Streptococcus Pneumoniae Nasopharyngeal Carriage

NCT ID: NCT01485029

Last Updated: 2012-12-18

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

NA

Total Enrollment

500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-31

Study Completion Date

2013-01-31

Brief Summary

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Antibiotic consumption and antimicrobial resistance remain notoriously high in France, particularly among children below three years of age. In France, the pneumococcal conjugate vaccine was officially recommended for all children under two in 2003, and consequently changes occurred in Streptococcus pneumoniae serotype distribution. Bacterial carriage among children attending day-care centres may result from vaccine- and antibiotic-driven selective pressure with possible repercussions on the community.

Detailed Description

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Antibiotic consumption and antimicrobial resistance remain notoriously high in France, particularly among children below three years of age. In France, the pneumococcal conjugate vaccine was officially recommended for all children under two in 2003, and consequently changes occurred in Streptococcus pneumoniae serotype distribution. Bacterial carriage among children attending day-care centres may result from vaccine- and antibiotic-driven selective pressure with possible repercussions on the community.

To identify prevalence (rates) and trends in antibiotic resistance patterns in Streptococcus pneumoniae (SP) among children attending day-care centres, as well as antibiotic prescriptions and vaccine rates, nasopharyngeal (NP) carriage was monitored, by conducting five cross-sectional surveys from January to March 1999, 2002, 2004, 2006 and 2008 among these children in the area of the Alpes Maritimes, in South-Eastern France.

Interventions promoting prudent antibiotic use (PAU) took place in 2000 and since 2003, with temporary effectiveness but national prescription rates are reported to be currently increasing again. A new pneumococcal conjugate vaccine covering more serotypes (13-valent) now replaces the previous one. In this situation, a new cross-sectional survey in day-care centres with the same design may answer the following questions.

* Increasing antibiotic susceptibility was observed during past successive surveys. Has this trend been sustained to this day?
* Are antibiotics prescription rates among children attending day-care centres still decreasing, have they stabilized, or are they on the rise again reflecting recently reported national trends?
* Regarding choice of antimicrobial treatment, are 3rd generation cephalosporin increasingly prescribed rather than aminopenicillins?
* Is implementation of the new wider spectrum pneumococcal conjugate vaccine exerting changes on serotype distribution and thus on the nasopharyngeal ecosystem of these children? These parameters will be useful to renew, or even reinforce, and adapt professional guidelines and community-oriented messages concerning prudent antibiotic use.

Sub-study: Antibiotic-resistant enterobacteriaceae, initially observed in the hospital setting, are currently spreading within the community, especially extended-spectrum beta-lactamase-producing enterobacteriaceae, threatening antibiotic effectiveness in case of infection. Such infections with Enterobacteriaceae, in particular urinary tract infections, can occur among children. Prevalence rates of such carriage among children attending day-care centres is unknown, although they are highly exposed to antibiotics in relation with frequent respiratory tract infections, in particular to 3rd generation cephalosporins. To assess this prevalence rate, faecal samples from children attending day-care centres will be collected during the cross-sectional nasopharyngeal survey quoted above.

Conditions

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Nursery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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NP children

Nasopharyngeal (NP) aspirate with a small flexible canule to obtain NP swabs

Group Type EXPERIMENTAL

Nasopharyngeal (NP) aspirate

Intervention Type PROCEDURE

Nasopharyngeal (NP) aspirate with a small flexible canule to obtain NP swabs

Interventions

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Nasopharyngeal (NP) aspirate

Nasopharyngeal (NP) aspirate with a small flexible canule to obtain NP swabs

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Children aged from 3 months to 4 years
* Attending a day care center
* Parents give informed consent

Exclusion Criteria

* parents refusal
Minimum Eligible Age

3 Months

Maximum Eligible Age

4 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Department of Clinical Research and Innovation

OTHER

Sponsor Role lead

Responsible Party

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Department of Clinical Research and Innovation

Pr PRADIER

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Christian PRADIER, PU-PH

Role: PRINCIPAL_INVESTIGATOR

Centre Hospitalier Universitaire de Nice

Locations

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Hôpital Archet 1

Nice, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Christian PRADIER, PU-PH

Role: CONTACT

Email: [email protected]

Vanina OLIVERI, ARC

Role: CONTACT

Phone: 0033 4 92 03 42 54

Email: [email protected]

Facility Contacts

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Pascale BRUNO, PH

Role: primary

Vanina OLIVERI, ARC

Role: backup

Other Identifiers

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11-APN-01

Identifier Type: -

Identifier Source: org_study_id