Predictive Value of the Immune Response of the Host in Clostridium Difficile Infections

NCT ID: NCT01946750

Last Updated: 2017-08-22

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

COMPLETED

Clinical Phase

NA

Total Enrollment

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-12-31

Study Completion Date

2017-06-30

Brief Summary

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Hypothesis: the antibody directed against certain antigens of Clostridium difficile would be predict the Clostridium difficile infection.

This study evaluates the weight of immunity by studying patients with Clostridium difficile infection versus controls (each patient is associated with two controls : diarrheal control without Clostridium difficile, and non-diarrheal control with or without Clostridium difficile). Recurrence and the kinetics of immune response following infection Clostridium difficile are studied by following the patients during three months.

There are also building biological samples collections clinically documented: sera, stool and strains.

Detailed Description

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Conditions

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Clostridium Difficile Infection

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Case

Hospitalized patient with clinical signs of Clostridium Difficile Infection and specific detection in stools of Clostridium Difficile toxins

Group Type EXPERIMENTAL

Serum

Intervention Type BIOLOGICAL

Stools

Intervention Type BIOLOGICAL

Saliva

Intervention Type BIOLOGICAL

Optional sample collected for the cases and non-diarrheal control at the same time as the serum, to compare the presence of specific salivary Immune globulin type A (IgA) of C. difficile antibodies than in the serum.

Whole blood

Intervention Type BIOLOGICAL

Optional sample collected for the cases and non-diarrheal control at the same time as the serum, in order to study cellular immunity and describe the determinants of the development of a protective adaptive response.

Non-diarrheal control

Hospitalized patient and asymptomatic carrier of Clostridium Difficile

Group Type OTHER

Serum

Intervention Type BIOLOGICAL

Stools

Intervention Type BIOLOGICAL

Saliva

Intervention Type BIOLOGICAL

Optional sample collected for the cases and non-diarrheal control at the same time as the serum, to compare the presence of specific salivary Immune globulin type A (IgA) of C. difficile antibodies than in the serum.

Whole blood

Intervention Type BIOLOGICAL

Optional sample collected for the cases and non-diarrheal control at the same time as the serum, in order to study cellular immunity and describe the determinants of the development of a protective adaptive response.

Interventions

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Serum

Intervention Type BIOLOGICAL

Stools

Intervention Type BIOLOGICAL

Saliva

Optional sample collected for the cases and non-diarrheal control at the same time as the serum, to compare the presence of specific salivary Immune globulin type A (IgA) of C. difficile antibodies than in the serum.

Intervention Type BIOLOGICAL

Whole blood

Optional sample collected for the cases and non-diarrheal control at the same time as the serum, in order to study cellular immunity and describe the determinants of the development of a protective adaptive response.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Hospitalized patients with clinical signs of Clostridium Difficile Infection and specific detection in stools of Clostridium Difficile toxins or/and isolating in stools and by digestive biopsy a strain producer of Clostridium Difficile toxins.
* Patients for which a serum prior to the episode of Clostridium Difficile Infection, ideally as far as possible of the episode, but at least 6 days before the day of diagnosis (D0) will be available.
* Patients for which consent has been signed or by their legal representative by default.
* Patients for whom is found Clostridium Difficile Infection in their file surgical and those for whom Clostridium Difficile Infection is the reason for admission will be included in the study but will be subject of a separate analysis, and their witnesses.

Exclusion Criteria

* Eligible patients for whom Clostridium Difficile Infection has been strongly suspected clinically but for which no microbiological confirmation will have been obtained.
* Eligible patients (or their legal representatives) who are opposed to the use of their samples, the achieving samples and/or the longitudinal follow-up.
* Eligible patients who underwent plasmapheresis or treated with monoclonal antibodies to toxin A and B or immunoglobulins during the year preceding the episode of Clostridium Difficile Infection.
* Eligible patients but already included in the study for a recent infection with Clostridium Difficile or transferred to a second health facility for the same episode of Clostridium Difficile Infection.
* Eligible patients whose physicians responsible for the management refused participation in the study.
* Protected persons: pregnant women and children under the age of 18.

Secondarily be excluded the following cases:

* Patients for whom no sample has been achieved or retained by the laboratory of Medical Biology who participated in the diagnosis and monitoring of the patient.
* Hospitalized patients at the time of Clostridium Difficile Infection suspicion and diagnostic sample but released or transferred before rendering necessary microbiological results at baseline (J0 or J3).
* Matched control in a case excluded will be excluded.

NON-DIARRHEAL CONTROL : Eligible patients are those who do not have diarrhea at the time of recruitment.

To ensure that exposure to risks similar for cases and controls (hospitalization, usually care epidemic period, ...) will be recruited eligible patients according to the following criteria:

* Within a maximum period of six months after the inclusion of cases.
* Hospitalized in the same hospitalization service type as the case.
* With a duration of prior hospitalization at least as long as the time between admission and the corresponding case J0,
* Matched on sex and three age categories (18-40, 41-60 and\> 60 years).

The inclusion of these controls depends on the one hand signing an informed consent for participation in the study and secondly the lack clinical signs suggestive of Clostridium Difficile Infection at the time of inclusion and known history of Clostridium Difficile Infection in their medical records (one no-diarrheal control hospitalized (ND) for one case).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Pasteur

INDUSTRY

Sponsor Role collaborator

Sanofi Pasteur, a Sanofi Company

INDUSTRY

Sponsor Role collaborator

Saint Antoine University Hospital

OTHER

Sponsor Role collaborator

Versailles Hospital

OTHER

Sponsor Role lead

Responsible Party

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Alban LE MONNIER

Microbiological coordinator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alban LE MONNIER, Microbiological coordinator

Role: PRINCIPAL_INVESTIGATOR

Versailles Hospital

Alix GREDER-BELAN, Clinical coordinator

Role: PRINCIPAL_INVESTIGATOR

Versailles Hospital

Locations

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CH Annecy Genevois

Annecy, , France

Site Status

Hôpital Jean Verdier

Bondy, , France

Site Status

Hôpital Ambroise Paré

Boulogne-Billancourt, , France

Site Status

Hôpital Côte de Nacre

Caen, , France

Site Status

Hôpital Antoine Béclère

Clamart, , France

Site Status

CHU de Dijon - Hôpital d'Enfants

Dijon, , France

Site Status

Hôpital Raymond Poincaré

Garches, , France

Site Status

CHU de Grenoble

Grenoble, , France

Site Status

CHD Vendée

La Roche-sur-Yon, , France

Site Status

CHRU de Montpellier - Hôpital Arnaud de Villeneuve

Montpellier, , France

Site Status

Hôpital Central de Nancy

Nancy, , France

Site Status

Fondation Hospitalière Sainte-Marie

Paris, , France

Site Status

Groupe Hospitalier Paris Saint Joseph

Paris, , France

Site Status

Groupe Hospitalier Sainte-Périne / Rossini / Chardon Lagache

Paris, , France

Site Status

Hôpital Lariboisière

Paris, , France

Site Status

Hôpital Saint Antoine

Paris, , France

Site Status

CHU de Reims - Hôpital Robert Debré

Reims, , France

Site Status

CHU de Rennes - Hôpital Pontchaillou

Rennes, , France

Site Status

CHU de Rouen - Hôpital Charles Nicolle

Rouen, , France

Site Status

CHU de Toulouse - Hôpital Purpan

Toulouse, , France

Site Status

CH de Tourcoing - Hôpital Gustave Dron

Tourcoing, , France

Site Status

CHRU de Tours - Hôpital Bretonneau

Tours, , France

Site Status

CH de Valenciennes

Valenciennes, , France

Site Status

Centre Hospitalier de Versailles

Versailles, , France

Site Status

Countries

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France

Other Identifiers

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P11/51_SERODIFF

Identifier Type: -

Identifier Source: org_study_id

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