A Study of DEcolonization in Patients With HAematological Malignancies (DEHAM)

NCT ID: NCT02966457

Last Updated: 2017-12-28

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

PHASE4

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-31

Study Completion Date

2017-12-31

Brief Summary

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MDR (multidrug resistant) gram-negative bacteria have emerged as an important cause of bloodstream infection in hospitalized patients, especially in immunocompromised hosts. It was previously shown, that intestinal colonization with extended-spectrum β-lactamases (ESBL)-producing or carbapenem-resistant Enterobacteriaceae, carbapenem-resistant A. baumannii and P. aeruginosa) is a clinical predictor of bloodstream infections in patients with haematological malignancies and/or haematopoietic stem cell transplantation \[Stoma I. et al., 2016\].

To the investigators knowledge no randomized, placebo-controlled clinical trial has been performed to study the efficacy and safety of selective intestinal decolonization strategies in high-risk patients with haematological malignancies. Possible decolonization of MDR gram-negative bacteria in haematological patients could be important for the patient by reducing the risk of infection and for the community by reducing the risk of transmission.

The purpose of the proposed study is to assess the efficacy and safety of selective intestinal decolonization of MDR gram-negative bacteria with oral administration of Colistimethate sodium in high risk patients with haematological malignancies.

Detailed Description

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Conditions

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Hematological Infection

Keywords

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hematological infection, decolonization

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Selective intestinal decolonization

Drug: Decolonization with Colistimethate sodium (2 mln I.U. 4x/day PO) for 14 days

Group Type EXPERIMENTAL

Colistimethate Sodium

Intervention Type DRUG

Selective oral intestinal decolonization

"Wait and watch" strategy

Group without decolonization interventions

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Colistimethate Sodium

Selective oral intestinal decolonization

Intervention Type DRUG

Other Intervention Names

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Colistin

Eligibility Criteria

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Inclusion Criteria

1. Microbiologically proven rectal carriage of ESBL-producing Enterobacteriaceae or carbapenem-resistant Enterobacteriaceae, A. baumannii, P. aeruginosa without signs and symptoms of active infection.
2. Patient must give written informed consent to participate in the study. The informed consent can be given by the legal representative if necessary.

Exclusion Criteria

1. Active bacterial, viral, fungal or protozoal infection
2. Women who are pregnant or nursing
3. Antibacterial therapy in previous 10 days
4. Contraindication to the use of one of the study drugs (including known hypersensitivity)
5. Patient already enrolled in another study, or in the present study for a previous episode
6. Psychiatric disorder or unable to understand or to follow the protocol directions
7. Resistance of the primarily isolated colonizing microorganism to polymyxin antibiotics proven by methods of polymerase chain reaction
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Belarusian State Medical University

OTHER

Sponsor Role collaborator

Minsk Scientific-Practical Center for Surgery, Transplantation and Hematology

OTHER_GOV

Sponsor Role lead

Responsible Party

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Ihar Iskrou

Head of Cell Transplant Division

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ihar Iskrou, Ph.D.

Role: STUDY_CHAIR

Republican Center of Hematology and Bone Marrow Transplantation

Locations

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Republican Center of Hematology and Bone Marrow Transplantation

Minsk, , Belarus

Site Status

Countries

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Belarus

References

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Stoma I, Karpov I, Milanovich N, Uss A, Iskrov I. Risk factors for mortality in patients with bloodstream infections during the pre-engraftment period after hematopoietic stem cell transplantation. Blood Res. 2016 Jun;51(2):102-6. doi: 10.5045/br.2016.51.2.102. Epub 2016 Jun 23.

Reference Type BACKGROUND
PMID: 27382554 (View on PubMed)

Rieg S, Kupper MF, de With K, Serr A, Bohnert JA, Kern WV. Intestinal decolonization of Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBL): a retrospective observational study in patients at risk for infection and a brief review of the literature. BMC Infect Dis. 2015 Oct 28;15:475. doi: 10.1186/s12879-015-1225-0.

Reference Type BACKGROUND
PMID: 26511929 (View on PubMed)

Stoma I, Karpov I, Iskrov I, Krivenko S, Uss A, Vlasenkova S, Lendina I, Cherniak V, Suvorov D. Decolonization of Intestinal Carriage of MDR/XDR Gram-Negative Bacteria with Oral Colistin in Patients with Hematological Malignancies: Results of a Randomized Controlled Trial. Mediterr J Hematol Infect Dis. 2018 May 1;10(1):e2018030. doi: 10.4084/MJHID.2018.030. eCollection 2018.

Reference Type DERIVED
PMID: 29755707 (View on PubMed)

Other Identifiers

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HEM-3_1

Identifier Type: -

Identifier Source: org_study_id