- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07569380
Long-Term Outcomes After CDI: FMT Versus Antibiotic-Only Treatment (LTO-CDI)
Long-Term Outcomes After Clostridioides Difficile Infection (CDI): Comparative Follow-Up of FMT Versus Antibiotic-Only Treatments (LTO-CDI Cohort)
The goal of this observational study is to learn about the long-term effects of fecal microbiota transplantation (FMT) compared with antibiotic-only treatment in adults who were treated for Clostridioides difficile infection (CDI) at Umeå University Hospital between 2016 and 2024. The main questions it aims to answer are:
- Do patients treated with FMT maintain higher gut bacterial diversity up to 10 years after CDI compared with patients treated with antibiotics only?
- Do donor gut bacteria introduced by FMT persist long-term in the recipient's gut?
- Are there differences in gut metabolism, gut barrier function, and systemic inflammation between FMT-treated and antibiotic-only treated patients at long-term follow-up?
- What are the long-term safety outcomes - including new diseases, hospitalizations, and mortality - in FMT-treated versus antibiotic-only treated patients?
Researchers will compare patients who received FMT to patients who received antibiotics only to see if FMT leads to lasting differences in gut microbiota, metabolism, immune markers, and clinical outcomes.
Participants will:
- Attend a single study visit at Umeå University Hospital
- Provide samples of blood, stool, urine, and a nasal swab
- Complete two quality-of-life questionnaires
Clinical data will be collected from medical records for all participants.
Přehled studie
Postavení
Podmínky
Detailní popis
Study design and setting This is a single-center, long-term observational cohort study conducted at the Department of Infectious Diseases, Umeå University Hospital, Sweden. The study enrolls adult patients treated for CDI between February 1, 2016 and December 31, 2024, providing up to 10 years of follow-up from the index CDI episode. Participants are stratified into two groups: FMT-treated and antibiotic-only treated.
CDI case definition Compatible clinical presentation (≥3 loose stools in 24 hours) plus a positive nucleic acid amplification test (LAMP) for C. difficile, consistent with ESCMID diagnostic criteria.
Recruitment Potentially eligible living subjects are identified from departmental diagnosis records and contacted by mail with written study information and an opt-out form. Those who do not return the opt-out form are contacted by telephone and invited to a single study visit for informed consent and enrollment. Deceased individuals are included in safety analyses only, without contact with next of kin.
Biological sampling Blood: EDTA plasma, serum, PBMC isolation Fecal sample Urine sample Nasopharyngeal swab
Archived donor fecal samples and pre- and post-FMT patient samples from the Umeå FMT biobank will be retrieved for longitudinal comparisons.
Observational measures Gut and nasopharyngeal microbiota will be characterized by shotgun metagenomics (strain-level resolution) and 16S rRNA sequencing. Resistome profiling and detection of multidrug-resistant organisms by culture will be performed on fecal samples. Global and targeted metabolomics (short-chain fatty acids, bile acids, redox metabolites) will be performed on feces, urine, and blood. Gut barrier markers in blood will include LPS, LPS-binding protein (LBP), and EndoCAb. Systemic immune profiling will include cytokine panels, soluble immune mediators, antibodies, and transcriptomic profiling of peripheral blood mononuclear cells. The host genome will not be sequenced. Clinical observational measures will include additional CDI after index CDI. Pharmacological treatments and comorbidity at index CDI and follow-up, as well as any antibiotic exposure during follow-up will be collected from the medical records.
Typ studie
Zápis (Odhadovaný)
Kontakty a umístění
Studijní kontakt
- Jméno: Johan Rasmuson, MD, PhD
- Telefonní číslo: 0046-907850000
- E-mail: johan.rasmuson@umu.se
Studijní místa
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Umeå, Švédsko
- Umea University Hospital
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Kontakt:
- Johan Rasmuson, MD, PhD
- Telefonní číslo: 0046-907850000
- E-mail: johan.rasmuson@umu.se
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Metoda odběru vzorků
Studijní populace
Popis
Inclusion Criteria:
- Adults aged 18 years or older
- Symptomatic, microbiologically verified index CDI from February 1 2016 to December 31 2024
- Having received CDI treatment at Umeå University Hospital (antibiotic-only or FMT)
Exclusion Criteria:
- Age below 18 years at follow-up
- Index CDI diagnosis not meeting ESCMID case definition
- Testing positive for another gastrointestinal pathogen (virus/bacteria) that is more plausible to explain the clinical picture at index CDI episode
- Declines participation
Studijní plán
Jak je studie koncipována?
Detaily designu
Kohorty a intervence
Skupina / kohorta |
|---|
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Antibiotic treatment
Participants having received antibiotic-only treatment for previous Clostridioides difficile infection.
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Fecal microbiota transplantation (FMT)
Participants having received FMT for previous Clostridioides difficile infection.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Intestinal microbiota diversity
Časové okno: At follow-up visit 1-10 years after baseline CDI
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Intestinal microbiota diversity assessed by metagenomic sequencing of stool samples.
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At follow-up visit 1-10 years after baseline CDI
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Donor gut microbiota long-term engraftment
Časové okno: At follow-up visit 1-10 years after baseline CDI
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Assessment of donor gut microbiota engraftment in participants stool samples 1-10 years post FMT, performed by metagenomic sequencing.
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At follow-up visit 1-10 years after baseline CDI
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Stool short-chain fatty acid concentrations
Časové okno: At follow-up visit 1-10 years after baseline CDI
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Stool short-chain fatty acid concentrations assessed using metabolomic methods.
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At follow-up visit 1-10 years after baseline CDI
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Circulating markers of intestinal barrier function
Časové okno: At follow-up visit 1-10 years after baseline CDI
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Circulating biomarkers related to intestinal barrier function measured in peripheral blood.
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At follow-up visit 1-10 years after baseline CDI
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Health-related quality of life
Časové okno: At follow-up visit 1-10 years after baseline CDI
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Patient-reported health-related quality of life assessed using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L).
The descriptive system comprises five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each with five levels (no problems to extreme problems), producing a 5-digit health state profile.
Higher index values indicate better health-related quality of life.
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At follow-up visit 1-10 years after baseline CDI
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Number of participants with new Clostridioides difficile infection episodes after subsequent antibiotic exposure
Časové okno: Within 1-10 years after baseline CDI
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Occurrence of new Clostridioides difficile infection episodes following exposure to non-CDI antibiotic treatment during follow-up.
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Within 1-10 years after baseline CDI
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Incidence of new comorbidities after FMT versus antibiotic-only treatment
Časové okno: From baseline CDI to 1-10 year follow-up or prior death
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Incidence of new diagnoses (autoimmune, autoinflammatory, neoplastic, and metabolic conditions) in FMT-treated participants compared with antibiotic-only treated participants, ascertained from medical records using ICD-10 diagnostic codes.
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From baseline CDI to 1-10 year follow-up or prior death
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Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Vyšetřovatelé
- Vrchní vyšetřovatel: Johan Rasmuson, MD, PhD, Umeå University, Department of Clinical Microbiology
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- LTO-CDI
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Informace o lécích a zařízeních, studijní dokumenty
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Studuje produkt zařízení regulovaný americkým úřadem FDA
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