Next Generation Sequencing Versus Traditional Cultures for Clinically Infected Penile Implants: Impact of Culture Identification on Outcomes

NCT ID: NCT05287438

Last Updated: 2022-03-18

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

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-27

Study Completion Date

2024-10-31

Brief Summary

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Randomized prospective study to evaluate next generation sequencing (NGS) and standard-of-care culture for clinically infected penile implants and to compare outcomes with identification of microbes.

Detailed Description

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Randomized prospective study to evaluate next generation sequencing (NGS) and standard-of-care culture for clinically infected penile implants and to compare outcomes with identification of microbes. Eligible subjects will undergo a baseline/screening visit at which time the following will be collected: demographics/history/known allergies to antibiotics, symptom scoring questionnaire. Drainage swabs OR needle aspiration will be collected for standard culture and PCR/NGS and empiric antibiotics will start.

Subjects will be randomized into the culture arm or the NGS arm. If randomized to NGS: central ID reviews result according to arm and offers recommendations. Physician will treat based on antibiotic recommendations (based on positive PCR/NGS or positive culture, if negative then empiric treatment will be continued) adjusted for patients contraindications and co-morbidities If randomized to the traditional culture arm: Physician will follow routine local standard of care.

A follow-up visit will occur within 10 days of starting empiric antibiotic therapy to collect symptoms scoring questionnaire. A 2nd and final visit will occur 6 months after baseline to collect similar data to the 1st follow up visit.

Conditions

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Penile Implantation Infections

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Group A will receive results based on standard culture and Group B will receive results based on NGS
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Group A - Culture

Following local standard of care, treatment will be based on standard culture

Group Type ACTIVE_COMPARATOR

Standard Culture

Intervention Type DIAGNOSTIC_TEST

Standard of care culture and sensitivity

Group B - NGS

Treatment will be based on NGS results reviewed by an infectious disease doctor

Group Type EXPERIMENTAL

Next-Generation DNA Sequencing

Intervention Type DIAGNOSTIC_TEST

NGS is a technique of microbiological sequencing, using 16s ribosomal RNA molecular identification has been implemented to detect bacteria and fungi present in the sample

Interventions

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Next-Generation DNA Sequencing

NGS is a technique of microbiological sequencing, using 16s ribosomal RNA molecular identification has been implemented to detect bacteria and fungi present in the sample

Intervention Type DIAGNOSTIC_TEST

Standard Culture

Standard of care culture and sensitivity

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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NGS

Eligibility Criteria

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Inclusion Criteria

* Male penile prosthesis patients
* Age range: 18-80
* Within 6 months of penile prosthesis surgery
* At least 1 of the following: Device part stuck to thinning skin, any drainage from the wound site, massive red and swollen genitalia parts, exposed penile prosthesis parts, draining open tract, draining hematoma

Exclusion Criteria

* Transgender / neophallus
* Not able to communicate or follow up well, or non-compliant
* Less than 18 or more than 80 years old
* Active addiction
* Main issue is implant pain
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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MicroGenDX

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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WK Advanced Urology

Bossier City, Louisiana, United States

Site Status RECRUITING

Duke University

Raleigh, North Carolina, United States

Site Status RECRUITING

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Ryan Griggs, MD

Role: primary

318-212-7335

Adi Molvin, RN, BSN

Role: primary

919-681-4990

Paul Chung, MD

Role: primary

215-955-1000

References

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Carrasquillo RJ, Munarriz RM, Gross MS. Infection Prevention Considerations for Complex Penile Prosthesis Recipients. Curr Urol Rep. 2019 Feb 1;20(3):12. doi: 10.1007/s11934-019-0875-7.

Reference Type BACKGROUND
PMID: 30707308 (View on PubMed)

Krzastek SC, Smith R. An update on the best approaches to prevent complications in penile prosthesis recipients. Ther Adv Urol. 2019 Jan 8;11:1756287218818076. doi: 10.1177/1756287218818076. eCollection 2019 Jan-Dec.

Reference Type BACKGROUND
PMID: 30671142 (View on PubMed)

Carvajal A, Benavides J, Garcia-Perdomo HA, Henry GD. Risk factors associated with penile prosthesis infection: systematic review and meta-analysis. Int J Impot Res. 2020 Nov;32(6):587-597. doi: 10.1038/s41443-020-0232-x. Epub 2020 Feb 3.

Reference Type BACKGROUND
PMID: 32015525 (View on PubMed)

Mahon J, Dornbier R, Wegrzyn G, Faraday MM, Sadeghi-Nejad H, Hakim L, McVary KT. Infectious Adverse Events Following the Placement of a Penile Prosthesis: A Systematic Review. Sex Med Rev. 2020 Apr;8(2):348-354. doi: 10.1016/j.sxmr.2019.07.005. Epub 2019 Sep 10.

Reference Type BACKGROUND
PMID: 31519461 (View on PubMed)

Carrasquillo RJ, Gross MS. Infection Prevention Strategies Prior to Penile Implant Surgery. Eur Urol Focus. 2018 Apr;4(3):317-320. doi: 10.1016/j.euf.2018.07.002. Epub 2018 Jul 13.

Reference Type BACKGROUND
PMID: 30017899 (View on PubMed)

Levy PY, Fenollar F. The role of molecular diagnostics in implant-associated bone and joint infection. Clin Microbiol Infect. 2012 Dec;18(12):1168-75. doi: 10.1111/1469-0691.12020.

Reference Type BACKGROUND
PMID: 23148447 (View on PubMed)

Salimnia H, Fairfax MR, Lephart PR, Schreckenberger P, DesJarlais SM, Johnson JK, Robinson G, Carroll KC, Greer A, Morgan M, Chan R, Loeffelholz M, Valencia-Shelton F, Jenkins S, Schuetz AN, Daly JA, Barney T, Hemmert A, Kanack KJ. Evaluation of the FilmArray Blood Culture Identification Panel: Results of a Multicenter Controlled Trial. J Clin Microbiol. 2016 Mar;54(3):687-98. doi: 10.1128/JCM.01679-15. Epub 2016 Jan 6.

Reference Type BACKGROUND
PMID: 26739158 (View on PubMed)

Tzeng A, Tzeng TH, Vasdev S, Korth K, Healey T, Parvizi J, Saleh KJ. Treating periprosthetic joint infections as biofilms: key diagnosis and management strategies. Diagn Microbiol Infect Dis. 2015 Mar;81(3):192-200. doi: 10.1016/j.diagmicrobio.2014.08.018. Epub 2014 Nov 5.

Reference Type BACKGROUND
PMID: 25586931 (View on PubMed)

Other Identifiers

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MDX-002

Identifier Type: -

Identifier Source: org_study_id

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