Rapid Metagenomic Diagnosis of Respiratory Infections in Hematopoietic Stem Cell Transplant Recipients

"3.1 Main objective of the research To determine the proportion of patients with a microbiologically confirmed infection depending on the use of rapidCMg in addition to Standard of Care diagnostic procedures. 3.2 Secondary objectives 1. Assess the clinical impact of implementing a rapidCMg approach on patient management, including drug treatments (initiation or discontinuation of antibiotics, antivirals, antifungals), isolation measures, and complementary investigations, including invasive respiratory sampling 2. Determine the prevalence of respiratory pathogens (including emerging infectious diseases such as influenza, RSV, SARS-CoV-2, PIV and new or emerging pathogens) in both groups 3. Evaluate the impact on patients' health, including the number of hospitalizations, associated mortality at month 3, instances of chronic lung dysfunction, graft rejection, and pulmonary GVHD in both groups 4. Determine the diagnostic performance of rapidCMg, including measures of sensitivity, specificity, positive and negative predictive values 5. Conduct a health economic evaluation to assess the impact of diagnostic approaches on medical direct costs from a hospital perspective 6. Determine if respiratory microbiota at inclusion is predictive of outcome at month 3 We will conduct a cluster-randomized trial to compare two diagnostic approaches for patients who have undergone HSCT and present with fever and respiratory symptoms."