- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03967301
Prevention and Decolonization of Multidrug-resistant Bacteria With Probiotics
Prevention and Decolonization of Carbapenemase-producing Enterobacteriaceae With Probiotics
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The use of antibiotics is known to have significant effects on the intestinal microbiota. Studies have linked this alteration with the risk of colonization and / or infection by Carbapenem resistant Enterobacteriaceae (CRE) and / or Clostridium difficile (Cd). The impact of these microorganisms has been demonstrated, with mortality rates in inpatients of around 30-50% for patients infected with CRE and 10% in Cd. It is necessary to implement mechanisms to contain dissemination and decrease colonization, in order to prevent infections caused by such agents.
Probiotics are foods consisting of live microorganisms and could restore the balance of the microbiota and avoid colonization by multi-resistant germs. Systematic reviews have shown a protective effect of probiotics for Cd. Studies on the effect on CRE are scarce and have been related mostly to prevention of colonization. Among the probiotics obtained by bacterial fermentation technology and already available in pharmacopoeia we have Bioflora ®. The objective of this trial is to explore the effect of probiotic consumption to decrease the duration of the colonization by CRE by comparing the percentage of patients colonized with CRE after the administration of probiotics and in the untreated group.
Methodology: Randomized clinical trial, single center. Known CRE colonized patients will be randomized to consume probiotics for 14 days or placebo. Then the colonization will be evaluated by means of anal swabs as indicated by the hospital standards with a follow up of 12 weeks from the initial intervention.
If the patient is discharged, home follow-up will be scheduled to supervise the intake of the dietary supplement and the control swabs.
The expected impact is to accelerate the process of decolonization of multi-resistant germs through the administration of probiotics leading to a shorter contact isolation time in and reducing the risk of complications in CRE colonized patients.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Maria I Staneloni, MD
- Phone Number: 1536670333.
- Email: maria.staneloni@hospitalitaliano.org.ar
Study Contact Backup
- Name: Sol Burokas, MD
- Phone Number: 8165 541149590200
- Email: maria.burokas@hiba.org.ar
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- CRE- colonized patients
- adult patients in hospital (over 18 years old)
- Part of the HIBA health care plan
- CRE positive rectal swab or stool in the last 14 days
Exclusion criteria:
- Enteral route enabled (oral, nasogastric tube, gastrostomy or jejunostomy)
- Refusal to participate in the study
- Not available for weekly checks, minimum up to 12 weeks from enrollment
- Clostridium difficile active infection concomitant with CRE swab in a 14-day period days
- Neutropenia G3 or greater (less than 1000 neutrophils at the time of enrollment).
- Severe immunosuppressed at the time of recruitment according to the CDC definition (patients transplanted, HIV with CD4 <200, congenital immunodeficiencies, leukemias, lymphomas, cancer disseminated, current chemotherapy or radiotherapy, treatment with corticoids high dose:prednisone 20 mg / d> 2 weeks or immunosuppressive drugs).
- Patient with valvular prostheses
- Imminent death
- Fistula or dehiscence of the gastrointestinal tract
- Acute pancreatitis
- Patient of critical units in ileus and / or with high requirement of vasopressors (noradrenaline equal to or greater than 0.5 gammas) at the time of recruitment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Probiotic isolated intestinal bacteria (active)
Patients randomized to active arm, will consume 5ml every 12 hours per day of a suspension of probiotics (Bioflora ® Lactobacillus casei, Lactobacillus plantarum, Streptococcus faecalis y Bifidobacterium brevis) for 14 days.The content of each bottle is reconstituted up to 50 ml (10 doses) with drinking water The prescription of the intervention will be carried out and monitored through the electronic medical record.
In the hospital setting, the probiotic is reconstituted by the nursing staff.
If the patient is discharged before this period the patient and family will be instructed to perform the reconstitution at home.
|
Intervention: defined as probiotic consumption
|
Placebo Comparator: Placebo
Patients randomized to the placebo arm, will consume 5ml every 12 hours per day of a suspension of placebo for 14 days.
The prescription of the intervention will be carried out and monitored through the electronic medical record.
|
Placebo consumption.
The placebo will be provided by the company that produces the probiotic.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
presence of CRE in anal swab or stool culture in follow-up control:
Time Frame: 12 weeks
|
CRE anal swab positive upon discharge, therapeutic adjustment or in-hospital death. ● Date of swab, therapeutic adjustment or in-hospital death. and within a month : ● Control CRE swab per month for KPC: Categorical binomial: Positive / Negative. Will be performed 30 days after enrollment and weekly for 8 weeks if positive. It will be considered negative when the patient as three consecutive negative swabs separated by a week. It will be persistently positive when during this period of follow-up at least one of the swabs is positive, total follow-up 12 weeks |
12 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
positive for clostridium difficile diarrhea
Time Frame: 12 weeks
|
If a patient develops diarrhea at some point during hospitalization, screening for Cd will be performed at the attending phisician´s discretion If the patient has diarrhea with a positive Cd toxin and is receiving probiotic he/she should leave the study and the data for CRE will be evaluated with the last available swab at the time of the exit event (positive for clostridium difficile diarrhea). |
12 weeks
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 3738
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
Clinical Trials on Probiotics
-
Sanjay Gandhi Postgraduate Institute of Medical...Indian Council of Medical ResearchCompleted
-
Cheng-Hsin General HospitalCompleted
-
Mackay Memorial HospitalBened Biomedical Co., Ltd.Completed
-
Stanford UniversityCompleted
-
Texas Christian UniversityCompleted
-
University of TurkuUniversity of Michigan; The Forsyth InstituteCompleted
-
Chang Gung Memorial HospitalGlac Biotech Co., LtdRecruiting
-
Taipei Medical University Shuang Ho HospitalTaipei Medical University; Delta ElectronicsUnknownProbiotics | Vancomycin-Resistant EnterococciTaiwan
-
Chr HansenUniversity of Copenhagen; Herlev HospitalCompleted
-
Lund UniversityRecruitingProbiotics | Healthy Diet | Gastrointestinal MicrobiomeSweden
Clinical Trials on Probiotic
-
King's College Hospital NHS TrustCompleted
-
Fudan UniversityInner Mongolia Yili Industrial Group Co., LtdCompletedObesity | AdiposityChina
-
Centros de Investigación de Nutrición y SaludNutribioticaCompletedFunctional ConstipationSpain
-
Universiti Kebangsaan Malaysia Medical CentreUnknownHypertension | Obesity | Type 2 Diabetes Mellitus | HyperlipidemiaMalaysia
-
Maastricht University Medical CenterCompleted
-
Fundació Sant Joan de DéuCompleted
-
University of LeedsUnknown
-
Centro Pediatrico Albina de PatinoCompletedAcute Gastroenteritis | Acute DiarrheaBolivia
-
BiocodexCompletedAcute GastroenteritisArgentina
-
Deivis de Oliveira guimaraesCompletedParkinson Disease | Alzheimer DiseaseBrazil