Multidrug Resistant Gram-negative Bacilli Colonization and Infection in Burn

NCT ID: NCT02653157

Last Updated: 2018-10-12

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

Total Enrollment

48 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-10-31

Study Completion Date

2017-12-31

Brief Summary

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This is a prospective observational study to determine the role of colonization and identify the timing of development of drug resistance in multidrug resistant Gram-negative bacilli (MDR-GNB) causing infection among critically ill burn patients.

Detailed Description

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This is a prospective observational study. Patients will be followed during a single admission for development of colonization or infection with MDR-GNB. Patient clinical characteristics, including infections, surgeries, and antibiotic exposure, will be collected in real-time.

Weekly surveillance wound and peri-rectal swabs and, if intubated, biweekly deep endotracheal or tracheostomy aspirates will be collected, de-identified, and stored from all patients and examined for the presence of MDR-GNB. All GNB isolates from blood, urine, respiratory, and wound cultures will be collected, coded, and stored.

Conditions

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Multi-drug Resistant Gram-negative Bacilli Colonization

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Burn patients with VAT or VAP with MDR-GNB

Adult patients with burn and/or inhalation injury requiring intubation

MDR-GNB

Intervention Type OTHER

Interventions

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MDR-GNB

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Severe burn injury, including partial or full thickness burn 20% or more total body surface area; or
2. inhalation injury; or
3. 18 years of age or older;

Exclusion Criteria

1. Intensive care unit stay of less than 5 days;
2. ICU admission more than 48 hours after burn trauma.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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North Carolina Translational and Clinical Sciences Institute

OTHER

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anne Lachiewicz, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina, Chapel Hill

Locations

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University of North Carolina Jaycee Burn Center

Chapel Hill, North Carolina, United States

Site Status

Countries

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United States

References

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Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. Available at http://www.cdc.gov/drugresistance/threat-report-2013 Accessed December 23, 2014.

Reference Type BACKGROUND

Mosier MJ, Pham TN. American Burn Association Practice guidelines for prevention, diagnosis, and treatment of ventilator-associated pneumonia (VAP) in burn patients. J Burn Care Res. 2009 Nov-Dec;30(6):910-28. doi: 10.1097/BCR.0b013e3181bfb68f.

Reference Type BACKGROUND
PMID: 19826271 (View on PubMed)

Brusselaers N, Logie D, Vogelaers D, Monstrey S, Blot S. Burns, inhalation injury and ventilator-associated pneumonia: value of routine surveillance cultures. Burns. 2012 May;38(3):364-70. doi: 10.1016/j.burns.2011.09.005. Epub 2011 Oct 29.

Reference Type BACKGROUND
PMID: 22040929 (View on PubMed)

Rue LW 3rd, Cioffi WG, Mason AD Jr, McManus WF, Pruitt BA Jr. The risk of pneumonia in thermally injured patients requiring ventilatory support. J Burn Care Rehabil. 1995 May-Jun;16(3 Pt 1):262-8. doi: 10.1097/00004630-199505000-00008.

Reference Type BACKGROUND
PMID: 7673306 (View on PubMed)

Shirani KZ, Pruitt BA Jr, Mason AD Jr. The influence of inhalation injury and pneumonia on burn mortality. Ann Surg. 1987 Jan;205(1):82-7. doi: 10.1097/00000658-198701000-00015.

Reference Type BACKGROUND
PMID: 3800465 (View on PubMed)

Tedja R, Nowacki A, Fraser T, Fatica C, Griffiths L, Gordon S, Isada C, van Duin D. The impact of multidrug resistance on outcomes in ventilator-associated pneumonia. Am J Infect Control. 2014 May;42(5):542-5. doi: 10.1016/j.ajic.2013.12.009. Epub 2014 Mar 14.

Reference Type BACKGROUND
PMID: 24630700 (View on PubMed)

Lachiewicz AM, van Duin D, DiBiase LM, Jones SW, Carson S, Rutala WA, Cairns BA, Weber DJ. Rates of hospital-associated respiratory infections and associated pathogens in a regional burn center, 2008-2012. Infect Control Hosp Epidemiol. 2015 May;36(5):601-3. doi: 10.1017/ice.2014.90. Epub 2015 Jan 28. No abstract available.

Reference Type BACKGROUND
PMID: 25626446 (View on PubMed)

Craven DE, Hjalmarson KI. Ventilator-associated tracheobronchitis and pneumonia: thinking outside the box. Clin Infect Dis. 2010 Aug 1;51 Suppl 1:S59-66. doi: 10.1086/653051.

Reference Type BACKGROUND
PMID: 20597674 (View on PubMed)

Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J, Srinivasan A, Kallen A, Limbago B, Fridkin S; National Healthcare Safety Network (NHSN) Team and Participating NHSN Facilities. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol. 2013 Jan;34(1):1-14. doi: 10.1086/668770. Epub 2012 Nov 27.

Reference Type BACKGROUND
PMID: 23221186 (View on PubMed)

Siegel JD, Rhinehart E, Jackson M, Chiarello L; Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in health care settings, 2006. Am J Infect Control. 2007 Dec;35(10 Suppl 2):S165-93. doi: 10.1016/j.ajic.2007.10.006. No abstract available.

Reference Type BACKGROUND
PMID: 18068814 (View on PubMed)

de La Cal MA, Cerda E, Garcia-Hierro P, Lorente L, Sanchez-Concheiro M, Diaz C, van Saene HK. Pneumonia in patients with severe burns : a classification according to the concept of the carrier state. Chest. 2001 Apr;119(4):1160-5. doi: 10.1378/chest.119.4.1160.

Reference Type BACKGROUND
PMID: 11296184 (View on PubMed)

American Burn Association. National Burn Repository 2014 Report. Available at http://www.ameriburn.org/2014NBRAnnualReport.pdf. Accessed December 23, 2014.

Reference Type BACKGROUND

Brusselaers N, Labeau S, Vogelaers D, Blot S. Value of lower respiratory tract surveillance cultures to predict bacterial pathogens in ventilator-associated pneumonia: systematic review and diagnostic test accuracy meta-analysis. Intensive Care Med. 2013 Mar;39(3):365-75. doi: 10.1007/s00134-012-2759-x. Epub 2012 Nov 28.

Reference Type BACKGROUND
PMID: 23188467 (View on PubMed)

Weber DJ, van Duin D, DiBiase LM, Hultman CS, Jones SW, Lachiewicz AM, Sickbert-Bennett EE, Brooks RH, Cairns BA, Rutala WA. Healthcare-associated infections among patients in a large burn intensive care unit: incidence and pathogens, 2008-2012. Infect Control Hosp Epidemiol. 2014 Oct;35(10):1304-6. doi: 10.1086/678067. Epub 2014 Sep 2. No abstract available.

Reference Type BACKGROUND
PMID: 25203188 (View on PubMed)

Wibbenmeyer L, Danks R, Faucher L, Amelon M, Latenser B, Kealey GP, Herwaldt LA. Prospective analysis of nosocomial infection rates, antibiotic use, and patterns of resistance in a burn population. J Burn Care Res. 2006 Mar-Apr;27(2):152-60. doi: 10.1097/01.BCR.0000203359.32756.F7.

Reference Type BACKGROUND
PMID: 16566558 (View on PubMed)

Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson-Liljequist B, Paterson DL, Rice LB, Stelling J, Struelens MJ, Vatopoulos A, Weber JT, Monnet DL. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012 Mar;18(3):268-81. doi: 10.1111/j.1469-0691.2011.03570.x. Epub 2011 Jul 27.

Reference Type BACKGROUND
PMID: 21793988 (View on PubMed)

American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416. doi: 10.1164/rccm.200405-644ST. No abstract available.

Reference Type BACKGROUND
PMID: 15699079 (View on PubMed)

Related Links

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http://www.unc.edu

University of North Carolina website

Other Identifiers

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US NIH Grant KL2TR001109

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

15-1505

Identifier Type: -

Identifier Source: org_study_id

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