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RecruitingNCT06456151Updated Jun 5, 2025

Invasive Candidiasis in Critical Care

An observational study in Invasive Candidiasis, sponsored by University Hospital Ostrava. Recruiting at 2 sites in Czechia. Open to participants aged 12 Months and older. Per ClinicalTrials.gov, last updated 2025-06-05.

Sponsored by University Hospital Ostrava · Observational

Study type
Observational
Model
Case-only
Time perspective
Prospective
Enrollment
100
Ages
12 Months and older
Sex
All
01

Study summary

The combination of acute phase marker monitoring and the "T2Candida" assay (name of the test) will represent an acceleration of the identification of the causative agent of mycotic infection, a significant improvement in the specificity and positive predictive value of this strategy in the diagnosis of invasive candidiasis and candidemia in ICU patients, thereby improving the clinical condition of patients and reducing the cost of specific antifungal therapy.

Read the detailed description

Speed of response in the treatment of sepsis is crucial for the patient. The time from the collection of a positive haemoculture to the identification of the causative agent of sepsis is around 2 days; therefore, physicians in intensive care units deploy combined empiric antibiotic and antifungal therapy immediately when acute phase markers such as procalcitonin, interleukin-6, Presepsin, C-reactive protein are elevated. A new acute phase marker is lipopolysaccharide-binding protein, which, together with Presepsin, appears to be a suitable marker to distinguish invasive candida infections from bacterial infections. But its kinetics needs to be further analyzed.

At the same time, the causative agent of sepsis, G-/G+ bacteria or yeast, must be identified as soon as possible. Haemoculture and culture of the established drain is the gold standard, but the disadvantage is the low sensitivity and the time delay to obtain the result. It is therefore advisable to combine haemoculture with molecular biology-based tests that can identify the causative organism within hours. Conversely, the disadvantage of these tests is that they identify only the most common sepsis pathogens and do not determine susceptibility to antibiotics and antifungals, but the advantage is that with prophylaxis in place, these tests are often positive when haemoculture is negative. The T2Candida test can detect Candida albicans, Candida tropicalis, Candida glabrata, Candida krusei and Candida parapsilosis, which are the more common causative agents of mycotic bloodstream infections.

02

Conditions studied

  • Invasive Candidiasis

Keywords

  • invasive candidiasis
  • biomarkers
  • candida sepsis
03

Who can participate

Ages eligible
12 Months and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients with suspected invasive candidasis.

Inclusion criteria

  • critically ill patients
  • new onset sepsis
  • rise in body temperature >38°C according to The Third Consensus Definitions for Sepsis and Septic Shock
  • colonization with Candida spp. from more than 1 non-sterile site
  • body temperature >38 °C despite 5 days of broad-spectrum antibiotic therapy with the presence of at least 1 of the following risk factors: abdominal surgery, secondary peritonitis, pancreatitis, central venous catheter (CVC) insertion, total parenteral nutrition (CPV), dialysis, steroid therapy, immunosuppressive therapy, or liver transplantation
  • microbiological test results will be reviewed and categorized based on whether Candida sp. is isolated from at least 2 non-sterile sites (±3 days) and whether there is an alternative microbiological diagnosis.

Exclusion criteria

Exclusion Criteria:

  • not signing the informed consent with participation in the study
  • administration of antifungal therapy prior to collection of the biological material required for the study
04

Study design

Observational model
Case-only
Time perspective
Prospective
Enrollment
100 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • Patients with suspected invasive candidiasis

    Patients with suspected invasive candidiasis will be enrolled in this study arm.

    Diagnostic Test: Invasive candidiasis test · Other: Urine sample collection for future research

Interventions

  • Diagnostic testInvasive candidiasis test

    The combination of acute phase marker monitoring and the T2Candida assay will be assessed.

  • OtherUrine sample collection for future research

    Patients will be asked to provide a urine sample for future research (urine biobank).

05

What researchers measure

Primary outcomes

  1. Acute-phase biomarkers dynamics - procalcitonin

    The levels of procalcitonin will be observed in time and measured in μg/L. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: 8 days

  2. Acute-phase biomarkers dynamics - interleukin-6

    The levels of interleukin-6 will be observed in time and measured in pg/ml. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: 8 days

  3. Acute-phase biomarkers dynamics - interleukin-10

    The levels of interleukin-10 will be observed in time and measured in pg/ml. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: 8 days

  4. Acute-phase biomarkers dynamics - Presepsin

    The levels of Presepsin will be observed in time and measured in pg/ml. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: 8 days

  5. Acute-phase biomarkers dynamics - C-reactive protein

    The levels of C-reactive protein will be observed in time and measured in mg/dL. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: 8 days

  6. Acute-phase biomarkers dynamics - 1,3-β-D-glucan

    The levels of C-reactive protein will be observed in time and measured in pg/ml. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: 8 days

  7. Acute-phase biomarkers dynamics - pentraxin 3

    The levels of C-reactive protein will be observed in time and measured in ng/ml. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: 8 days

  8. T2Candida test

    The T2Candida test is able to detect the presence of Candida albicans, C. tropicalis, C. glabrata, C. krusei and C. parapsilosis. The results will be assessed as positive or negative.

    Time frame: One-time measurement at the enrolment into the study

  9. Lipopolysaccharide binding protein

    The levels of Lipopolysaccharide binding protein (LBP)_S/P will be observed in time and measured in mg/L. The follow-up will last 8 days, the patient may be observed repeatedly, depend-ing on the patient's condition.

    Time frame: One-time measurement at the enrolment into the study

06

Study locations

2 of 2 sites recruiting
  • University Hospital Ostrava
    Ostrava, Moravian-Silesian Region 708 52, Czechia
    • Jiří Hynčica · Contact · jiri.hyncica@fno.cz · 0042059737
    • Hana Slepčanová, Mgr. · Principal investigator
    • Marcela Káňová, Assoc.Prof.,MD,PhD · Sub investigator
    • Tomáš Zaoral, MD,PhD · Sub investigator
    • Radim Dobiáš, Mgr.,PhD · Sub investigator
    • Iveta Láryšová · Sub investigator
    Recruiting
  • University Hospital Motol
    Prague, 150 06, Czechia
    Recruiting
07

References and documents

Publications

  • Dobias R, Kanova M, Petejova N, Pisti SK, Bocek R, Krejci E, Struzkova H, Cachova M, Tomaskova H, Hamal P, Havlicek V, Raska M. Combined Use of Presepsin and (1,3)-beta-D-glucan as Biomarkers for Diagnosing Candida Sepsis and Monitoring the Effectiveness of Treatment in Critically Ill Patients. J Fungi (Basel). 2022 Mar 17;8(3):308. doi: 10.3390/jof8030308. PubMed 35330311 ↗
  • Bassetti M, Giacobbe DR, Vena A, Wolff M. Diagnosis and Treatment of Candidemia in the Intensive Care Unit. Semin Respir Crit Care Med. 2019 Aug;40(4):524-539. doi: 10.1055/s-0039-1693704. Epub 2019 Oct 4. PubMed 31585478 ↗

Individual participant data

Plan to share: No — There is no plan to make individual participant data available to other researchers. The data may be provided upon request.

08

Registry details

Key details

Study ID
NCT06456151
Lead sponsor
University Hospital Ostrava
Collaborators
University Hospital, Motol
Responsible party
Sponsor
First posted
Jun 13, 2024
Start date
Apr 11, 2024
Primary completion
Dec 2025 (estimated)
Completion
Dec 2027 (estimated)
Last update
Jun 5, 2025

Study contacts

Jiří Hynčica
Contact
jiri.hyncica@fno.cz
0042059737 ext. 2587
Hana Slepčanová, Mgr.
principal investigator · University Hospital Ostrava

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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