- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03190421
Expanded Quantitative Urinary Culture (EQUC) vs Standard Culture (SUC) Techniques in the Clinical Care
June 11, 2020 updated by: Elizabeth Mueller, Loyola University
The Use of Expanded Quantitative Urinary Culture (EQUC) Versus Standard Culture (SUC) Techniques in the Clinical Care of Women With Symptoms of Urinary Tract Infections.
This purpose of this study is to see if expanded urine culture techniques used in the laboratory improve the clinical care of women over standard urine culture techniques.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
The investigators request permission to recruit 225 women who respond "yes" to the question "do you feel you have a urinary tract infection".
All participants will provide baseline urine specimens obtained by transurethral catheter (to avoid vulvo-vaginal contamination) and will complete a UTISA questionnaire to assess their current urinary tract symptoms.
Participants will be randomized to the SUC treatment algorithm or the EQUC treatment algorithm.
Treating physicians will receive either the SUC results or the EQUC results from the clinical laboratory and the results will be part of their clinical record.
Treating physicians will follow the Loyola FPMRS treatment algorithm.
Women in the study will also give consent for us to contact them using email, text messaging or phone call within 7-10 days after "treatment plan" has been implemented.
The treatment plan options will include no treatment if the culture results show no pathogenic bacteria.
All participants will be queried 7-10 days after their treatment plan (by email or text) "do you feel you continue to have a urinary tract infection".
Women who respond "yes' will be asked to return for a second urine specimen which is our standard protocol.
The second urine specimen will be analyzed using EQUC culture techniques only.
Again, a treatment plan will be developed by the attending physician and the patient participant will be queried 7-10 days after the plan is implemented.
Study Type
Interventional
Enrollment (Actual)
225
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Illinois
-
Maywood, Illinois, United States, 60153
- Loyola University Medical Center
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- A "yes" answer to the screening question "do you feel you have a UTI"?
- Non-pregnant women ages 18 years or older
- Agreement to respond to a text or email question 7-10 days after treatment plan for their UTI (note: the treatment plan may include "no treatment").
Exclusion Criteria:
- Women currently on antibiotics
- Patients who cannot communicate or read in English
- Patients under the age of 18
- Pregnant patients
- Women with an indwelling catheter and intermittent self-catheterization
- Men
- Urine obtained via the "clean catch method" (i.e. voided urine)
- Women who refuse to be catheterized
- Women who cannot or will not agree to respond to an email or text message 7-10 days after treatment plan is initiated.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Expanded Urinary Culture (EQUC)
Participants in this arm will receive the expanded urine culture
|
involves the inoculation of 100X (0.1mL) more urine onto diverse types of media (BAP, chocolate agar, colistin and nalidixic acid (CNA) agar, CDC anaerobe 5% BAP) with incubation in more environments and temperatures (5% CO2 at 35°C for 48 h, aerobic conditions at 35°C and 30°C for 48 h, Campy gas mixture (5% O2, 10% CO2, 85% N) or anaerobic conditions at 35°C for 48 h).
The level of detection for EQUC is 10 CFU/mL, represented by 1 colony of growth on any of the plates.
EQUC is designed to isolate a broad array of Gram-negative and Gram-positive bacteria, including anaerobes and fastidious bacteria that grow slowly.
|
Active Comparator: Standard Urine Culture (SUC)
Participants in this arm will receive the standard urine culture
|
involves inoculation of 0.001 mL of urine onto 5% sheep blood agar plate (BAP) and MacConkey agar plate with the plates being incubated aerobically at 35°C for 24 h.
Thus, the level of detection for standard culture is 103 CFU/mL, represented by 1 colony of growth on either plate.
Standard culture is designed specifically to grow Gram-negative rods, especially UPEC.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Compare UTI symptom resolution rates in women with symptoms of UTI who are treated based on EQUC versus SUC results.
Time Frame: 4 weeks
|
Using the FPMRS treatment algorithms (see appendix I & II Standard Urine Culture Treatment and Expanded Urine Culture Treatment Algorithms), attending physicians will treat participants based on their randomization to EQUC versus SUC.
Following a 3-5 day standard course of treatment (which may include no antibiotics if the culture is negative), participants will be queried 7-10 days "do you continue to have UTI symptoms".
Women who report "no" will be categorized as successful treatment, women who respond "yes" will be categorized as treatment failures.
|
4 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Revise the EQUC treatment algorithm.
Time Frame: 6 months
|
The EQUC treatment algorithm was based on known uropathogens that we had previously identified as most likely to be symptomatic.
During the course of this work we may identify other pathogens that are present and causing symptoms.
These organisms will be identified and added to the treatment algorithm.
This interim analysis is planned and was part of the statistical calculations to determine sample size.
|
6 months
|
Identify the symptom profile associated with specific organisms.
Time Frame: 1 year
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Using the UTISA questionnaire, we will perform a symptoms association study with specific bacteria.
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1 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Elizabeth Mueller, MD, Loyola University
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- KASS EH. Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians. 1956;69:56-64. No abstract available.
- Maskell R, Pead L, Allen J. The puzzle of "urethral syndrome": a possible answer? Lancet. 1979 May 19;1(8125):1058-9. doi: 10.1016/s0140-6736(79)92953-2.
- Yuan S, Cohen DB, Ravel J, Abdo Z, Forney LJ. Evaluation of methods for the extraction and purification of DNA from the human microbiome. PLoS One. 2012;7(3):e33865. doi: 10.1371/journal.pone.0033865. Epub 2012 Mar 23.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 15, 2017
Primary Completion (Actual)
March 30, 2020
Study Completion (Actual)
April 30, 2020
Study Registration Dates
First Submitted
June 14, 2017
First Submitted That Met QC Criteria
June 14, 2017
First Posted (Actual)
June 16, 2017
Study Record Updates
Last Update Posted (Actual)
June 16, 2020
Last Update Submitted That Met QC Criteria
June 11, 2020
Last Verified
June 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 209545
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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