Chinese Hospital Acquired Pneumonia Collaboration Network: Epidemiology, Diagnosis and Treatment

Study Overview
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Brief Summary
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The goal of this prospective and observatory study is to learn about the pathogen, clinical manifestations, prognosis, treatment and antibiotic resistance of bacteria in hospital-acquired pneumonia patients in China. The main purposes of this study are: clarify the regional differences and changes over time in the pathogen spectrum and antibiotic resistance rate among HAP patients in China; build a continuously optimized nationwide HAP pathogen and antibiotic resistance surveillance network; identify the molecular epidemiology of common pathogens

Official Title
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A Prospective Study on Pathogen Investigation, Risk Factors, and Prognostic Factors Analysis of Hospital Acquired Pneumonia (HAP)

Conditions
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Hospital-acquired Pneumonia, Antibiotic Resistant Infection

Intervention / Treatment
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* Other: prognosis status


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 years old. Meets the clinical diagnostic criteria for HAP in the 2018 HAP/VAP guidelines. Chest X-ray or CT shows new or progressive infiltrative shadows, consolidation shadows, or ground glass shadows, combined with 2 or more of the following 3 clinical symptoms, to establish a clinical diagnosis: 1) Fever, body temperature>38 ℃; 2) Purulent airway secretions; 3) Peripheral blood white blood cell count >10 × 10^9/L or <4 × 10^9/L. Having qualified evidence of responsible pathogen. On the basis of clinical diagnosis, one of the following conditions should be met simultaneously: 1) Qualified lower respiratory tract secretions (neutrophil count >25/low magnification field, epithelial cell count <10/low magnification field, or a ratio of the two >2.5:1), pathogenic bacteria cultured through bronchoscopy anti pollution brush (PSB), bronchoalveolar lavage fluid (BALF), lung tissue or sterile body fluid, and consistent with clinical manifestations; 2) Pathology, cytopathology, or direct microscopic examination of lung tissue specimens showing fungi and evidence of tissue damage; 3) The serum IgM antibodies of atypical pathogens or viruses change from negative to positive, or the titers of specific IgG antibodies in both acute and recovery phases show a 4-fold or more change. During the outbreak of respiratory viruses and with a history of epidemiological contact, respiratory secretions were tested positive for corresponding virus antigens, nucleic acid tests, or virus culture. obtained informed consent Exclusion Criteria: Those who cannot understand and execute the investigation plan. Active pulmonary tuberculosis; Severely immunosuppressed patients: absolute neutrophil count <0.5× 10^9/L, CD4<200/ml.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| survival group<br>patients still survive at 28 days | Other: prognosis status<br>* observatory; patients will be divided into survival group and mortality group according to their prognosis at day 28<br>|
| mortality group<br>patients die within 28 days | Other: prognosis status<br>* observatory; patients will be divided into survival group and mortality group according to their prognosis at day 28<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mortality at day 28 | prognosis | 28 days after enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| clinical characteristics | symptoms, physical examinations, comorbidity, laboratory tests, imaging findings and treatment | 0 day, 3 days, 7days, 14 days and 28 days after enrollment | 
| pathogen | molecular characteristics of responsible pathogen; antibiotic resistance of bacteria | 0 day, 3 days, 7days, 14 days and 28 days after enrollment |