Validatie van de prestaties van biomarkers om overmatig gebruik van antibiotica bij pasgeborenen met vermoedelijke klinische tekenen van infectie te verminderen (RUBIS)
Late-onset neonatal sepsis (LOS), occurring in newborn of at least 7 days of life, is frequently observed in Neonatal Intensive Care Units (NICUs) and potentially severe (mortality, neurologic and respiratory impairments).
Despite its high prevalence, a reliable diagnostic remains difficult. Currently, nonspecific clinical signs that might be related to other neonatal conditions such as prematurity and birth defects, are used to determine the diagnosis of LOS. Laboratory results of biological markers, such as C-Reactive Protein (CRP) and Procalcitonin (PCT) are often delayed in comparison with LOS onset. Blood culture results are too late and lack sensitivity. This explains why excessive antibiotic use is observed in a large proportion of NICU hospitalized newborns. This results in an increased antibiotic resistance, microbiota modification, neonatal complications (pulmonary, ophthalmologic and neurologic) and mortality.
A previous study (EMERAUDE) aimed to identify new biomarkers to early exclude the diagnosis of LOS, in order to limit antibiotic overuse. This study including 230 neonates revealed high performances of IL6, IL10, NGAL and combinations of PCT/IL10 and PTX3/NGAL.
The main objective of the present study will be to validate the performances of these biomarkers in another cohort. The secondary objectives will be to explore transcriptomic biomarkers and salivary biomarkers.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studiecontact
- Naam: Marine BUTIN, Pr
- Telefoonnummer: +33 4 27 85 52 84
- E-mail: marine.butin@chu-lyon.fr
Studie Contact Back-up
- Naam: Sophie TROUILLET-ASSANT
- Telefoonnummer: +33 4 72 67 87 80
- E-mail: sophie.trouillet-assant@chu-lyon.fr
Studie Locaties
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Bron, Frankrijk, 69500
- Werving
- neonatal Intensive care unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, France
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Contact:
- Marine BUTIN, Pr
- Telefoonnummer: +33 4 27 85 52 84
- E-mail: marine.butin@chu-lyon.fr
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Grenoble, Frankrijk, 38700
- Werving
- Hôpital Couple-Enfant - CHU Grenoble Alpes
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Contact:
- LAYLI ALIN, MD
- Telefoonnummer: 00334 27 85 52 84
- E-mail: lalin@chu-grenoble.fr
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Nantes, Frankrijk, 44300
- Werving
- Neonatal intensive care unit, Hôpital femme-maternité
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Contact:
- FLAMANT Cyril, Pr
- Telefoonnummer: +33 2.40.08.34.83
- E-mail: cyril.flamant@chu-nantes.fr
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Newborns aged ≥ 7 days hospitalized in one of the 2 neonatal intensive care units (Nantes or Lyon) for whom an infection is suspected.
Beschrijving
Inclusion Criteria:
- Patient hospitalized in the NICU of one of the two recruiting centers at the time of inclusion
- Patients aged ≥ 7 days
- Patients weighted ≥ 500 g the day of blood sample
- patients with suggestive signs of LOS including at least one of the following:Fever > 38°C; tachycardia > 160bpm; capillary refill time > 3 seconds; grey and/or pale skin complexion; apnea/ bradycardia syndrome, bloating; vomiting; rectal bleeding; hypotonia; lethargy; seizures without other obvious cause; increased ventilatory support and/or increased FiO2; cutaneous rash; inflammation at the needle-puncture site of the central venous catheter; or any other condition for which the clinician suspected an infection
- patients with a standard of care blood sampling, including at least a blood culture;
Exclusion Criteria:
- Patient treated with antibiotics for a bacteriologically confirmed infection at the time of sampling or within 48 hours prior to sampling
- Patient who underwent surgery within the previous 7 days
- Patients vaccinated within the previous 7 days
- Patient who received treatment with systemic corticosteroid therapy in the 48 hours prior to sampling
- Patient with severe combined immunodeficiency
- Opposition from parent(s)/guardian(s)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Observatiemodellen: COHORT
- Tijdsperspectieven: PROSPECTIVE
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Diagnosis of late onset sepsis
Tijdsspanne: 72 hours maximum after inclusion
|
The primary outcome measure will be determined by an independent adjudication committee that will classify the patients into the following categories : infection, non infected or undetermined. This committee will be blinded to the biomarkers of the study. It will be composed of two neonatologists and a pediatrician specialized in pediatric infectious diseases. The diagnostic performance of the biomarkers combination will be based on the adjudication committee classification (gold standard). |
72 hours maximum after inclusion
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Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 69HCL23_0633
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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