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Impact of the Contamination Mode on the Clinical Evolution During Pseudomonas Aeruginosa Ventilator Acquired Pneumonia (PYO GEN) (PYO GEN)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01745796
Recruitment Status : Unknown
Verified December 2015 by University Hospital, Grenoble.
Recruitment status was:  Recruiting
First Posted : December 10, 2012
Last Update Posted : December 2, 2015
Information provided by (Responsible Party):
University Hospital, Grenoble

Brief Summary:

Pseudomonas aeruginosa is the main pathogen of nosocomial respiratory infections. Its increasing resistance to antibiotics requires the development of new strategies for prevention and control, demanding a better understanding of the modes of transmission and evolutionary dynamics of this bacteria. In patients under invasive mechanical ventilation, the main mode of contamination by Pseudomonas remains debated, with 3 modes of contamination (endogenous, crossed transmission between patients, or environmental origin) of varying importance, mainly depending on the endemic situation of the place of study.

The emergence of new genotyping technologies (DiversiLab) can now facilitate studies of molecular epidemiology. Thanks to the multidisciplinary collaboration and innovative techniques, the investigators wish to study the impact of the mode of contamination on the outcome of ICU patients, intubated and ventilated for more than 72 hours.

Condition or disease
Pseudomonas Aeruginosa Ventilation Acquired Pneumonia

Detailed Description:

The presence of environmental reservoirs can cause infections and multidrug-resistant P. aeruginosa colonization with P. aeruginosa is itself a prognostic factor, but the impact of the route of infection on the evolution of the history and future of the infectious patient is not established.

A second factor that may influence the evolution infectious is the degree of genetic heterogeneity of the bacterial population. Multiple exposure pathways could also influence the genetic diversity.

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Study Type : Observational
Estimated Enrollment : 180 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Impact of the Contamination Mode on the Clinical Evolution During Pseudomonas Aeruginosa Ventilator Acquired Pneumonia
Study Start Date : January 2013
Estimated Primary Completion Date : January 2016
Estimated Study Completion Date : January 2016

Intubated ICU patients

Primary Outcome Measures :
  1. The occurrence of unfavorable patient's outcome, depending on the mode of contamination, such as persistence, relapse or superinfection of the airways at Day 7, and mortality at Day 28 [ Time Frame: From day 3 of intubation until the end of mechanical ventilation (an average of 28 days). ]

Secondary Outcome Measures :
  1. Number of different clones of P. aeruginosa found in each sample analyzed for the same patient at diagnosis of colonization and VAP. [ Time Frame: From day 3 of intubation until the end of mechanical ventilation (an average of 28 days). ]
    Samples of infected patients are analyzed once a week, strains are considered from different clones if their genetic homology rate is below 97%

Biospecimen Retention:   Samples Without DNA
In order to achieve an antibiogram according to conventional methods and PCR genotyping Rep (DiversiLab ®) to assess the clonality of bacterial populations, there will be taken 5 different isolated colonies (possibly diluted)from each clinical sample of bronchial secretion, selected according to morphological criteria or randomly if no visible differences are noted.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
ICU patients over 72 hours of intubation and mechanically ventilated

Inclusion Criteria:

  • Patients> 18 years
  • hospitalized in the intensive care unit
  • with more than 72 hours of mechanical ventilation
  • Presenting a positive bacteriological sample P. aeruginosa.

Exclusion Criteria:

  • Minors.
  • Pregnant or lactating women.
  • Patients under guardianship, under judiciary placement, or hospitalized without their consent.
  • Patients not affiliated to a social security scheme.
  • Long-term corticosteroid therapy (> 2mg/kg or> 1 month before the onset of established infection suspected)
  • Ongoing chemotherapy, AIDS, transplant patient under immunosuppressive drugs.
  • Bedridden patient or therapeutic decision at ICU arrival

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01745796

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Medical ICU of Universitary Hospital of Grenoble Recruiting
Grenoble, Isère, France, 38700
Contact: CALVINO CS Silvia, IDE   
Principal Investigator: TIMSIT Jean-françois         
Sponsors and Collaborators
University Hospital, Grenoble
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Responsible Party: University Hospital, Grenoble Identifier: NCT01745796    
Other Study ID Numbers: 12SC02
First Posted: December 10, 2012    Key Record Dates
Last Update Posted: December 2, 2015
Last Verified: December 2015
Keywords provided by University Hospital, Grenoble:
Pseudomonas Aeruginosa
Ventilated Acquired Pneumonia
Transmission modes
Additional relevant MeSH terms:
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Pseudomonas Infections
Pneumonia, Ventilator-Associated
Lung Diseases
Respiratory Tract Diseases
Respiratory Tract Infections
Gram-Negative Bacterial Infections
Bacterial Infections
Cross Infection