Study Of Bacterial/Fungal Infections in Hospitalized Patients With Liver Cirrhosis in China

NCT ID: NCT03676777

Last Updated: 2019-11-19

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

Total Enrollment

1232 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-11-07

Study Completion Date

2020-02-29

Brief Summary

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This is a national, investigator-initiated, multicenter, prospective, observational, web-based registry in hospitalized patients with cirrhosis across China.

The overarching aim of this study is to investigate the epidemiology and clinical impact of bacterial/fungal infections in hospitalized patients with liver cirrhosis in China within the collaborative network. We also aimed to build up the national prospective cohort of hospitalized cirrhosis in China to stand in the future for the backbone of various research programs focused on infection, other complications of cirrhosis, organ failure, the ACLF syndrome, end-stage liver disease and beyond.

Detailed Description

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Patients with cirrhosis are prone to infections due to the abnormal bacterial translocation and immune dysfunction. Infections are more common when these patients are admitted into the hospital. Infections are life-threatening complications of cirrhosis which can precipitate hepatic encephalopathy, acute kidney injury, and the acute-on-chronic liver failure (ACLF) syndrome. The survival rate is significantly decreased once infections set in, especially when the first-line empirical antibiotic therapy is insufficient or inappropriate. Moreover, the prevalence of multi-drug-resistant organism (MDRO) is naturally increasing across the world due to the overuse of antibiotics. Patients with cirrhosis, especially those at the decompensated stage are at high risk of developing MDRO due to recurrent hospitalizations and repeatedly exposed to antibiotics either for treatment or prophylactic purposes. Empiric antibiotic therapy could be very difficult without understanding the profile of antibiotic resistance and could be varied significantly among different areas.

The issue of infection in patients with cirrhosis has been recently highlighted by International Club of Ascites with its "GLOBAL" study (ILC2018, GS-001) showing that the global prevalence of MDRO across the world was 34% (95% CI=31-37%). The prevalence of MDRO varies across the world with the highest in India followed by South America and other Asian countries. The source of acquisition (Community acquire, health-care related or nosocomial origin), site of infection (Spontaneous bacterial peritonitis, urinary tract, blood, respiratory tract, etc.) and category of the organism (Gram negative or positive) had an influence on the prevalence of MDRO and response to empirical antibiotic treatment. The results highlight the need to develop different empirical antibiotic strategies across different continents and countries, although China was not included in this study. Epidemiology data and investigation on the role of bacterial/fungal infection in patients with cirrhosis from China is therefore urgently needed.

The overarching aim of this study is to investigate the epidemiology and clinical impact of bacterial/fungal infections in hospitalized patients with liver cirrhosis in China within the collaborative network. We also aimed to build up the national prospective cohort of hospitalized cirrhosis in China to stand in the future for the backbone of various research programs focused on infection, other complications of cirrhosis, organ failure, the ACLF syndrome, end-stage liver disease and beyond.

Conditions

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Cirrhosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Infection

Patients admitted or developed bacterial/fungal infection while hospitalization

No interventions assigned to this group

Non-infection

Patients without bacterial/fungal infection

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Inpatient with cirrhosis as confirmed either by the histological scoring system, imaging technique (abdominal Ultrasound, CT or MRI), endoscopic findings or a combination of biochemical and clinical manifestation.
* Admitted for at least one of the following reasons:

1. Bacterial infection/fungal infection
2. Overt Ascites (Grade II-III)
3. Gastrointestinal bleeding
4. Hepatic encephalopathy
5. Jaundice (Total bilirubin ≥5 mg/dL) with coagulation dysfunction (INR ≥1.5)

Exclusion Criteria

* 1\. Age below 16 or over 80 years
* 2\. Lactation/ Pregnancy women
* 3\. HIV infection
* 4\. Admitted for scheduled procedures (e.g., band ligation, splenectomy, transjugular intrahepatic portosystemic shunting, liver biopsy) or re-examination or multidisciplinary consultation)
* 5\. Hepatocellular carcinoma (HCC) outside Milan criteria or other disseminated malignancies
* 6\. Previous liver transplantation
* 7\. With previously known severe extra-hepatic diseases (e.g., chronic renal failure requiring hemodialysis, severe heart disease; severe chronic pulmonary disease, psychiatric disorders)
* 8\. Taking immunosuppressive or anticoagulation drugs for the treatment of extra-hepatic disease.
* 9\. Patient' s refusal to participation
* 10\. Failure to provide prior informed consent or with documented evidence that the patient has no legal surrogate decision maker and it appears unlikely that the patient will regain consciousness or sufficient ability to provide delayed informed consent
Minimum Eligible Age

16 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ruijin Hospital

OTHER

Sponsor Role lead

Responsible Party

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Qing XIe

Head of the Department of Infectious diseases, Ruijin Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Qing Xie, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Ruijin Hospital

Locations

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First Affiliated Hospital of Anhui Medical University

Hefei, Anhui, China

Site Status RECRUITING

Department of Critical Care Medicine of Liver Disease, Beijing You'an Hospital, Capital Medical University

Beijing, Beijing Municipality, China

Site Status RECRUITING

Second Affiliated Hospital of Chongqing Medical University

Chongqing, Chongqing Municipality, China

Site Status RECRUITING

Department of severe Liver Diseases, Fuzhou Municipal Infectious Disease Hospital, Mengchao Hepatobiliary Hospital of Fujian Medical University,

Fuzhou, Fujian, China

Site Status RECRUITING

Xiamen Hospital of Traditional Chinese Medicine

Xiamen, Fujian, China

Site Status RECRUITING

Department of Infectious Disease, The First Hospital of Lanzhou University

Lanzhou, Gansu, China

Site Status RECRUITING

The First People's Hospital of Lanzhou City

Lanzhou, Gansu, China

Site Status RECRUITING

The Third People's Hospital of Guilin

Guilin, Guangxi, China

Site Status RECRUITING

Department of Infectious Disease, The First Affiliated Hospital of Guangxi Medical University

Nanning, Guangxi, China

Site Status RECRUITING

Department of Infectious Diseases, Third Affiliated Hospital of Hebei Medical University

Shijiazhuang, Hebei, China

Site Status RECRUITING

Department of Liver Diseases, The Third People's Hospital of Changzhou

Changzhou, Jiangsu, China

Site Status RECRUITING

Department of Infectious Diseases, the Fifth People's Hospital of Suzhou

Suzhou, Jiangsu, China

Site Status RECRUITING

The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University

Wuxi, Jiangsu, China

Site Status RECRUITING

The First Affiliated Hospital of Nanchang University

Nanchang, Jiangxi, China

Site Status RECRUITING

Shengjing Hospital of China Medical University

Shenyang, Liaoning, China

Site Status RECRUITING

Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Department of Hepatology and Infection, Tongren Hospital, Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Department of Infectious Diseases , Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University.

Xi’an, Shanxi, China

Site Status RECRUITING

Department of Infectious Diseases, Zhejiang Provincial People's Hospital

Hangzhou, Zhejiang, China

Site Status RECRUITING

The first Hospital of Jiaxing

Jiaxing, Zhejiang, China

Site Status RECRUITING

Ningbo no.2 Hospital

Ningbo, Zhejiang, China

Site Status RECRUITING

First Affiliated Hospital, Wenzhou Medical University

Wenzhou, Zhejiang, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Qing Xie, M.D., Ph.D.

Role: CONTACT

0086 13651804273

Zhujun Cao, M.D.

Role: CONTACT

0086 15216652990

Facility Contacts

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Jiabin Li, M.D., Ph.D.

Role: primary

Qinghua Meng, M.D.

Role: primary

0086 13601398756

Peng Hu, M.D., Ph.D.

Role: primary

0086 13608338064

Minghua Lin, M.D.

Role: primary

0086 13860691603

Lijuan Ouyang, M.D.

Role: primary

0086 13799768907

Xiaorong Mao, M.D., Ph.D.

Role: primary

0086 13919157938

Yuerong Zhang, M.D.

Role: primary

Yongchao Xian, M.D.

Role: primary

0086 18007736836

Minghua Su, M.D.

Role: primary

0086 15807719292

Caiyan Zhao, M.D., Ph.D.

Role: primary

0086 18533112898

Longgen Liu, M.D.

Role: primary

0086 13606140932

Chuanwu Zhu, M.D., Ph.D.

Role: primary

0086 13606202525

Lihua Huang, M.D., Ph.D.

Role: primary

0086 13601513551

Xiaoping Wu, M.D., Ph.D.

Role: primary

0086 13330122823

Xiaoguang Dou, M.D.,Ph.D.

Role: primary

0086 18940251121

Chenghai Liu, M.D.,Ph.D.

Role: primary

021-20256666

Qin Zhang, M.D.,Ph.D.

Role: primary

0086 13916348835

Qing Xie, M.D., Ph.D.

Role: primary

0086 13651804273

Zhujun Cao, M.D., Ph.D.

Role: backup

0086 15216652990

Yingren Zhao, M.D., Ph.D.

Role: primary

0086 13509187086

Hongying Pan, M.D.

Role: primary

0086 13958020498

Xingsheng Xie, M.D.,Ph.D.

Role: primary

0573-82082937

Yaoren Hu, M.D.

Role: primary

0086 13957881518

Huadong Yan, M.D., Ph.D.

Role: backup

0086 13586579885

Yongping Chen, M.D.

Role: primary

Other Identifiers

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SONIC

Identifier Type: -

Identifier Source: org_study_id

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