About this trial
This will be an exploratory descriptive study designed to conduct surveillance for the identification of invasive fungal pathogens among hospitalized patients in Bangladesh at two tertiary care acute-level hospitals. including the Dhaka Medical College Hospital, the Dhaka Hospital of icddr,b, and the National Institute of Cancer Research Hospital (NICRH). Respiratory samples, blood, urine, cerebrospinal fluid, surgical wound infection swabs, and other samples including biopsy tissue specimens will be obtained at intensive care units, general medicine and surgery wards, post-operative care, etc. The collected specimens will be sent to the clinical microbiology laboratories of the surveillance hospitals or to the pathology laboratory (biopsy tissue specimens) to test for Aspergillus, Histoplasms, Candida, Pneumocystis, Cryptococcus, and Mucormycetes. The lab. methods will include microscopy, staining, culture, and biochemical tests mainly and if feasible then some specimens may undergo molecular or immunological methods.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Admitted/hospitalized patients of any age and gender in tertiary-level acute care hospitals AND
Chronic lung conditions including asthma, COPD
Hemodialysis patients,
diabetes,
Disqualifiers
History of taking antifungal drugs within 2 weeks
Not willing to give consent
Trial population
Hospitalized patients meeting the inclusion criteria and having ONE of the following groups of clinical features suggestive of infection of a particular organ system during sample collection: * Clinical features suggestive of infection of the respiratory system: * Fever or chills WITH * Cough or shortness of breath WITH * Abnormal lung findings on chest auscultation or on chest X-ray or CT scans * Clinical features of sepsis: * Hyperthermia or hypothermia (rectal temperature \>38.5 Celsius or \<35 Celsius respectively) and tachycardia plus either bounding pulses or, altered mental status or, hypoxemia in absence of pneumonia or, abnormal WBC count (\>12×109 ⁄ L or, \<4 ×109 ⁄ L or, band and neutrophil ratio ≥ 0.1) or, increased serum lactate level (diagnosed by physicians)
Trial design
Cohort
Other
Treatments tested in this trial
Invasive Fungal disease surveillance
Other interventionManagement of invasive fungal infection according to pathogen identification and susceptibility report.
Treatment groups
Trial outcomes
Primary outcomes
The proportion of laboratory-identified invasive fungal pathogens among hospitalized patients.
The primary goal will be to ensure a sustainable surveillance platform in low-income settings such as Bangladesh. The Investigators will utilize four strategies to establish a sustainable fungal surveillance platform/program in Bangladesh which will be as follows: 1. Increase capacity to conduct surveillance 2. Identify and respond 3. Target and train 4. Monitor, evaluate and improve
Sponsors and contacts
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International Centre for Diarrhoeal Disease Research, Bangladesh
Lead sponsor
Centers for Disease Control and Prevention
Collaborator
Institute of Epidemiology, Disease Control and Research
Collaborator