Maternal- Fetal Infection

NCT ID: NCT03371056

Last Updated: 2022-09-27

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

2600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-28

Study Completion Date

2023-12-30

Brief Summary

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The purpose of the protocol is to validate a novel point of care multiplex system to detect and characterize microorganisms responsible for neonatal sepsis, as well as biomarkers of infection, from a simple vaginal sample, in order to improve the prevention of perinatal bacterial infections.

Detailed Description

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Early-onset neonatal sepsis (EOS) is a major global public health challenge. Prevention during pregnancy and delivery, early diagnosis and treatment of perinatal infections are essential to avoid EOS. Risk factors for include prematurity, maternal Group B streptococcus (GBS) colonization, premature rupture of membranes (PROM), and chorioamnionitis. Screening and intrapartum antimicrobial prophylaxis administered to GBS-colonized women has reduced early onset GBS infections. However, other pathogens are frequently involved in EOS following preterm PROM and preterm birth (PTB), such as Gram-negative bacteria and Staphylococci, which are not covered by penicillin prophylaxis. The prevalence of neonatal infection arising from antibiotic-resistant bacteria is increasing, thus the challenge is to eliminate the widespread unnecessary use of broad-spectrum antibiotics to treat non-infected infants, while recognizing when antibiotics are truly needed. Rapid diagnostic test(s) to detect and quantify specifically pathogens in vaginal samples, could be a major breakthrough. Several rT- PCR ( reverse Transcriptase Polymerase Chain Reaction) tests are on the market, however so far no test is able to detect, quantify and characterize in terms of antibiotic resistance and virulence genes, a range of pathogens.

A novel multiplex platform, using microfluidics technology, is under development by Elvesys, Inc in France. This platform will be able to offer results within 15 minutes on-site.

In addition, the study of the vaginal microbiome may identify signatures associated with a risk of maternal-fetal infection, particularly in case of PROM or PTB. Advanced sequencing technology and metagenomics will be used to characterize these signatures, and may lead to further markers to be included in the point-of-care test. Finally, biomarkers of inflammation will be detected, including IL-6 (Interleukin).

In this study, the InSPIRe platform will be compared in the laboratory to conventional microbiological and immunological detection.

Four groups of pregnant women will be recruited in prospective cohorts : uneventful pregnancies, term PROM, preterm labor and preterm PROM.

The purpose of the InSPIRe project is to improve the prevention of perinatal bacterial infections, with the novel Elvesys point of care system to rapidly detect and characterize microorganisms responsible for neonatal sepsis from a single vaginal sample.

Conditions

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Neonatal Infection

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

There are 4 pre-specified groups
Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Woman at low risk of infection

Women with systematic vaginal sample for detection of GBS will be included.

Group Type EXPERIMENTAL

Bacteriological analyses on clinical samples performed with swabs

Intervention Type BIOLOGICAL

Bacteriological analyses will be performed to assess the InSPIRe kit

Woman with high risk of infection > 37 SA

Women with premature rupture of membranes (\> 12 hours before labor) but \> 37 SA will be included.

Group Type EXPERIMENTAL

Bacteriological analyses on clinical samples performed with swabs

Intervention Type BIOLOGICAL

Bacteriological analyses will be performed to assess the InSPIRe kit

Women with premature rupture of membranes (<37SA)

Woman with high risk of infection \<37SA

Group Type EXPERIMENTAL

Bacteriological analyses on clinical samples performed with swabs

Intervention Type BIOLOGICAL

Bacteriological analyses will be performed to assess the InSPIRe kit

Women with premature delivery or premature delivery threat

Woman with high risk of infection \<37SA and Women with premature delivery or premature delivery threat

Group Type EXPERIMENTAL

Bacteriological analyses on clinical samples performed with swabs

Intervention Type BIOLOGICAL

Bacteriological analyses will be performed to assess the InSPIRe kit

Interventions

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Bacteriological analyses on clinical samples performed with swabs

Bacteriological analyses will be performed to assess the InSPIRe kit

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Pregnant woman,
* Gestational age over 22 SA,
* Patient agreeing to sign informed consent,
* Patient aged at least 18 years old,
* Patient with health insurance,
* Singleton, twin or multiple pregnancy.

Exclusion Criteria

* Fetal death or non-viable fetus,
* maternal age under 18,
* Patient unable to express her consent,
* Patient under guardianship.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Bforcure

UNKNOWN

Sponsor Role collaborator

BPIfrance

OTHER

Sponsor Role collaborator

Institut National de la Santé Et de la Recherche Médicale, France

OTHER_GOV

Sponsor Role collaborator

Institut Cochin

OTHER

Sponsor Role collaborator

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Laurent Mandelbrot, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Claire Poyart, MD, PhD

Role: STUDY_DIRECTOR

Assistance Publique - Hôpitaux de Paris

Pierre Yves Ancel, MD, PhD

Role: STUDY_DIRECTOR

Assistance Publique - Hôpitaux de Paris

Locations

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Hopital Louis Mourier

Colombes, , France

Site Status RECRUITING

Hôpital Cochin

Paris, , France

Site Status RECRUITING

Hopital Bichat

Paris, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Laurent Mandelbrot, MD, PhD

Role: CONTACT

+33 1 47 60 63 39

Charly LARRIEU

Role: CONTACT

+33 1 58 41 28 99

Facility Contacts

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Laurent Mandelbrot, MD, PhD

Role: primary

1 47 60 63 39

François Goffinet, MD, PhD

Role: primary

+33 1 58 41 37 98

Dominique Luton, MD PhD

Role: primary

+33 1.40.25.76.83

References

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Joubrel C, Tazi A, Six A, Dmytruk N, Touak G, Bidet P, Raymond J, Trieu Cuot P, Fouet A, Kerneis S, Poyart C. Group B streptococcus neonatal invasive infections, France 2007-2012. Clin Microbiol Infect. 2015 Oct;21(10):910-6. doi: 10.1016/j.cmi.2015.05.039. Epub 2015 Jun 5.

Reference Type BACKGROUND
PMID: 26055414 (View on PubMed)

Dussaux C, Senat MV, Bouchghoul H, Benachi A, Mandelbrot L, Kayem G. Preterm premature rupture of membranes: is home care acceptable? J Matern Fetal Neonatal Med. 2018 Sep;31(17):2284-2292. doi: 10.1080/14767058.2017.1341482. Epub 2017 Jul 6.

Reference Type BACKGROUND
PMID: 28612662 (View on PubMed)

Kayem G, Batteux F, Girard N, Schmitz T, Willaime M, Maillard F, Jarreau PH, Goffinet F. Predictive value of vaginal IL-6 and TNFalpha bedside tests repeated until delivery for the prediction of maternal-fetal infection in cases of premature rupture of membranes. Eur J Obstet Gynecol Reprod Biol. 2017 Apr;211:8-14. doi: 10.1016/j.ejogrb.2017.01.013. Epub 2017 Jan 12.

Reference Type BACKGROUND
PMID: 28160689 (View on PubMed)

Lorthe E, Ancel PY, Torchin H, Kaminski M, Langer B, Subtil D, Sentilhes L, Arnaud C, Carbonne B, Debillon T, Delorme P, D'Ercole C, Dreyfus M, Lebeaux C, Galimard JE, Vayssiere C, Winer N, L'Helias LF, Goffinet F, Kayem G. Impact of Latency Duration on the Prognosis of Preterm Infants after Preterm Premature Rupture of Membranes at 24 to 32 Weeks' Gestation: A National Population-Based Cohort Study. J Pediatr. 2017 Mar;182:47-52.e2. doi: 10.1016/j.jpeds.2016.11.074. Epub 2017 Jan 9.

Reference Type BACKGROUND
PMID: 28081890 (View on PubMed)

Delorme P, Goffinet F, Ancel PY, Foix-L'Helias L, Langer B, Lebeaux C, Marchand LM, Zeitlin J, Ego A, Arnaud C, Vayssiere C, Lorthe E, Durrmeyer X, Sentilhes L, Subtil D, Debillon T, Winer N, Kaminski M, D'Ercole C, Dreyfus M, Carbonne B, Kayem G. Cause of Preterm Birth as a Prognostic Factor for Mortality. Obstet Gynecol. 2016 Jan;127(1):40-48. doi: 10.1097/AOG.0000000000001179.

Reference Type BACKGROUND
PMID: 26646125 (View on PubMed)

Plainvert C, El Alaoui F, Tazi A, Joubrel C, Anselem O, Ballon M, Frigo A, Branger C, Mandelbrot L, Goffinet F, Poyart C. Intrapartum group B Streptococcus screening in the labor ward by Xpert(R) GBS real-time PCR. Eur J Clin Microbiol Infect Dis. 2018 Feb;37(2):265-270. doi: 10.1007/s10096-017-3125-2. Epub 2017 Oct 29.

Reference Type BACKGROUND
PMID: 29082442 (View on PubMed)

Six A, Firon A, Plainvert C, Caplain C, Bouaboud A, Touak G, Dmytruk N, Longo M, Letourneur F, Fouet A, Trieu-Cuot P, Poyart C. Molecular Characterization of Nonhemolytic and Nonpigmented Group B Streptococci Responsible for Human Invasive Infections. J Clin Microbiol. 2016 Jan;54(1):75-82. doi: 10.1128/JCM.02177-15. Epub 2015 Oct 21.

Reference Type BACKGROUND
PMID: 26491182 (View on PubMed)

Other Identifiers

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K170907J

Identifier Type: -

Identifier Source: org_study_id

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