise infection management in young infants by improving early diagnostics and allowing early modification of antibiotic treatment. This will reduce antibiotic resistance, side effects, unnecessary hospitalisation and invasive procedures.

Conditions

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Bacterial Infections Urinary Tract Infections Sepsis Fever Viral Infection Infant, Newborn, Disease Bacteremia Meningitis

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1

70 young infants with proven bacterial infection.

Interventions:

Diagnostic test: Host RNA expression profiling (whole transcriptome profiling) using whole blood RNA sequencing. Cases will be randomly assigned to a "Discovery Cohort" (identification of diagnostic RNA profiles) or a "Validation Cohort" (validation of the identified RNA profiles).

No interventions assigned to this group

Group 2

70 young infants with non-bacterial infection.

Interventions:

Diagnostic test: Host RNA expression profiling (whole transcriptome profiling) using whole blood RNA sequencing. Cases will be randomly assigned to a "Discovery Cohort" (identification of diagnostic RNA profiles) or a "Validation Cohort" (validation of the identified RNA profiles).

No interventions assigned to this group

Group 3

30 young infants without infection.

Interventions:

Diagnostic test: Host RNA expression profiling (whole transcriptome profiling) using whole blood RNA sequencing. Cases will be randomly assigned to a "Discovery Cohort" (identification of diagnostic RNA profiles) or a "Validation Cohort" (validation of the identified RNA profiles).

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. age 0-3 months
2. admitted from home
3. suspected of infection
4. having routine blood sampling done
5. gestational age or corrected gestational age greater than or equal to 37+0
6. informed consent

Exclusion Criteria

1. not possible to draw blood tests
2. withdrawal of consent
3. sampling \>48 hours after admission
Maximum Eligible Age

3 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rigshospitalet, Denmark

OTHER

Sponsor Role lead

Responsible Party

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Kia Hee Schultz Dungu

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kia Hee Schultz Dungu, MD

Role: PRINCIPAL_INVESTIGATOR

Rigshospitalet, Denmark

Ulrikka Nygaard, Ass Prof PhD

Role: STUDY_CHAIR

Rigshospitalet, Denmark

Locations

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Department of Paediatrics and Adolescent Medicine, Rigshospitalet

Copenhagen, , Denmark

Site Status

Department of Paediatrics and Adolescent Medicine, Herlev Hospital

Herlev, , Denmark

Site Status

Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital - Hillerød

Hillerød, , Denmark

Site Status

Department of Paediatrics, Hvidovre Hospital

Hvidovre, , Denmark

Site Status

Countries

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Denmark

Other Identifiers

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H-18065635-YIC

Identifier Type: -

Identifier Source: org_study_id