Validering av biomarkørers ytelse for å redusere antibiotikaoverbruk hos nyfødte med mistenkte kliniske tegn på infeksjon (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.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Studietype
Registrering (Antatt)
Kontakter og plasseringer
Studiekontakt
- Navn: Marine BUTIN, Pr
- Telefonnummer: +33 4 27 85 52 84
- E-post: marine.butin@chu-lyon.fr
Studer Kontakt Backup
- Navn: Sophie TROUILLET-ASSANT
- Telefonnummer: +33 4 72 67 87 80
- E-post: sophie.trouillet-assant@chu-lyon.fr
Studiesteder
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Bron, Frankrike, 69500
- Rekruttering
- neonatal Intensive care unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, France
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Ta kontakt med:
- Marine BUTIN, Pr
- Telefonnummer: +33 4 27 85 52 84
- E-post: marine.butin@chu-lyon.fr
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Grenoble, Frankrike, 38700
- Rekruttering
- Hôpital Couple-Enfant - CHU Grenoble Alpes
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Ta kontakt med:
- LAYLI ALIN, MD
- Telefonnummer: 00334 27 85 52 84
- E-post: lalin@chu-grenoble.fr
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Nantes, Frankrike, 44300
- Rekruttering
- Neonatal intensive care unit, Hôpital femme-maternité
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Ta kontakt med:
- FLAMANT Cyril, Pr
- Telefonnummer: +33 2.40.08.34.83
- E-post: cyril.flamant@chu-nantes.fr
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Prøvetakingsmetode
Studiepopulasjon
Newborns aged ≥ 7 days hospitalized in one of the 2 neonatal intensive care units (Nantes or Lyon) for whom an infection is suspected.
Beskrivelse
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)
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Observasjonsmodeller: COHORT
- Tidsperspektiver: PROSPECTIVE
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Diagnosis of late onset sepsis
Tidsramme: 72 hours maximum after inclusion
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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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Samarbeidspartnere og etterforskere
Sponsor
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 69HCL23_0633
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
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