Impact of the Contamination Mode on the Clinical Evolution During Pseudomonas Aeruginosa Ventilator Acquired Pneumonia
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 77
- 试验地点
- 1
- 主要终点
- The occurrence of unfavorable patient's outcome, depending on the mode of contamination, such as persistence, relapse or superinfection of the airways at Day 7, and mortality at Day 28
研究概览
简要总结
Pseudomonas aeruginosa is the main pathogen of nosocomial respiratory infections. Its increasing resistance to antibiotics requires the development of new strategies for prevention and control, demanding a better understanding of the modes of transmission and evolutionary dynamics of this bacteria. In patients under invasive mechanical ventilation, the main mode of contamination by Pseudomonas remains debated, with 3 modes of contamination (endogenous, crossed transmission between patients, or environmental origin) of varying importance, mainly depending on the endemic situation of the place of study.
The emergence of new genotyping technologies (DiversiLab) can now facilitate studies of molecular epidemiology. Thanks to the multidisciplinary collaboration and innovative techniques, the investigators wish to study the impact of the mode of contamination on the outcome of ICU patients, intubated and ventilated for more than 72 hours.
详细描述
The presence of environmental reservoirs can cause infections and multidrug-resistant P. aeruginosa colonization with P. aeruginosa is itself a prognostic factor, but the impact of the route of infection on the evolution of the history and future of the infectious patient is not established.
A second factor that may influence the evolution infectious is the degree of genetic heterogeneity of the bacterial population. Multiple exposure pathways could also influence the genetic diversity.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients> 18 years
- •hospitalized in the intensive care unit
- •with more than 72 hours of mechanical ventilation
- •Presenting a positive bacteriological sample P. aeruginosa.
排除标准
- •Pregnant or lactating women.
- •Patients under guardianship, under judiciary placement, or hospitalized without their consent.
- •Patients not affiliated to a social security scheme.
- •Long-term corticosteroid therapy (> 2mg/kg or> 1 month before the onset of established infection suspected)
- •Ongoing chemotherapy, AIDS, transplant patient under immunosuppressive drugs.
- •Bedridden patient or therapeutic decision at ICU arrival
结局指标
主要结局
The occurrence of unfavorable patient's outcome, depending on the mode of contamination, such as persistence, relapse or superinfection of the airways at Day 7, and mortality at Day 28
时间窗: From day 3 of intubation until the end of mechanical ventilation (an average of 28 days).
次要结局
- Number of different clones of P. aeruginosa found in each sample analyzed for the same patient at diagnosis of colonization and VAP.(From day 3 of intubation until the end of mechanical ventilation (an average of 28 days).)