Cutaneous Microbiota Evolution in ICU Patients With CVC (ICMc)

Last updated: October 20, 2023
Sponsor: Centre Hospitalier de Cayenne
Overall Status: Active - Recruiting

Phase

N/A

Condition

Catheter Complications

Treatment

Skin swabbing

Data collection

Clinical Study ID

NCT06095076
2023_006
  • Ages > 18
  • All Genders
  • Accepts Healthy Volunteers

Study Summary

Intensive Care Unit (ICU) patients are exposed to catheter-related infections with an important morbidity. Catheter colonization is constant but infection is not. Cutaneous dysbiosis could be the missing link. Our study aims to evaluate the evolution of cutaneous microbiota in ICU patients with a central venous catheter in place, through metagenomics. Our main objective is to evaluate the evolution of alpha-diversity, quantified by intra-patient variation of Shannon diversity index (a diversity index used in bacterial metagenomics).

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Adult hospitalized in ICU at the Cayenne Hospital Center in whom the installation of aCVC is indicated

Exclusion

Exclusion Criteria:

  • Patient under 18 years of age
  • Patient or trusted person or family or relative objecting to participation in thestudy (refusal)
  • Patient under judicial safeguard or under any other protective regime (guardianship orcuratorship)
  • Patient with cutaneous lesions (infection, burn) near the cutaneous insertion site ofthe CVC

Study Design

Total Participants: 120
Treatment Group(s): 2
Primary Treatment: Skin swabbing
Phase:
Study Start date:
June 02, 2023
Estimated Completion Date:
June 02, 2024

Study Description

Central venous catheters (CVCs) are necessary in up to 60% of ICU patients, representing a risk of catheter-related infections with high morbidity and mortality. Catheter colonization originating mostly from the skin is constant, but infection is not. Dysbiosis is known to be associated with pathological states and infection, for example post-antibiotic C. difficile diarrheas, or atopic dermatitis, in which flares are associated with dysbiosis and S. aureus predominance. Cutanous dysbiosis could be the missing link between catheter colonization and infection. Our hypothesis is that under the influence of multiple ICU factors (stress, antibiotic administration, local dysinfection procedures), cutaneous dybiosis appears in ICU patients with a central venous catheter.

All adult ICU patients with an indication for CVC placement will be included over a 6 months period. Skin swabbing will be performed on CVC insertion site before CVC placement (baseline), and then every 3 days (or when dressing is changed) while CVC is in place, then at ICU discharge. Bacterial metagenomics using bacterial DNA extraction, 16S PCR amplification and Nanopore sequencing will allow for description of cutaneous microbiota and diversity evaluation through Shannon index. Evolution of alpha-diversity will be evaluated through time-series data analysis: comparison of Shannon index at various time points with baseline Shanonn index (before CVC placement). Standard microbiologic culture of skin swabbing will be performed. General patient characteristics and informations relative to CVC infection and treatment will be collected.

This study will have no impact on patient management.

Category 3 Non-Interventional Human Person Research (RIPH 3)

Connect with a study center

  • Centre Hospitalier de Cayenne

    Cayenne, Guyane Française 97306
    French Guiana

    Active - Recruiting

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