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Evaluation of the Antibiofilmogramme® Test During Diabetic Foot Infections

Completed
Conditions
Staphylococcus Aureus
Diabetic Foot
Interventions
Biological: Antibiofilmogramme
Registration Number
NCT02378493
Lead Sponsor
Centre Hospitalier Universitaire de Nīmes
Brief Summary

This is an observational study that does not change routine care.

The primary objective of this study is to investigate the role of antibiogramme-antibiofilmogramme concordance (in terms of S. aureus strains and prescribed antibiotics) in the presence/absence of S. aureus strains at the end of a first regimen of antibiotics.

Detailed Description

The secondary objectives are:

A. Should a first regimen of antibiotics fail, to describe the bacterial community present in the wound, and its potential to create biofilms.

B. To investigate the role of antibiogramme-antibiofilmogramme concordance (in terms of S. aureus strains and prescribed antibiotics) in wound healing.

C. To study the potential role of additional antibiofilmogramme data, as well as that of other pre-defined co-factors, in predicting wound changes.

D. Create an S. aureus strain collection for future ancillary studies.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
33
Inclusion Criteria
  • The patient must have given his/her informed and signed consent
  • The patient must be insured or beneficiary of a health insurance plan
  • The patient is available for 7 to 10 weeks of follow-up
  • Patient with a foot wound (at least stage 2 or more) that is infected by at least 1 strain of S. aureus
Exclusion Criteria
  • The patient is participating in, or has participated in within the past 3 months, another interventional study, or is currently in an exclusion period determined by a preceding study
  • The patient is under judicial protection, under tutorship or curatorship
  • The patient refuses to sign the consent
  • It is impossible to correctly inform the patient
  • The patient is pregnant, parturient, or breastfeeding
  • Emergency situation precluding correct study implementation

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Exposure: Concordance between testsAntibiofilmogrammeThe study population is composed of diabetic patients with foot wounds (at least stage \>=2) that are infected by at least 1 strain of S. aureus. Patients whose antibiogrammes and Antibiofilmogrammes are concordant will fall into this group (the "exposed" group). Upon inclusion, 1) all patients' wounds will be sampled, and 2) the associated bacterial strains identified via Vitek and 3) antibiograms performed; the latter are all part of routine procedure. 4) S. aureus isolates will be further analysed via an antiobiofilmogramme, which is an experimental element added by this research. At the end of the 1st regimen of antibiotics prescribed, if the treatment failed steps 1 to 4 can be repeated. 30 days after the end of the 1st regimen of antibiotics prescribed, steps 1 to 4 are systematically performed.
Non exposure: Not concordance between tests.AntibiofilmogrammeThe study population is composed of diabetic patients with foot wounds (at least stage \>=2) that are infected by at least 1 strain of S. aureus. Patients who do not fall into the concordance (exposure) group, will fall into the non exposure group. The latter includes semi-concordance or discordance between antibiogrammes and Antiobiofilmogrammes. Upon inclusion, 1) all patients' wounds will be sampled, and 2) the associated bacterial strains identified via Vitek and 3) antibiograms performed; the latter are all part of routine procedure. 4) S. aureus isolates will be further analysed via an antiobiofilmogramme, which is an experimental element added by this research. At the end of the 1st regimen of antibiotics prescribed, if the treatment failed steps 1 to 4 can be repeated. 30 days after the end of the 1st regimen of antibiotics prescribed, steps 1 to 4 are systematically performed.
Primary Outcome Measures
NameTimeMethod
Presence/absence of S. aureus strains in the woundAt the end of 1st antibiotics (expected average of 21 days)
Antibiofilmogramme resultsBaseline (Day 0)

Qualitative results per antibiotic type and dose: classification as sensitive, intermediate, resistance.

Antibiogram resultsBaseline (Day 0)

Qualitative results per antibiotic type and dose: classification as sensitive, intermediate, resistance.

Secondary Outcome Measures
NameTimeMethod
The surface area of the wound has decreased by 40% compared to initial size: yes/no.30 days after end of 1st antibiotics (expected average of 51 days)
Presence/absence of S. aureus strains in the wound30 days after end of 1st antibiotics (expected average of 51 days)
Antibiofilmogramme results30 days after end of 1st antibiotics (expected average of 51 days)

Qualitative results per antibiotic type and dose: classification as sensitive, intermediate, resistance.

Antibiogram results30 days after end of 1st antibiotics (expected average of 51 days)

Qualitative results per antibiotic type and dose: classification as sensitive, intermediate, resistance.

Wound surface area (mm^2)30 days after end of 1st antibiotics (expected average of 51 days)
Wound depth (mm)30 days after end of 1st antibiotics (expected average of 51 days)
The capacity of the S. aureus strains isolated to create biofilms in the presence of antibiotics30 days after end of 1st antibiotics (expected average of 51 days)

Score varying from 0 to 80

The number of bacterial strains detected in the wound.30 days after end of 1st antibiotics (expected average of 51 days)

Trial Locations

Locations (6)

CHU de Clermont-Ferrand - Hôpital Gabriel-Montpied

🇫🇷

Clermont Ferrand, France

CHRU de Nîmes - Hôpital Universitaire Carémeau

🇫🇷

Nîmes Cedex 09, France

CHU

🇫🇷

Nantes, France

CHRU de Strasbourg - Hôpital Civil

🇫🇷

Strasbourg Cedex, France

CHU de Lyon - Hôpital de la Croix-Rousse

🇫🇷

Lyon Cedex 4, France

CHU de Lyon - Centre Hospitalier Lyon Sud

🇫🇷

Pierre Benite, France

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