Rifampicin Resistance in S. Aureus During and After Treatment for Latent Tuberculosis

NCT ID: NCT05073926

Last Updated: 2024-07-15

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

RECRUITING

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-09-30

Study Completion Date

2026-12-31

Brief Summary

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Two commonly used treatments for latent tuberculosis infection are either 4 months rifampicin or 6-9 months isoniazid. The invistigators will study the risk of acquisition of rifampicin resistance in commensal Staphylococcus aureus in persons treated with rifampicin versus in persons treated with isoniazide. Through repeated swab cultures before, during, and after treatment the investigators will also investigate potential accumulation of mutations associated with rifampicin resistance over time. Finally, household contacts to persons with rifampicin-resistant S. aureus will be examined to investigate whether onward transmission of rifampicin-resistant S. aureus occurs within households.

Detailed Description

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The use of rifampicin for treatment of latent tuberculosis has gained popularity due to a shorter treatment course compared with isoniazide (4 versus 6-9 months) since this can lead to a higher proportion of treatment completion. An estimated 25% of the global population is latently infected with tuberculosis. Hence, a shift towards rifampicin instead of isoniazide, which has a more narrow antibacterial spectrum, could have a large impact on the prevalence of rifampicin resistance among commensal bacteria with pathogenic potential, such as Staphylococcus aureus (S.aureus).

The investigators will investigate the risk of acquisition of rifampicin resistance in commensal S.aureus during out-patient treatment for latent tuberculosis using 4 months rifampicin versus 6-9 months isoniazide at Skåne University Hospital in Malmö, Sweden.

Swabs will be obtained from the nose, throat, groin and possible wounds for culture and resistance testing before, during and after cessation of treatment for latent tuberculosis. Whole genome sequencing will be used to analyze accumulation of mutations over time and to determine if it is the primarily detected S.aureus that develop resistance or if the individual is colonized by new, rifampicin-resistant S.aureus over the course of treatment. Household contacts to persons with rifampicin-resistant S.aureus will be examined to investigate onward spread of bacteria within a household.

Conditions

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Latent Tuberculosis Staphylococcus Aureus

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Persons with latent tuberculosis treated with 4 months rifampicin

Oral rifampicin 10 mg/kg (max 600mg) once daily during 4 months

No intervention is part of the study protocol

Intervention Type OTHER

No intervention is part of the study protocol. The choice of treatment for latent tuberculosis is is made by the treating physician.

Persons with latent tuberculosis treated with 6-9 months isoniazide

Oral isoniazide 5 mg/kg (max 300mg) once daily in combination with 40mg vitamin B6 (pyridoxin) during 6-9 months

No intervention is part of the study protocol

Intervention Type OTHER

No intervention is part of the study protocol. The choice of treatment for latent tuberculosis is is made by the treating physician.

Interventions

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No intervention is part of the study protocol

No intervention is part of the study protocol. The choice of treatment for latent tuberculosis is is made by the treating physician.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* diagnosed with latent tuberculosis
* prescribed either 4 months rifampicin or 6-9 months isoniazide
* informed consent

Exclusion Criteria

* none
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Region Skane

OTHER

Sponsor Role lead

Responsible Party

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Anton Reepalu

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Skåne University Hospital

Malmo, , Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Anton Reepalu, PhD

Role: CONTACT

+4640337818

Anna Nilsson, PhD

Role: CONTACT

+4640337760

Facility Contacts

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Anton Reepalu, MD PhD

Role: primary

Other Identifiers

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2021-02312

Identifier Type: -

Identifier Source: org_study_id

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