Impact of the Contamination Mode on the Clinical Evolution During Pseudomonas Aeruginosa Ventilator Acquired Pneumonia (PYO GEN) (PYO GEN)

Impact of the Contamination Mode on the Clinical Evolution During Pseudomonas Aeruginosa Ventilator Acquired Pneumonia

Pseudomonas aeruginosa is the main pathogen of nosocomial respiratory infections. Its increasing resistance to antibiotics requires the development of new strategies for prevention and control, demanding a better understanding of the modes of transmission and evolutionary dynamics of this bacteria. In patients under invasive mechanical ventilation, the main mode of contamination by Pseudomonas remains debated, with 3 modes of contamination (endogenous, crossed transmission between patients, or environmental origin) of varying importance, mainly depending on the endemic situation of the place of study.

The emergence of new genotyping technologies (DiversiLab) can now facilitate studies of molecular epidemiology. Thanks to the multidisciplinary collaboration and innovative techniques, the investigators wish to study the impact of the mode of contamination on the outcome of ICU patients, intubated and ventilated for more than 72 hours.

Study Overview

• Status: Completed
• Conditions: Pseudomonas Aeruginosa; Ventilation Acquired Pneumonia

Detailed Description

The presence of environmental reservoirs can cause infections and multidrug-resistant P. aeruginosa colonization with P. aeruginosa is itself a prognostic factor, but the impact of the route of infection on the evolution of the history and future of the infectious patient is not established.

A second factor that may influence the evolution infectious is the degree of genetic heterogeneity of the bacterial population. Multiple exposure pathways could also influence the genetic diversity.

• Study Type: Observational
• Enrollment (Actual): 77

Contacts and Locations

Study Locations

• France
  • Isère
    • Grenoble, Isère, France, 38700
      • Medical ICU of Universitary Hospital of Grenoble

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

ICU patients over 72 hours of intubation and mechanically ventilated

Description

Inclusion Criteria:

• Patients> 18 years
• hospitalized in the intensive care unit
• with more than 72 hours of mechanical ventilation
• Presenting a positive bacteriological sample P. aeruginosa.

Exclusion Criteria:

• Minors.
• Pregnant or lactating women.
• Patients under guardianship, under judiciary placement, or hospitalized without their consent.
• Patients not affiliated to a social security scheme.
• Long-term corticosteroid therapy (> 2mg/kg or> 1 month before the onset of established infection suspected)
• Ongoing chemotherapy, AIDS, transplant patient under immunosuppressive drugs.
• Bedridden patient or therapeutic decision at ICU arrival

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Intubated ICU patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The occurrence of unfavorable patient's outcome, depending on the mode of contamination, such as persistence, relapse or superinfection of the airways at Day 7, and mortality at Day 28	From day 3 of intubation until the end of mechanical ventilation (an average of 28 days).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of different clones of P. aeruginosa found in each sample analyzed for the same patient at diagnosis of colonization and VAP.	Samples of infected patients are analyzed once a week, strains are considered from different clones if their genetic homology rate is below 97%	From day 3 of intubation until the end of mechanical ventilation (an average of 28 days).

Collaborators and Investigators

• Sponsor: University Hospital, Grenoble

Study record dates

Study Major Dates

• Study Start: July 3, 2013
• Primary Completion (Actual): June 2, 2015
• Study Completion (Actual): June 2, 2015

Study Registration Dates

• First Submitted: October 8, 2012
• First Submitted That Met QC Criteria: December 6, 2012
• First Posted (Estimate): December 10, 2012

Study Record Updates

• Last Update Posted (Actual): November 8, 2022
• Last Update Submitted That Met QC Criteria: November 7, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

• Keywords: Pseudomonas Aeruginosa; Ventilated Acquired Pneumonia; Transmission modes
• Additional Relevant MeSH Terms: Pathologic Processes; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Lung Diseases; Disease Attributes; Gram-Negative Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Cross Infection; Iatrogenic Disease; Healthcare-Associated Pneumonia; Pneumonia; Pneumonia, Ventilator-Associated; Pseudomonas Infections
• Other Study ID Numbers: 12SC02