Impact of the Contamination Mode on the Clinical Evolution During Pseudomonas Aeruginosa Ventilator Acquired Pneumonia (PYO GEN)
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.
Ventilation Acquired Pneumonia
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Impact of the Contamination Mode on the Clinical Evolution During Pseudomonas Aeruginosa Ventilator Acquired Pneumonia|
- 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 [ Time Frame: From day 3 of intubation until the end of mechanical ventilation (an average of 28 days). ] [ Designated as safety issue: No ]
- Number of different clones of P. aeruginosa found in each sample analyzed for the same patient at diagnosis of colonization and VAP. [ Time Frame: From day 3 of intubation until the end of mechanical ventilation (an average of 28 days). ] [ Designated as safety issue: No ]Samples of infected patients are analyzed once a week, strains are considered from different clones if their genetic homology rate is below 97%
Biospecimen Retention: Samples Without DNA
In order to achieve an antibiogram according to conventional methods and PCR genotyping Rep (DiversiLab ®) to assess the clonality of bacterial populations, there will be taken 5 different isolated colonies (possibly diluted)from each clinical sample of bronchial secretion, selected according to morphological criteria or randomly if no visible differences are noted.
|Study Start Date:||January 2013|
|Estimated Study Completion Date:||January 2016|
|Estimated Primary Completion Date:||January 2016 (Final data collection date for primary outcome measure)|
|Intubated ICU patients|
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.
|Medical ICU of Universitary Hospital of Grenoble||Recruiting|
|Grenoble, Isère, France, 38700|
|Contact: CALVINO CS Silvia, IDE SCalvinoemail@example.com|
|Principal Investigator: TIMSIT JFT Jean-françois|