Emergence of Fluoroquinolone Resistance in Commensal Flora (FQEMERG)
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Purpose
The emergence of resistance to fluoroquinolone (FQ) is a major problem worldwide. The commensal flora is the main reservoir for antibiotic resistance. Understanding the factors (environmental, patient-related, dosis-related, drug-related…) involved in the emergence of resistance to fluoroquinolones in the commensal flora of patients treated with a FQ, may help prevent it and preserve the efficiency of these important antibiotics. Samples of rectal, nasal and pharyngeal flora will be collected from hospitalized patients before receiving a FQ, at the end of the treatment and 1 month after the end of treatment. Clinical data will be collected. The incidence and risk-factors associated with the emergence of resistance to FQ will be assessed by comparing groups with and without resistance both at the end of treatment and 1 month later.
| Condition | Intervention |
|---|---|
|
All Types of Infections |
Other: Nasal, rectal and pharyngeal swabs |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Emergence of Fluoroquinolone Resistance in the Commensal Flora of Patients Receiving Fluoroquinolone Treatment. |
- emergence of fluoroquinolone-resistance [ Time Frame: 4 months ] [ Designated as safety issue: No ]To know the incidence and describe risk-factors involved in the emergence of fluoroquinolone-resistance in the commensal flora of patients treated by a fluoroquinolone.
| Enrollment: | 571 |
| Study Start Date: | October 2010 |
| Study Completion Date: | December 2012 |
| Primary Completion Date: | October 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: patient treated by fluoroquinolone
patient treated by fluoroquinolone. Nasal, rectal and pharyngeal swabs
|
Other: Nasal, rectal and pharyngeal swabs
Nasal, rectal and pharyngeal swabs were performed before, during, and one month after the end of FQ treatment.
Other Name: Nasal, rectal and pharyngeal swabs
|
|
Placebo Comparator: patient not receiving FQ treatment
reference group of patients not receiving FQ treatment, but hospitalized in the same wards at the same time
|
Other: Nasal, rectal and pharyngeal swabs
Nasal, rectal and pharyngeal swabs were performed before, during, and one month after the end of FQ treatment.
Other Name: Nasal, rectal and pharyngeal swabs
|
Detailed Description:
Population involved: Patients hospitalized (>1day) in one of the two participating university hospitals and receiving a treatment by a fluoroquinolone (FQ) antibiotic.
Number of centers : 2 (SAINT LOUIS and BEAUJON Hospitals, ASSISTANCE PUBLIQUE HOPITAUX DE PARIS, Paris, France).
Expected number of patients : 720
Aim : To study the incidence and risk-factors involved in the emergence of resistance to FQ in the commensal flora during and after treatment by a FQ.
Methods: Nasal, rectal and pharyngeal swabs were performed before, during, and one month after the end of FQ treatment. Microbiological analysis will focus on 3 target bacterial species: Escherichia coli from the faecal flora, alpha-haemolytic streptococci from the pharyngeal flora and non-coagulase staphylococci in the nasal flora. Patients carrying resistance at day 0 in all three flora will be excluded. The incidence and risk-factors of the emergence of resistance to FQ will be assessed at the end of treatment by FQ and 1 month after the end of treatment. Patients having resistant bacteria in their flora at the end and/or after treatment will be compared with those with no resistance.
The same swabs will be collected from a reference group of patients not receiving FQ treatment, but hospitalized in the same wards at the same time as the case patients in order to eventually detect horizontal transmission of FQ-resistant strains in the hospital ward.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Hospitalisation >24hours in one of the participating wards Treatment by a fluoroquinolone antibiotic.
Exclusion Criteria:
- Pregnancy or breast feeding Patients refusal to participate
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Assistance Publique - Hôpitaux de Paris |
| ClinicalTrials.gov Identifier: | NCT01209247 History of Changes |
| Other Study ID Numbers: | AOR09005 |
| Study First Received: | September 24, 2010 |
| Last Updated: | January 23, 2013 |
| Health Authority: | France: Ministry of Health |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
Fluoroquinolone -resistance Commensal flora Emergence of resistance |
Additional relevant MeSH terms:
|
Fluoroquinolones Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses |
Pharmacologic Actions Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 19, 2013