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The Epidemiology of Ventricular Assist Device-Related Infections

15 november 2011 bijgewerkt door: 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.

Studie Overzicht

Toestand

Voltooid

Conditie

Congestief hartfalen

Gedetailleerde beschrijving

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.

Studietype

Observationeel

Inschrijving (Werkelijk)

150

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Bemonsteringsmethode

Kanssteekproef

Studie Bevolking

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

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Aantal groepen / cohorten

Cohorten en interventies

Groep / Cohort
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat	Maatregel Beschrijving	Tijdsspanne
The incidence of suspected infections, characterized by infecting organism and location. Tijdsspanne: 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.

Secundaire uitkomstmaten

Uitkomstmaat	Maatregel Beschrijving	Tijdsspanne
Collect and quantify culture results for suspected infections and the secondary manifestations of infection Tijdsspanne: 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 Tijdsspanne: 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) Tijdsspanne: 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 Tijdsspanne: 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.

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Icahn School of Medicine at Mount Sinai

Medewerkers

National Heart, Lung, and Blood Institute (NHLBI)

Onderzoekers

Hoofdonderzoeker: Michael Parides, PhD, Icahn School of Medicine at Mount Sinai
Studie directeur: Patrice Desvigne-Nickens, National Heart, Lung, and Blood Institute (NHLBI)
Studie stoel: Yoshifumi Naka, MD, Columbia University

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 januari 2006

Primaire voltooiing (Werkelijk)

1 januari 2009

Studie voltooiing (Werkelijk)