Comparison of Community and Hospital Antibiotic Use Practices, Susceptibility and ResisTance and Determinants of Care Seeking Among Patients With Urinary Tract Infections (CAST-UTI)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 890
- 试验地点
- 2
- 主要终点
- A comparison of resistance profiles between GLASS and community uropathogens in Uganda
研究概览
简要总结
- General objective
This pilot study aims to compare the prevalence of resistance in bacteria causing UTIs among patients seeking care outside the hospital settings (CDROs) to the WHO-GLASS data. 2. Specific objectives
2-1 Primary objectives:
- Determine the resistance profiles of uropathogens and carriage strains from patients with uncomplicated UTIs attending community drug retail outlets (CDRO's) and in hospitals*.
- Compare the resistance profiles of the uropathogens from patients with uncomplicated UTIs attending CDROs and hospitals to those in the WHO-GLASS database.
- Explore the patient pathway and its impact on antibiotic use among patients presenting to CDROs and hospitals with uncomplicated UTIs.
- Determine the appropriateness of antimicrobial use in the treatment of uncomplicated UTIs among patients presenting to CDROs and hospitals
2-2 Secondary objectives:
- Compare resistance profiles among the uropathogens from patients from two neighbourhoods in Kampala.
- Examine environmental samples between the study sites to determine the presence of antibiotic residues and AMR in two neighbourhoods in Kampala.
研究设计
- 研究类型
- Observational
- 观察模型
- Ecologic Or Community
- 时间视角
- Prospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Must have one or more of the following clinical presentations regardless of age:
- •acute (< 2 weeks) dysuria. increased urinary urgency and frequency, irritation, discharge. increased lower abdominal pain or discomfort and sometimes gross haematuria.
- •In elderly patients with pre-existing urinary symptoms: increased acute urinary changes.
排除标准
- •People without symptoms of UTI.
研究组 & 干预措施
Namuwongo community
The Namuwongo informal settlement is located in the urban area of Kampala, Uganda. An estimated 70% of residents in the informal settlement routinely (within the last month) use antibiotics. Houses are overcrowded with residents paying to use public toilets.
The investigators are recruiting from community drug retail outlets and the outpatient department of Kitsugu health centre located next to Namuwongo.
Muyenga community
The Muyenga and Bukasa neighbourhoods are also located in the urban area of Kampala, Uganda, but is more affluent than the Namuwongo informal settlement. Residents in Muyenga can afford more expensive treatments at community drug retail outlets (CDROs)/clinics.
The investigators are recruiting from community drug retail outlets and the outpatient department of Naguru hospital located next to Muyenga and Bukasa neighbourhoods.
结局指标
主要结局
A comparison of resistance profiles between GLASS and community uropathogens in Uganda
时间窗: At the end of 12 months data collection
Twelve-month prevalence of antimicrobial resistance in Escherichia coli and Klebsiella pneumoniae isolates causing urinary tract infections, comparing GLASS surveillance data and data collected in the community in Uganda. Resistance will be measured as the proportion of isolates non-susceptible to key antibiotic classes (e.g., third-generation cephalosporins, fluoroquinolones, carbapenems).
A comparison of resistance profiles between GLASS and community uropathogens in Uganda
时间窗: through study completion, an average of 1 year
Prevalence of antimicrobial resistance in Escherichia coli and Klebsiella pneumoniae isolates causing urinary tract infections, comparing GLASS surveillance data and data collected in the community in Uganda. Resistance will be measured as the proportion of isolates non-susceptible to key antibiotic classes (e.g., third-generation cephalosporins, fluoroquinolones, carbapenems).
次要结局
- Patient pathway and antibiotic use in the community(28 days)
- Appropriateness of antimicrobial use in the treatment(7 days after enrolment)
- Retail outlet determinants of treating healthcare-seeking among patients with suspected UTIs(At the end of 12 months after enrolment)
- Antibiotic residues and AMR in two neighbourhoods in Kampala(Once a month for 12 months after study commencement)
- Retail outlet determinants of treating healthcare-seeking among patients with suspected UTIs(through study completion, an average of 1 year)
- Antibiotic residues and AMR in two neighbourhoods in Kampala(through study completion, an average of 1 year)
- Comparison of the diagnostic accuracy and usability of 'Utilizer ID' to Gold Standard microbiology, culture and sensitivity(through study completion, an average of 1 year)