Risk-factors for Multidrug-resistant Bacteria Colonization Among Patients at High Risk of STIs

NCT ID: NCT03767374

Last Updated: 2024-10-04

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

2186 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-05-11

Study Completion Date

2020-12-31

Brief Summary

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The aim of this study is to identify risk factors and prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria colonization among patients at high risk of STIs

Detailed Description

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The spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria have become a worldwide public health concern. Infection with MDR/XDR bacteria is associated with increased morbidity, increased risk of therapeutic failure and healthcare costs. The largest burden is from extended-spectrum betalactamase-producing enterobacteriaceae (ESBL) and carbapenem-resistant enterobacteriaceae (CRE).

The World Health Organization (WHO) has considered the epidemic of MDR/XDR bacteria as a major health concern and has registered these bacteria in the "priory pathogens list." This list includes pathogens for which new antibiotics are urgently needed. Moreover, in their recent report on ESBL, the French National Authorities of Health (HAS) has recommended that additional studies be conducted to improve knowledge about colonization risk factors.

Some risk factors have been already identified: antibiotic intake and travel to countries with high MCR/XDR bacteria prevalence; however, many others are poorly identified. Patients visiting the CeGIDD (free information, screening and diagnosis center for sexually transmitted infections) and those receiving pre-exposure prophylaxis (PrEP) to prevent HIV infection are more exposed to STIs (including methicillin-resistant staphylococcus aureus, MRSA) and receive antibiotics for STI treatment. Moreover, an increase of STIs has been recently observed in men who have sex with men and in patients receiving PrEP. As antibiotic use is likely considerably increased in this population, we anticipate a high proportion with MDR/XDR colonization.

The objective of the "BMR-IST" study is to identify risk-factors (i.e. sexual behaviors, HIV status, antiretroviral PrEP, STIs, antibiotic use and travel to epidemic countries) of MDR/XDR bacteria colonization among patients at high risk of acquiring STIs and to determine the prevalence of MDR colonization in the studied population.

Conditions

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Bacterial Infections HIV Infections

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Main study group (HIV-negative)

2000 HIV-negative individuals seeking care at the STI clinic of Saint-Antoine Hospital

* Inguinal swab sample
* Anal swab sample
* Fecal sample
* Risk factor assessment

Inguinal swab sample

Intervention Type PROCEDURE

Inguinal samples using swab at cross-sectional visit

Anal swab sample

Intervention Type PROCEDURE

Anal samples using swab at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)

Fecal sample

Intervention Type PROCEDURE

Fecal sample at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)

Risk factor assessment

Intervention Type OTHER

Patients will be asked questions on risk factors associated with MDR/XDR colonization at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization

Exposure-matched group (HIV-positive)

500 HIV-positive men who have sex with men from the Infectious Diseases Unit of Saint- Antoine Hospital. These individuals will be compared to 500 HIV-negative MSM from the main study group, matching on age (+/-5 years).

* Inguinal swab sample
* Anal swab sample
* Fecal sample
* Risk factor assessment

Inguinal swab sample

Intervention Type PROCEDURE

Inguinal samples using swab at cross-sectional visit

Anal swab sample

Intervention Type PROCEDURE

Anal samples using swab at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)

Fecal sample

Intervention Type PROCEDURE

Fecal sample at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)

Risk factor assessment

Intervention Type OTHER

Patients will be asked questions on risk factors associated with MDR/XDR colonization at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization

Interventions

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Inguinal swab sample

Inguinal samples using swab at cross-sectional visit

Intervention Type PROCEDURE

Anal swab sample

Anal samples using swab at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)

Intervention Type PROCEDURE

Fecal sample

Fecal sample at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)

Intervention Type PROCEDURE

Risk factor assessment

Patients will be asked questions on risk factors associated with MDR/XDR colonization at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization

Intervention Type OTHER

Other Intervention Names

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ESwab ESwab

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* Consulting at the STI clinic of Saint-Antoine Hospital
* Signed the informed consent form


\- No fluency in French

Cohort 2 -


* Men who have sex with men
* Seeking care at Saint-Antoine Hospital
* HIV-positive


\- No fluency in French
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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ANRS, Emerging Infectious Diseases

OTHER_GOV

Sponsor Role collaborator

Institut de Médecine et d'Epidémiologie Appliquée - Fondation Internationale Léon M'Ba

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Laure Surgers, MD

Role: PRINCIPAL_INVESTIGATOR

Saint-Antoine Hospital, Paris, France 75012

Locations

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CeGIDD and Infections Diseases Unit

Paris, , France

Site Status

Countries

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France

References

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Other Identifiers

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IMEA 52

Identifier Type: -

Identifier Source: org_study_id

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