1. Predictive value of cell-surface markers in infections in critically ill patients: protocol for an observational study (ImmuNe FailurE in Critical Therapy (INFECT) Study)
- Author
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Jillian Rennie, K. Alun Brown, Deepankar Datta, Adriano G. Rossi, A. John Simpson, Jean Antonelli, Ian Dimmick, Timothy S. Walsh, Gillian Hulme, Tracey Mare, Jim Keenan, Noel L. Warner, Andrew Conway Morris, Manu Shankar-Hari, Christopher J. Weir, Alice Wang, Sion M. Lewis, Conway Morris, Andrew [0000-0002-3211-3216], Datta, Deepankar [0000-0001-9971-9434], and Apollo - University of Cambridge Repository
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0301 basic medicine ,Male ,Neutrophils ,T-Lymphocytes, Regulatory ,IMMUNOLOGY ,Monocytes ,law.invention ,law ,Risk Factors ,Protocol ,Prospective Studies ,Prospective cohort study ,education.field_of_study ,Cross Infection ,predictive value ,adult ,risk assessment ,General Medicine ,INFECTIOUS DISEASES ,cohort analysis ,Intensive care unit ,Intensive Care Units ,Infectious Diseases ,Research Design ,Female ,hospital infection ,Risk assessment ,Cohort study ,prospective study ,medicine.medical_specialty ,Adolescent ,cell surface marker ,Critical Illness ,Population ,Immunology ,Article ,Sepsis ,03 medical and health sciences ,critically ill patient ,Intensive care ,medicine ,critical illness ,Humans ,human ,infection risk ,education ,Intensive care medicine ,Receptor, Anaphylatoxin C5a ,business.industry ,disease predisposition ,Intensive Care ,Membrane Proteins ,HLA-DR Antigens ,Length of Stay ,medicine.disease ,major clinical study ,Respiration, Artificial ,030104 developmental biology ,multicenter study ,Immune System ,Observational study ,observational study ,business ,Biomarkers - Abstract
INTRODUCTION: Critically ill patients are at high risk of nosocomial infections, with between 20% and 40% of patients admitted to the intensive care unit (ICU) acquiring infections. These infections result in increased antibiotic use, and are associated with morbidity and mortality. Although critical illness is classically associated with hyperinflammation, the high rates of nosocomial infection argue for an importance of effect of impaired immunity. Our group recently demonstrated that a combination of 3 measures of immune cell function (namely neutrophil CD88, monocyte HLA-DR and % regulatory T cells) identified a patient population with a 2.4-5-fold greater risk for susceptibility to nosocomial infections.METHODS AND ANALYSIS: This is a prospective, observational study to determine whether previously identified markers of susceptibility to nosocomial infection can be validated in a multicentre population, as well as testing several novel markers which may improve the risk of nosocomial infection prediction. Blood samples from critically ill patients (those admitted to the ICU for at least 48 hours and requiring mechanical ventilation alone or support of 2 or more organ systems) are taken and undergo whole blood staining for a range of immune cell surface markers. These samples undergo analysis on a standardised flow cytometry platform. Patients are followed up to determine whether they develop nosocomial infection. Infections need to meet strict prespecified criteria based on international guidelines; where these criteria are not met, an adjudication panel of experienced intensivists is asked to rule on the presence of infection. Secondary outcomes will be death from severe infection (sepsis) and change in organ failure.ETHICS AND DISSEMINATION: Ethical approval including the involvement of adults lacking capacity has been obtained from respective English and Scottish Ethics Committees. Results will be disseminated through presentations at scientific meetings and publications in peer-reviewed journals.TRIAL REGISTRATION NUMBER: NCT02186522; Pre-results.
- Published
- 2016
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