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The Epidemiology of Ventricular Assist Device-Related Infections

15 novembre 2011 aggiornato da: Icahn School of Medicine at Mount Sinai

Infections often occur after ventricular assist devices (VADs) are placed. These infections can be very serious. The goal of this study is to understand why these infections occur. Bacteria (germs) normally live on our skin and in our noses. After surgery, they can infect the VAD. The investigators will collect cultures of your skin and nose before and after surgery. The investigators will compare these bacteria to bacteria that cause infections. Their genes will be compared to see which ones help the bacteria cause infection.

Panoramica dello studio

Stato

Completato

Condizioni

Insufficienza cardiaca congestizia

Descrizione dettagliata

Infections are one of the most serious of ventricular assist device (VAD) related complications. Many of these infections are associated with significant patient morbidity and mortality. Diagnosis of these infections is often difficult due to the complicated nature of the patient's medical problems, the need for rapid institution of empiric antibiotic therapy and the lack of established criteria that define infection. Staphylococci are among the most common causes of VAD infections. The basis for this high incidence is not well understood but is believed to be in part due to inoculation of staphylococcal commensal flora into wound sites at the time of surgery or thereafter. The goals of this observational study are to develop a better understanding of the pathogenesis and epidemiology of Staphylococcus aureus and epidermidis-VAD infections as well as to develop a set of criteria that can be used to help diagnose the presence or absence of a VAD related infection.

This is a prospective, multi-center, observational study to identify risk factors associated with the development of VAD-related infections. Patients will be followed for up to one year following VAD implantation, time of death or transplantation, whichever comes first. There will be no randomization for this observational study.

Tipo di studio

Osservativo

Iscrizione (Effettivo)

150

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

Stati Uniti
- Alabama
  - Birmingham, Alabama, Stati Uniti, 35294
    - University of Alabama at Birmingham
- California
  - San Diego, California, Stati Uniti, 92123
    - Sharp Memorial Hospital
- Illinois
  - Oak Lawn, Illinois, Stati Uniti, 60453
    - Advocate Christ Medical Center
- Kentucky
  - Louisville, Kentucky, Stati Uniti, 40202
    - Jewish Hospital
- Michigan
  - Ann Arbor, Michigan, Stati Uniti, 48109
    - University of Michigan
- Minnesota
  - Minneapolis, Minnesota, Stati Uniti, 55455
    - University of Minnesota
- New York
  - Bronx, New York, Stati Uniti, 10467
    - Montefiore Medical Center
  - New York, New York, Stati Uniti, 10032
    - Columbia Presbyterian Medical Center
- Pennsylvania
  - Philadelphia, Pennsylvania, Stati Uniti, 19104
    - Hospital of the University of Pennsylvania
- Utah
  - Salt Lake City, Utah, Stati Uniti, 84143
    - LDS Hospital
- Washington
  - Spokane, Washington, Stati Uniti, 99204
    - Sacred Heart Medical Center
- Wisconsin
  - Madison, Wisconsin, Stati Uniti, 53792
    - University of Wisconsin Hospital
  - Milwaukee, Wisconsin, Stati Uniti, 53215
    - St. Luke's Medical Center

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

Sessi ammissibili allo studio

Tutto

Metodo di campionamento

Campione di probabilità

Popolazione di studio

Patients with end-stage heart failure who demonstrate the need for intermediate or long-term support with a VAD.

Descrizione

Inclusion Criteria:

Age greater than or equal to 18 years.
Approved by the institution's heart failure/transplant committee for VAD implantation, either as a bridge to cardiac transplantation or for destination therapy for end-stage heart failure.
Signed informed consent, release of medical information, and HIPAA forms.
Expectation of compliance with protocol procedures and study visit schedule.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

Coorti e interventi

Gruppo / Coorte Gruppo / Coorte Un gruppo o sottogruppo di partecipanti a uno studio osservazionale che viene valutato per gli esiti biomedici o sanitari.
Study Population 150 subjects with end-stage heart failure who have been scheduled to undergo device implantation with a VAD, either as a bridge to cardiac transplantation or for destination therapy.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato	Misura Descrizione	Lasso di tempo
The incidence of suspected infections, characterized by infecting organism and location. Lasso di tempo: Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.	The primary goal is to collect information that describes infections in patients receiving LVADs.	Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.

Misure di risultato secondarie

Misura del risultato	Misura Descrizione	Lasso di tempo
Collect and quantify culture results for suspected infections and the secondary manifestations of infection Lasso di tempo: Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.	Bacteria normally live on our skin and in our noses.After surgery, they can infect the VAD. We will collect cultures before and after surgery and compare these bacteria to bacteria that cause infections.Their genes will be compared to see which ones help the bacteria cause infection. We hope this will help develop new ways to help prevent VAD infections.	Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.
Develop Guidelines to properly diagnose VAD infections Lasso di tempo: Up to one year following VAD implantation, time of death or transplantation, whichever comes first.	Information will be collected on patient's medical condition after surgery including blood tests to help determine if an infection is present.	Up to one year following VAD implantation, time of death or transplantation, whichever comes first.
Costs (direct) Lasso di tempo: Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.	The value of all resources that are consumed in the provision of an intervention or dealing with the side-effects or other current and future consequences linked to it.	Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.
Adverse Events Lasso di tempo: Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.	Since this is an observational study there will be no adverse events directly attributable to a study intervention. However, adverse events that might potentially contribute to the risk or course of VAD-related infections will be monitored.	Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Icahn School of Medicine at Mount Sinai

Collaboratori

National Heart, Lung, and Blood Institute (NHLBI)

Investigatori

Investigatore principale: Michael Parides, PhD, Icahn School of Medicine at Mount Sinai
Direttore dello studio: Patrice Desvigne-Nickens, National Heart, Lung, and Blood Institute (NHLBI)
Cattedra di studio: Yoshifumi Naka, MD, Columbia University

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 gennaio 2006

Completamento primario (Effettivo)

1 gennaio 2009

Completamento dello studio (Effettivo)