Optimizing Mastitis Identification and Treatment

NCT ID: NCT05794945

Last Updated: 2023-10-30

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

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-10-01

Study Completion Date

2027-06-30

Brief Summary

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The goal of this observational study is to gain more information about the aetiology and progression of mastitis and breast inflammation, in order to develop evidence-based clinical guidelines and treatment plans, especially concerning judicious use of antibiotics.

The main questions it aims to answer are:

* Do clinical symptoms differ between inflammatory and infectious mastitis?
* What is the microbial composition in human milk, and does it change before, during, and after episodes of mastitis?
* Does the bacterial composition change due to antibiotic treatment?
* Are all mastitis episodes treated with antibiotics bacterial mastitis?
* Do mothers with recurrent mastitis have a distinct microbial composition?
* Are there immunological markers that can differentiate between bacterial and inflammatory mastitis?

Researchers will compare breastfeeding women with and without mastitis to see if the microbiological composition in milk and on the skin of the breast and breast nipple differs.

Detailed Description

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Mastitis (breast inflammation) is experienced by up to one-fifth of all breastfeeding mothers. Mastitis is a painful condition and a leading cause of early weaning, an undesired outcome with potentially negative implications for both mother and baby. Empirical evidence explaining the aetiology of mastitis is lacking; thus the definitions and treatment of mastitis is conflicting. The recent mechanobiological model proposes that the mechanical forces of lactation, especially at the onset of milk production, can cause damage to the mammary tissue, which induces an inflammatory response. Concurrently a growing amount of evidence shows that bacteria previously written off as contaminants have a role in mastitis which has been overlooked. The dynamics between the mechanobiological model and bacterial colonization have not yet been investigated. To fill this knowledge gap, researchers will conduct a longitudinal study collecting milk samples and questionnaires during the breastfeeding period with a particular emphasis on mastitis. Milk and skin swab samples will be used for culture dependent and culture independent assessment of the microbial composition in mastitis, and will be compared to the composition found in mothers without mastitis.

The main objective of this clinical study is to gather empirical data to provide an evidence-based update to the clinical guidelines for mastitis diagnosis and care. This will provide a foundation for improving the treatment and prevention of mastitis, with better outcomes for mothers and newborns.

Conditions

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Mastitis Postpartum

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Breastfeeding mothers

In this study breastfeeding mothers will be included. Samples will be collected from breast-feeding mothers experiencing mastitis Samples will be collected from breast-feeding mothers after the mastitis episode is resolved Breastfeeding mothers will be sampled at each mastitis episode, and with the final sample collected after a maximum of 12 months

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Pregnant mothers aged \> 18
* mothers must understand information given in Norwegian or English
* participants must be willing to complete study questionnaires
* participants must be willing to and provide biological samples
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Norwegian Institute of Public Health

OTHER_GOV

Sponsor Role collaborator

The University of Western Australia

OTHER

Sponsor Role collaborator

Helse Nord

INDUSTRY

Sponsor Role collaborator

University of Tromso

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jorunn Pauline Cavanagh, PhD

Role: PRINCIPAL_INVESTIGATOR

The Arctic university of Norway-UiT

Locations

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Tromsø municipality, health centre

Tromsø, Troms, Norway

Site Status RECRUITING

UiT-The Arctic University of Norway

Tromsø, , Norway

Site Status RECRUITING

Countries

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Norway

Central Contacts

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Jorunn Pauline Cavanagh, PhD

Role: CONTACT

40498490 ext. 47

Claus Klingenberg, MD, PhD

Role: CONTACT

91563167 ext. 47

Facility Contacts

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Pauline Cavanagh, PhD

Role: primary

References

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Wilson E, Woodd SL, Benova L. Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review. J Hum Lact. 2020 Nov;36(4):673-686. doi: 10.1177/0890334420907898. Epub 2020 Apr 14.

Reference Type RESULT
PMID: 32286139 (View on PubMed)

Mitchell KB, Johnson HM, Rodriguez JM, Eglash A, Scherzinger C, Zakarija-Grkovic I, Cash KW, Berens P, Miller B; Academy of Breastfeeding Medicine. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeed Med. 2022 May;17(5):360-376. doi: 10.1089/bfm.2022.29207.kbm.

Reference Type RESULT
PMID: 35576513 (View on PubMed)

Grzeskowiak LE, Saha MR, Ingman WV, Nordeng H, Ystrom E, Amir LH. Incidence, antibiotic treatment and outcomes of lactational mastitis: Findings from The Norwegian Mother, Father and Child Cohort Study (MoBa). Paediatr Perinat Epidemiol. 2022 Mar;36(2):254-263. doi: 10.1111/ppe.12824. Epub 2021 Nov 28.

Reference Type RESULT
PMID: 34841537 (View on PubMed)

Castro I, Garcia-Carral C, Furst A, Khwajazada S, Garcia J, Arroyo R, Ruiz L, Rodriguez JM, Bode L, Fernandez L. Interactions between human milk oligosaccharides, microbiota and immune factors in milk of women with and without mastitis. Sci Rep. 2022 Jan 25;12(1):1367. doi: 10.1038/s41598-022-05250-7.

Reference Type RESULT
PMID: 35079053 (View on PubMed)

Other Identifiers

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2023/578416 (REK)

Identifier Type: -

Identifier Source: org_study_id

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