Urinary Tract Infections in Cirrhosis

NCT ID: NCT05335213

Last Updated: 2022-04-19

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

35 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-05

Study Completion Date

2024-04-05

Brief Summary

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Evaluate the prevalence and types of urinary tract infections, the features of the gut and urinary tract microbiota in cirrhosis, to assess its importance in the development of complications and outcomes of cirrhosis.

Detailed Description

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Asymptomatic bacteriuria in an individual without urinary tract symptoms is defined by a mid-stream sample of urine showing bacterial growth \> 105 cfu/mL in two consecutive samples in women and in one single sample in men. A complicated urinary tract infections occurs in an individual in whom factors related to the host (e.g. underlying diabetes or immunosuppression) or specific anatomical or functional abnormalities related to the urinary tract. Laboratory urine culture is the recommended method to determine the presence or absence of clinically significant bacteriuria.

Catheter-associated urinary tract infections refers to urinary tract infections occurring in a person whose urinary tract is currently catheterised or has been catheterised within the past 48 hours. Signs and systemic symptoms compatible with сatheter-associated urinary tract infections include new onset or worsening of fever, rigors, altered mental status, malaise, or lethargy with no other identified cause, flank pain, costovertebral angle tenderness, acute haematuria, pelvic discomfort and in those whose catheters have been removed dysuria, urgent or frequent urination and suprapubic pain or tenderness. Microbiologically, сatheter-associated urinary tract infections is defined by microbial growth of \> 103 cfu/mL of one or more bacterial species in a single catheter urine specimen or in a mid-stream voided urine specimen from a patient whose urethral, suprapubic, or condom catheter has been removed within the previous 48 hours.

Conditions

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Liver Cirrhosis Urinary Tract Infections

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Participants with cirrhosis and urinary tract infections

Participants collect urine and fecal specimens at first two days when they admit to hospital, after 7-10 days and last two days hospital treatment and during episodes of complications (variceal bleeding, hepatic coma, hepatorenal syndrome).

Urine samples take from patients via clean catch if the patient not have a catheter placed, otherwise take from urinary catheters if present. Straight catheterization utilize if the patient unable to void and doesn't have a catheter placed.

Fecal specimens collect using a toilet specimen collection kit. Clinical, standart laboratory and cultural test, molecular genetic methods, using 16S rRNA gene sequencing of the V4-V5 hypervariable region be administered.

16S rRNA gene sequencing

Intervention Type DIAGNOSTIC_TEST

DNA extraction and 16S rRNA gene sequencing DNA extraction, 16S rRNA gene amplification, and deep sequencing of the 16S rRNA amplicon performe.

The V4-V5 region of the 16S rRNA gene amplify with barcodes for multiplexing.

Participants with cirrhosis without urinary tract infections

Participants ask to collect urine and fecal specimens at first two days when they admit to hospital, after 7-10 days and last two days hospital treatment and during episodes of complications (variceal bleeding, hepatic coma, hepatorenal syndrome).

Urine samples take from patients via clean catch if the patient not have a catheter placed, otherwise take from urinary catheters if present. Straight catheterization utilize if the patient unable to void and doesn't have a catheter placed.

Fecal specimens collect using a toilet specimen collection kit. Clinical, standart laboratory and cultural test, molecular genetic methods, using 16S rRNA gene sequencing of the V4-V5 hypervariable region be administered.

16S rRNA gene sequencing

Intervention Type DIAGNOSTIC_TEST

DNA extraction and 16S rRNA gene sequencing DNA extraction, 16S rRNA gene amplification, and deep sequencing of the 16S rRNA amplicon performe.

The V4-V5 region of the 16S rRNA gene amplify with barcodes for multiplexing.

Interventions

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16S rRNA gene sequencing

DNA extraction and 16S rRNA gene sequencing DNA extraction, 16S rRNA gene amplification, and deep sequencing of the 16S rRNA amplicon performe.

The V4-V5 region of the 16S rRNA gene amplify with barcodes for multiplexing.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* clinical diagnosis of cirrhosis

Exclusion Criteria

* human immunodeficiency virus or acquired immune deficiency syndrome
* autoimmune diseases
* oncology
* organ transplantation
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gomel State Medical University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Igor Stoma, D.Sc.

Role: PRINCIPAL_INVESTIGATOR

Gomel State Medical University

Locations

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Gomel State Clinical Hospital №3

Homyel, Ilicha Str. 286, Belarus

Site Status RECRUITING

Countries

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Belarus

Central Contacts

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Ekaterina Malaeva, PhD

Role: CONTACT

+375 29 338 07 08

Facility Contacts

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Marina Menshakova, MD

Role: primary

53 37 83 ext. +375 232

References

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Arvaniti V, D'Amico G, Fede G, Manousou P, Tsochatzis E, Pleguezuelo M, Burroughs AK. Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis. Gastroenterology. 2010 Oct;139(4):1246-56, 1256.e1-5. doi: 10.1053/j.gastro.2010.06.019. Epub 2010 Jun 14.

Reference Type RESULT
PMID: 20558165 (View on PubMed)

Mestrovic T, Matijasic M, Peric M, Cipcic Paljetak H, Baresic A, Verbanac D. The Role of Gut, Vaginal, and Urinary Microbiome in Urinary Tract Infections: From Bench to Bedside. Diagnostics (Basel). 2020 Dec 22;11(1):7. doi: 10.3390/diagnostics11010007.

Reference Type RESULT
PMID: 33375202 (View on PubMed)

Neugent ML, Hulyalkar NV, Nguyen VH, Zimmern PE, De Nisco NJ. Advances in Understanding the Human Urinary Microbiome and Its Potential Role in Urinary Tract Infection. mBio. 2020 Apr 28;11(2):e00218-20. doi: 10.1128/mBio.00218-20.

Reference Type RESULT
PMID: 32345639 (View on PubMed)

Related Links

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https://pubmed.ncbi.nlm.nih.gov/20558165/

In patients with cirrhosis, infections increase mortality 4-fold; 30% of patients die within 1 month after infection and another 30% die by 1 year.

https://pubmed.ncbi.nlm.nih.gov/33375202/

Consequently, studying the relationship between gut microbiota and the subsequent development of bacteriuria and UTI represents an important field of research.

https://pubmed.ncbi.nlm.nih.gov/32345639/

The contribution of the urinary tract microbiome to urinary tract infection and recurrent urinary tract infection

Other Identifiers

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2.15

Identifier Type: -

Identifier Source: org_study_id

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