Probiotics for Eradication of Carbapenem Resistant Klebsiella Pneumonia

NCT ID: NCT00722410

Last Updated: 2008-07-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE1/PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2010-09-30

Brief Summary

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Infection by Klebsiella pneumonia producing class A carbapenemases is a major clinical and public health problem in Israel and worldwide. The aim of this study is to determine the safety and efficacy of alteration of the gut microflora by probiotics, alone or in combination with mechanical bowel cleansing, as a strategy to eradicate colonization of the gastrointestinal tract by CRKP. We hypothesize that administration of probiotics will decrease the rate of GI colonization by CRKP.

Detailed Description

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CRKP colonization will be determined by culture and PCR of rectal swabs. The study will include 3 arms - no intervention, probiotics and mechanical bowel cleansing + probiotics. Followup examination of rectal swab samples for the presence of CRKP will be performed at 4 weeks and 12 weeks from study entry.

Conditions

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Anti-Biotic Resistance Klebsiella Pneumoniae

Keywords

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Carbapenem resistant Klebsiella pneumoniae Carpapenemases Probiotics VSL3

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A

Group Type NO_INTERVENTION

No interventions assigned to this group

B

VSL#3 for 4 weeks

Group Type EXPERIMENTAL

VSL#3

Intervention Type DIETARY_SUPPLEMENT

A probiotic preparation.

C

Mechanical bowel cleansing followed by VSL#3 for 4 weeks.

Group Type EXPERIMENTAL

VSL#3

Intervention Type DIETARY_SUPPLEMENT

A probiotic preparation.

Polyethylene glycol

Intervention Type DRUG

Oral ingestion of 3 liters of polyethylene glycol solution.

Interventions

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VSL#3

A probiotic preparation.

Intervention Type DIETARY_SUPPLEMENT

Polyethylene glycol

Oral ingestion of 3 liters of polyethylene glycol solution.

Intervention Type DRUG

Other Intervention Names

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New Meroken. Precolonoscopy solution.

Eligibility Criteria

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Inclusion Criteria

1. Subjects who are \> 18 years of age.
2. Signing of informed consent by subject or legal custodian.
3. Colonization of the gastrointestinal tract by CRKP as determined by stool culture or PCR of stool for the blakpc gene.
4. Negative cultures for CRKP from extra-intestinal sites excluding urine.

Exclusion Criteria

1. Subjects who have participated in another clinical trial within the last three months.
2. Women with childbearing potential unless using adequate contraception (IUD, oral or depot contraceptive or barrier plus spermicide).
3. Subjects who are pregnant or breast feeding.
4. Subjects who will be unavailable for the duration of the trial, are likely to be non-compliant with the protocol, or who are felt to be unsuitable by the investigator for any other reason.
5. Subjects with chronic diarrhea (\>4 weeks).
6. Subjects with inflammatory bowel disease.
7. Subjects whose stool is positive for Clostridium difficile toxin.
8. Subjects receiving immunosuppressive treatment (i.e. corticosteroids; azathioprine or 6-MP; cyclosporine; tacrolimus; OKT3, methotrexate; anti TNF agents; chemotherapy).
9. Subjects who underwent solid organ or hematopoietic stem cell transplantation.
10. Subjects with primary or secondary immunodeficiency disorders, including HIV.
11. Subjects with chronic advanced cardiac, respiratory, renal or liver disease.
12. Subjects with advanced malignant disease.
13. Subjects with severe acute organ failure.
14. Subjects in whom CRKP is isolated from sites other than stool or urine (i.e. blood, sputum or wound cultures).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tel Aviv University

OTHER

Sponsor Role collaborator

Hadassah Medical Organization

OTHER

Sponsor Role lead

Responsible Party

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Hadassah Medical Organization

Principal Investigators

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Maya Margalit, MD

Role: PRINCIPAL_INVESTIGATOR

Hadassah Medical Organization

Locations

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Hadassah Medical Organization

Jerusalem, , Israel

Site Status

Countries

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Israel

Central Contacts

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Maya Margalit, MD

Role: CONTACT

Phone: 972-50-7874561

Email: [email protected]

Hadas Lamberg, PhD

Role: CONTACT

Phone: 00 972 2 6777572

Email: [email protected]

Facility Contacts

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Arik Tzukert, DMD

Role: primary

Hadas Lamberg, PhD

Role: backup

References

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Leavitt A, Navon-Venezia S, Chmelnitsky I, Schwaber MJ, Carmeli Y. Emergence of KPC-2 and KPC-3 in carbapenem-resistant Klebsiella pneumoniae strains in an Israeli hospital. Antimicrob Agents Chemother. 2007 Aug;51(8):3026-9. doi: 10.1128/AAC.00299-07. Epub 2007 Jun 11.

Reference Type BACKGROUND
PMID: 17562800 (View on PubMed)

Manley KJ, Fraenkel MB, Mayall BC, Power DA. Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial. Med J Aust. 2007 May 7;186(9):454-7. doi: 10.5694/j.1326-5377.2007.tb00995.x.

Reference Type BACKGROUND
PMID: 17484706 (View on PubMed)

Other Identifiers

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CRKP-HMO-CTIL

Identifier Type: -

Identifier Source: org_study_id