SepsisNOBISNCT01359891
Clinical Evaluation of Novel Biomarkers in Patients With Septicemia
An observational study of Sepsis and Bacteremia, run by Medical University of Graz at 1 site in Austria.
Trial summary
The protein ST2 is a member of the interleukin-1 receptor family. Blood concentrations of the soluble isoform of ST2 (sST2) are increased in inflammatory and heart diseases and are considered a prognostic marker in both. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Sepsis, Bacteremia, Fungemia
- How many people
- 750 participants
- Where
- 1 siteAustria
- Study dates
- Nov 2010to Aug 2021
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients >18years with suspected / proven bacteremia/septicaemia admitted to the medical university hospital Graz, Austria
Who may be able to join
- Patients above 18 years
Who cannot join
- Patients < 18 years
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Clinical Evaluation of Novel Biomarkers for Diagnosis, Therapy- Monitoring and Prognosis of Outcome in Patients With Septicemia
The protein ST2 is a member of the interleukin-1 receptor family. Blood concentrations of the soluble isoform of ST2 (sST2) are increased in inflammatory and heart diseases and are considered a prognostic marker in both. The Presage™ST2 assay was recently shown to meet the needs of quality specifications of laboratory medicine. Soluble urokinase plasminogen activator receptor (suPAR) levels reflect inflammation and elevated suPAR levels are found in several infectious diseases and cancer. Both sST2 and suPAR have recently been introduced as sensitive biomarkers for patients with septicemia. Both may be promising or even superior alternatives to currently established sepsis markers leading to an improvement of outcome in patients with septicemia. However, a clinical study which clarifies kinetics of values over time/possible correlation with causative pathogen/progress/deterioration of septic patients is urgently needed before these biomarkers can be established in clinical routine.
Primary study objectives To clinically evaluate sST2 and suPAR in patients with bacteremia /septicemia. To correlate results with causative bacterial organisms, response to or failure of antiinfective treatment, severity of clinical status as well as outcome.
Read more
To study the kinetics of the test results and to correlate the sST2/suPAR results with other well established infection markers (e.g. C-reactive protein, procalcitonin, blood counts).
Natural endpoints of the study will be patient's death or complete recovery.
This is an explorative study. To meet the objectives both novel biomarkers will be clinically evaluated in a cohort of 500 in-patients with septicemia at the University Hospital Graz. Starting the day a patient's blood culture turned positive the investigators will collect samples every 12h within the first two days and then every 24h.Measurement of sST2 and suPAR values will be done retrospectively. To analyze clinical sensitivity/specificity of the novel biomarkers sST2 and suPAR as prognostic factors for development of bacteremia/septicemia, a second cohort consisting of 250 in-patients will be investigated in a longitudinal matter. Patients without a previous positive blood culture test during the current episode of disease for which blood cultures are ordered by a physician will be included and sST2 and suPAR levels will be determined from samples taken simultaneously with this first blood cultures.
Read the detailed description
The two most common causative pathogens of septicemia (Escherichia coli and Staphylococcus aureus) as well as cases of fungemia (Candida spp., Aspergillus spp., and others) will be included in the first study group. At our hospital the estimated yearly cases of bacteremia/fungemia (230 for Escherichia coli, 150 for Staphylococcus aureus, and 50 for fungi) will be included in the first study group. Furthermore, the two biomarkers will be determined in 70 cases of septicemia with other bacterial pathogens and sepsis due to viral pathogens or viremia for evaluation of further clinical impact of these two biomarkers.
- Conditions
- Sepsis, Bacteremia, Fungemia
- Medical subject headings
- Sepsis, Bacteremia, Fungemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1 | All patients >18 years admitted to the University Hospital Graz, Austria, with positive blood cultures tested in the Microbiology Laboratory, Department of Internal Medicine, Medical University Graz, or the Institute for Hygiene, Microbiology and Environmental Medicine, Medical University Graz, are screened for study inclusion. Patients eligible for the study have to have Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecium, Enterococcus faecalis, Streptococcus pneumoniae, Klebsiella pneumoniae or medically relevant fungi / viral pathogens identified as causative pathogen. The estimated total number of patients included in this first study cohort will be 500. | |
| Cohort 2 | All patients >18 years admitted to the University Hospital Graz, Austria, will be screened for study inclusion if the attending emergency department physicians on the very first visit suspects bacteremia/fungemia/sepsis and consecutively orders blood cultures. Patients will be included in this second cohort if these initially taken blood culture turns positive (n=200) or stays negative (n=50) at the Microbiology Laboratory, Department of Internal Medicine, Medical University Graz. As soon as the number of 50 is reached for the control group enrollment will be stopped for this group. As soon as the proposed number of 250 patients is reached enrolment for this second cohort will be stopped. Patients enrolled in cohort 2 may also be consecutively enrolled in cohort 1. | |
| Validation Cohort | To verify the employed Presage™ST2 assay established in our study laboratory for its intended use, a total number of 70 left over plasma samples obtained from septic patients which have prior been tested for sST2 with the same assay at the Department of Laboratory Medicine, Barmherzige Brueder Linz, Austria, will be retested. This cohort therefore serves as a validation cohort. |
What is being measured
The primary outcome is the main question the study is designed to answer.
prognostic value of biomarkers in bacteremia
Measured: 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 May 2011 (estimated)
- Study startNov 2010
- Primary completionAug 2021
- Study completionAug 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for SepsisStudies of the same condition, open and under way.
- More trials run by Medical University of GrazThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 750 participants (actual)
Sponsor and investigators
- Lead sponsor
- Medical University of Graz
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Robert Krause, MD, Medical University of Graz
- Investigators
- Martin Hoenigl, MD, Principal investigator, Medical University of GrazRobert Krause, MD, Principal investigator, Medical University of GrazReinhard R Raggam, MD, Principal investigator, Medical University Hospital Graz
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01359891
- Sponsor's protocol ID
- 21-469
- Acronym
- NOBIS
- Status last verified
- Aug 2021
- First submitted
- 23 May 2011
- Last updated
- 1 Sep 2021
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 1 Sep 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Evaluation of Novel Biomarkers for Diagnosis, Therapy- Monitoring and Prognosis of Outcome in Patients With Septicemia
- ClinicalTrials.gov ID
- NCT01359891
- Acronym / sponsor ID
- NOBIS / 21-469
- Conditions
- Sepsis, Bacteremia, Fungemia
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 750 participants (actual)
- Lead sponsor
- Medical University of GrazUniversity, hospital or other
- Study start
- Nov 2010
- Primary completion
- Aug 2021 (actual)
- Study completion
- Aug 2021 (actual)
- First posted
- 25 May 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The protein ST2 is a member of the interleukin-1 receptor family. Blood concentrations of the soluble isoform of ST2 (sST2) are increased in inflammatory and heart diseases and are considered a prognostic marker in both. The Presage™ST2 assay was recently shown to meet the needs of quality specifications of laboratory medicine. Soluble urokinase plasminogen activator receptor (suPAR) levels reflect inflammation and elevated suPAR levels are found in several infectious diseases and cancer. Both sST2 and suPAR have recently been introduced as sensitive biomarkers for patients with septicemia. Both may be promising or even superior alternatives to currently established sepsis markers leading to an improvement of outcome in patients with septicemia. However, a clinical study which clarifies kinetics of values over time/possible correlation with causative pathogen/progress/deterioration of septic patients is urgently needed before these biomarkers can be established in clinical routine.
Primary study objectives To clinically evaluate sST2 and suPAR in patients with bacteremia /septicemia. To correlate results with causative bacterial organisms, response to or failure of antiinfective treatment, severity of clinical status as well as outcome.
To study the kinetics of the test results and to correlate the sST2/suPAR results with other well established infection markers (e.g. C-reactive protein, procalcitonin, blood counts).
Natural endpoints of the study will be patient's death or complete recovery.
This is an explorative study. To meet the objectives both novel biomarkers will be clinically evaluated in a cohort of 500 in-patients with septicemia at the University Hospital Graz. Starting the day a patient's blood culture turned positive the investigators will collect samples every 12h within the first two days and then every 24h.Measurement of sST2 and suPAR values will be done retrospectively. To analyze clinical sensitivity/specificity of the novel biomarkers sST2 and suPAR as prognostic factors for development of bacteremia/septicemia, a second cohort consisting of 250 in-patients will be investigated in a longitudinal matter. Patients without a previous positive blood culture test during the current episode of disease for which blood cultures are ordered by a physician will be included and sST2 and suPAR levels will be determined from samples taken simultaneously with this first blood cultures.
Detailed description
The two most common causative pathogens of septicemia (Escherichia coli and Staphylococcus aureus) as well as cases of fungemia (Candida spp., Aspergillus spp., and others) will be included in the first study group. At our hospital the estimated yearly cases of bacteremia/fungemia (230 for Escherichia coli, 150 for Staphylococcus aureus, and 50 for fungi) will be included in the first study group. Furthermore, the two biomarkers will be determined in 70 cases of septicemia with other bacterial pathogens and sepsis due to viral pathogens or viremia for evaluation of further clinical impact of these two biomarkers.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Cohort 1 | – | –All patients >18 years admitted to the University Hospital Graz, Austria, with positive blood cultures tested in the Microbiology Laboratory, Department of Internal Medicine, Medical University Graz, or the Institute for Hygiene, Microbiology and Environmental Medicine, Medical University Graz, are screened for study inclusion. Patients eligible for the study have to have Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecium, Enterococcus faecalis, Streptococcus pneumoniae, Klebsiella pneumoniae or medically relevant fungi / viral pathogens identified as causative pathogen. The estimated total number of patients included in this first study cohort will be 500. |
| Cohort 2 | – | –All patients >18 years admitted to the University Hospital Graz, Austria, will be screened for study inclusion if the attending emergency department physicians on the very first visit suspects bacteremia/fungemia/sepsis and consecutively orders blood cultures. Patients will be included in this second cohort if these initially taken blood culture turns positive (n=200) or stays negative (n=50) at the Microbiology Laboratory, Department of Internal Medicine, Medical University Graz. As soon as the number of 50 is reached for the control group enrollment will be stopped for this group. As soon as the proposed number of 250 patients is reached enrolment for this second cohort will be stopped. Patients enrolled in cohort 2 may also be consecutively enrolled in cohort 1. |
| Validation Cohort | – | –To verify the employed Presage™ST2 assay established in our study laboratory for its intended use, a total number of 70 left over plasma samples obtained from septic patients which have prior been tested for sST2 with the same assay at the Department of Laboratory Medicine, Barmherzige Brueder Linz, Austria, will be retested. This cohort therefore serves as a validation cohort. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients >18years with suspected / proven bacteremia/septicaemia admitted to the medical university hospital Graz, Austria
Key inclusion criteria (1 listed)
- Patients above 18 years
Key exclusion criteria (1 listed)
- Patients < 18 years
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
prognostic value of biomarkers in bacteremia
Time frame: 2 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Sep 2021.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Martin Hoenigl, MD principal investigator
Medical University of Graz
Robert Krause, MD principal investigator
Medical University of Graz
Reinhard R Raggam, MD principal investigator
Medical University Hospital Graz
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Sepsis and Bacteremia, run by Medical University of Graz at 1 site in Austria.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 1 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Austria. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
prognostic value of biomarkers in bacteremia (time frame: 2 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Sep 2021.