Ignite Creation Date:
2024-05-06 @ 5:22 PM
Last Modification Date:
2024-10-26 @ 2:27 PM
Study NCT ID:
NCT05285046
Status:
UNKNOWN
Last Update Posted:
2022-03-17
First Post:
2022-02-28
Brief Title:
Phenotypic Profile and Molecular Mechanism of Resistance in Carbapenemase-producing Enterobacterales and Pseudomonas Aeruginosa Isolates From Brazilian Hospitals Implications for the Introduction of IMIPENEM-RELEBACTAM
Sponsor:
DOr Institute for Research and Education
Organization:
DOr Institute for Research and Education
Study Overview
Official Title:
Phenotypic Profile and Molecular Mechanism of Resistance in Carbapenemase-producing Enterobacterales and Pseudomonas Aeruginosa Isolates From Brazilian Hospitals Implications for the Introduction of IMIPENEM-RELEBACTAM
Status:
UNKNOWN
Status Verified Date:
2022-03
Last Known Status:
ENROLLING_BY_INVITATION
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The global dissemination of carbapenem-resistant Enterobacteriaceae CRE and Pseudomonas aeruginosa CRPA are a significant threat to health care especially for severely ill patients Antibiotics currently used to treat CRE and CRPA infections are usually toxic and not very effective Novel treatments include beta-lactamase inhibitors with broad-spectrum activity among them IMI-REL IMI-REL is a promising molecule due to the ability of REL to diminish carbapenem MICs to the susceptible range potentially restoring the activity of this potent drug However few studies have systematically examined IMI-REL activity against a diverse clinical collection of CRE and CRPA strains in particular from a region where the resistance is high and the main mechanisms are in general unknown Brazil- Latin America As the use of molecular diagnostics becomes increasingly available in clinical settings it is crucial to identify molecular markers predicting antimicrobial efficacy to guide therapeutic decision-making In the present study we will acess different species of CRE and CRPA from clinically relevant isolates to determine if the species clonal lineage and resistance gene profile have influence to the response to IMI-REL
Detailed Description:
Prospective evaluation of 150 one hundred and fifty Enterobacterales and 100 one hundred Pseudomonas aeruginosa isolates from 12 hospitals in the city of Rio de Janeiro A sequential number of isolates per unit will be selected considering the inclusion criteria of resistance to carbapenem only one isolate per patient will be evaluated The isolate will be identified in genus and species by the VITEK MS MALDI-TOF bioMérieux - France mass spectrometry methodology from bloodstream isolates and respiratory specimens
The detection of carbapenemase production by rapid colorimetric method will be performed using the RAPIDEC Carba NP test bioMérieux - France The isolates that present positive carbapenemase test by colorimetric method will be submitted to the PCR extended-spectrum beta-lactamase and carbapenemase gene characterization test for the following genes blaSHV blaCTX-M KPC NDM VIM IMP SME NMC IMI GES GIM SMP IMP OXA 23 OXA 24 OXA 48 OXA 51 and OXA 58
After characterization of the carbapenemase-producing genes isolates possessing the Class A and D carbapenemase gene it will be evaluated the susceptibility profile of imipenem-relebactam using BMD Broth Microdilution to determine the minimum inhibitory concentration and its respective sensitivity and resistance criteria using recent CLSI MIC breakpoints - M100 29th Ed Clinical and Laboratory Standards Institute - 2020 and EUCAST Version 100 European Committee on Antimicrobial Susceptibility Testing V 100 Isolates showing positive results for carbapenemase production but with negative PCR results for the genes described above will be further investigated for the likely presence of other carbapenemase producing genes or other mechanisms of resistance to carbapenem antibiotics For the study and evaluation of the genetic diversity of the isolates the Multilocus Sequence Typing MLST methodology will be used Isolates that show simultaneous resistance to carbapenems polymyxin B and fluoroquinolones will be subjected to next generation sequencing NGS for further evaluation of other genes or mechanisms associated with antibiotic resistance or virulence markers
The detection of carbapenemase production by rapid colorimetric method will be performed using the RAPIDEC Carba NP test bioMérieux - France The isolates that present positive carbapenemase test by colorimetric method will be submitted to the PCR extended-spectrum beta-lactamase and carbapenemase gene characterization test for the following genes blaSHV blaCTX-M KPC NDM VIM IMP SME NMC IMI GES GIM SMP IMP OXA 23 OXA 24 OXA 48 OXA 51 and OXA 58
After characterization of the carbapenemase-producing genes isolates possessing the Class A and D carbapenemase gene it will be evaluated the susceptibility profile of imipenem-relebactam using BMD Broth Microdilution to determine the minimum inhibitory concentration and its respective sensitivity and resistance criteria using recent CLSI MIC breakpoints - M100 29th Ed Clinical and Laboratory Standards Institute - 2020 and EUCAST Version 100 European Committee on Antimicrobial Susceptibility Testing V 100 Isolates showing positive results for carbapenemase production but with negative PCR results for the genes described above will be further investigated for the likely presence of other carbapenemase producing genes or other mechanisms of resistance to carbapenem antibiotics For the study and evaluation of the genetic diversity of the isolates the Multilocus Sequence Typing MLST methodology will be used Isolates that show simultaneous resistance to carbapenems polymyxin B and fluoroquinolones will be subjected to next generation sequencing NGS for further evaluation of other genes or mechanisms associated with antibiotic resistance or virulence markers
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None