Microbe: Gut Microbiota Association With ESBL-E Colonisation and Subsequent ESBL-E Infection

• Sponsor: University of Bordeaux (Other)
• Overall Status: Unknown status
• CT.gov ID: NCT04131569
• Collaborator: (none)
• Enrollment: 60
• Location: 1
• Anticipated Duration (Months): 5
• Patients Per Site Per Month: 12

Study Details

Study Description

Brief Summary

Antimicrobial resistance is a major threat worldwide and extended-spectrum beta-lactamase producing Enterobacteriales (ESBL-E) are a leading cause because of their wide dissemination. Gut microbiota seems to be correlated with multi-drug resistant organism carriage. This study thus aims to analyse the correlation between gut microbiota, ESBL-E fecal carriage and subsequent infection.

Condition or Disease	Intervention/Treatment	Phase
Extended Spectrum Beta-Lactamase Producing Bacteria Infection; Microbial Colonization; Critical Illness	Diagnostic Test: ESBL-E fecal carriage screening according to routine care

Detailed Description

The rising antimicrobial resistance has led to more than 33,000 deaths in Europe in 2015. Among them, extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are the most frequent in Europe and have disseminated both in the community and in healthcare settings. Some studies have suggested that microbiota could be different between multi-drug resistant organisms, with different relative abundances of some bacteria. One study focused on ESBL-E fecal carriers, but in the community, with Bacteroides uniformis being more abundant in ESBL-E non-carriers than carriers. As identification of species discriminating between ESBL-E fecal carriers and non-carriers could pave the way for the design of ESBL-E carriage eliminating probiotics, we aim to analyse the correlation between gut microbiota and ESBL-E fecal carriage.

Moreover, mechanisms in the link between ESBL-E fecal carriage and subsequent ESBL-E infection remain, so far, poorly understood and this study aims to provide a first insight in the involvement of gut microbiota in the link between colonization and infection.

Study Design

• Study Type: Observational
• Anticipated Enrollment: 60 participants
• Observational Model: Case-Control
• Time Perspective: Prospective
• Official Title: Association of Gut Microbiota Diversity With Extended-spectrum Beta-lactamase Producing Enterobacteriales Fecal Carriage and Subsequent Infection in Intensive Care Unit: Microbe Study
• Actual Study Start Date: Oct 15, 2019
• Anticipated Primary Completion Date: Mar 15, 2020
• Anticipated Study Completion Date: Mar 15, 2020

Arms and Interventions

Arm	Intervention/Treatment
ESBL-E fecal carriers Patients with a positive ESBL-E fecal carriage according to routine screening	Diagnostic Test: ESBL-E fecal carriage screening according to routine care; ESBL-E fecal carriage screening according to routine care
non ESBL-E fecal carriers Patients without positive ESBL-E fecal carriage according to routine screening	Diagnostic Test: ESBL-E fecal carriage screening according to routine care; ESBL-E fecal carriage screening according to routine care

Outcome Measures

Primary Outcome Measures

1. Gut bacteriobiota diversity according to ESBL specie [at positive screening]

   Comparison of gut bacteriobiota alpha diversity between ESBL E. coli and ESBL K. pneumoniae fecal carriers

Secondary Outcome Measures

1. Gut mycobiota diversity according to ESBL specie [at positive screening]

   Comparison of gut mycobiota alpha diversity between ESBL E. coli and ESBL K. pneumoniae fecal carriers

2. Gut bacteriobiota diversity according to ESBL specie [at positive screening]

   Analysis of gut bacteriobiota beta diversity between ESBL E. coli and ESBL K. pneumoniae fecal carriers

3. Gut mycobiota diversity according to ESBL specie [at positive screening]

   Analysis of gut mycobiota beta diversity between ESBL E. coli and ESBL K. pneumoniae fecal carriers

4. bacteria and the absence of ESBL E. coli fecal carriage [at admission]

   Association of bacteria with the absence of ESBL E. coli fecal carriage by LefSe method

5. fungi and the absence of ESBL E. coli fecal carriage [at admission]

   Association of fungi with the absence of ESBL E. coli fecal carriage by LefSe method

6. fungi and the absence of ESBL K. pneumoniae fecal carriage [at admission]

   Association of fungi with the absence of ESBL K. pneumoniae fecal carriage by LefSe method

7. bacteria and the absence of ESBL K. pneumoniae fecal carriage [at admission]

   Association of bacteria with the absence of ESBL K. pneumoniae fecal carriage by LefSe method

8. Gut bacteriobiota and subsequent ESBL-E infection [at admission]

   Comparison of gut bacteriobiota alpha diversity between ESBL-E fecal carriers subsequently ESBL-E infected and non-subsequently ESBL-E infected.

9. Gut bacteriobiota and subsequent ESBL-E infection [at admission]

   Analysis of gut bacteriobiota beta diversity between ESBL-E fecal carriers subsequently ESBL-E infected and non-subsequently ESBL-E infected

10. Gut mycobiota and subsequent ESBL-E infection [at admission]

    Comparison of gut mycobiota alpha diversity between ESBL-E fecal carriers subsequently ESBL-E infected and non-subsequently ESBL-E infected.

11. Gut mycobiota and subsequent ESBL-E infection [at admission]

    Analysis of gut mycobiota beta diversity between ESBL-E fecal carriers subsequently ESBL-E infected and non-subsequently ESBL-E infected

12. Bacteria and the absence of subsequent ESBL-E infection [at admission]

    Association of bacteria with ESBL-E subsequent infection among ESBL-E fecal carriers by LefSe method

13. Fungi and the absence of subsequent ESBL-E infection [at admission]

    Association of fungi with ESBL-E subsequent infection among ESBL-E fecal carriers by LefSe method

Other Outcome Measures

1. Association of gut bacteriobiota with ventilator-associated pneumonia [at admission]

   Patients with oro-tracheal intubation for more than 48 hours among those included will be included in this ancillary analysis. Association of alpha and beta diversities for both gut bacteriobiota and mycobiota with subsequent ventilator-associated pneumoniae will be assessed

2. Association of gut bacteriobiota with intensive care unit mortality [at admission]

   Association of alpha and beta diversities for both gut bacteriobiota and mycobiota with subsequent intensive care unit mortality will be assessed

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Patient above 18 year-old admitted to intensive care unit

• ESBL-E fecal carriage according to current screening recommendations for ESBL-E carriage group

• Feces quantity on rectal swab adequate for routine screening and microbiota analysis

Exclusion Criteria:

• Guardianship, curatorship, or prisoners

• No health insurance

• No legal representative

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Medical intensive care unit, Pelelgrin hospital	Bordeaux	Nouvelle-Aquitaine	France	33000

Sponsors and Collaborators

• University of Bordeaux

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Dr Pauline Esteves, Doctor, University of Bordeaux
• ClinicalTrials.gov Identifier: NCT04131569
• Other Study ID Numbers: Microbe
• First Posted: Oct 18, 2019
• Last Update Posted: Oct 21, 2019
• Last Verified: Oct 1, 2019

• Individual Participant Data (IPD) Sharing Statement: No
• Plan to Share IPD: No
• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No
• Keywords provided by Dr Pauline Esteves, Doctor, University of Bordeaux: ESBL-E; fecal carriage; microbiota; nosocomial infection
• Additional relevant MeSH terms: Infections; Communicable Diseases; Critical Illness

Study Results

No Results Posted as of Oct 21, 2019