Organ Failure, Multiple
Conditions
Keywords
multidrug resistant bacteria, outbreak, prevention and infection control, bacterial typing, Fourier transform infrared spectroscopy
Brief summary
This study will assess the impact of FTIRS typing on the spread of ESBL-E in intensive care units
Detailed description
Multidrug resistant enterobacterales (MDR-E) are a major threat for patients hospitalized in intensive care units (ICUs). To prevent MDR-E spread in ICUs, rectal swabs are routinely performed and cultured on selective media. However, bacterial identification and antimicrobial susceptibility results are not sufficient to diagnose cross transmissions. The gold standard technique is based on genomic analysis that require whole genome sequencing (WGS) of bacteria and followed by multilocus sequence typing (MLST) and Single Nucleotide Polymorphism (SNP) typing. This technology is rather expensive and not applicable in all centers. Fourier Transform InfraRed Spectroscopy (FTIRS) is a developing method for rapid bacterial typing. This technology is simple and results can be obtained in one hour. It is therefore adapted to continuous surveillance of MDR-E. In France, extended spectrum betalactamase producing enterobacteriaceae (ESBL-E) represent the vast majority of MDR-E. We postulate that early diagnosis of cross-transmission by FTIRS may prevent the spread of ESBL-E in ICUs and favor compliance with hygiene measures. The aim of this study will be to assess the impact of systematic FTIRS typing of ESBL-E on ESBL-E cross-transmissions in ICUs.
Interventions
DIAGNOSTIC_TESTFTIR results
Weekly transmission of FTIRS typing of ESBL-E to centers
Sponsors
University Hospital, Caen
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Stepped-wedge
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients hospitalized in ICU * ESBL-E carrier
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Baseline frequency of ESBL-E cross transmission as assessed by WGS | Month 9 to Month 12 (depending on centers, stepped wedge design) | Number of patients with hospital acquired ESBL-E / total number of ESBL-E carriers |
| Post intervention frequency of ESBL-E cross transmission as assessed by WGS | Month 24 | Number of patients with hospital acquired ESBL-E / total number of ESBL-E carriers |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of FTIRS to diagnose cross transmissions compared to WGS | Month 24 | Sensitivity |
| Specificity of FTIRS to diagnose cross transmissions compared to WGS | Month 24 | Specificity |
| Positive predictive value of FTIRS to diagnose cross transmissions compared to WGS | Month 24 | Positive predictive value |
| Negative predictive value of FTIRS to diagnose cross transmissions compared to WGS | Month 24 | Negative predictive value |
Countries
France
Contacts
Primary ContactCamille Jeanne-Leroyer
Backup ContactOlivier Join-Lambert, MD, PhD
Outcome results
None listed