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Observational study of the effects of antibiotics on commensal flora. Realization of stool samples and nasal swabs before and after antibiotic therapy.
The emergence of resistance to fluoroquinolone (FQ) and is a major problem worldwide. The commensal flora is the main reservoir for antibiotic resistance. Understanding the factors (environmental, patient-related, dosis-related, drug-related…) involved in the emergence of resistance to fluoroquinolones in the commensal flora of patients treated with a FQ, may help prevent it and preserve the efficiency of these important antibiotics. Samples of digestive flora will be collected from hospitalized patients before receiving a FQ or Ceftriaxone, at the end of the treatment and 3 month after the end of treatment. Clinical data will be collected.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ceftriaxone | Patients receiving a C3G (ceftriaxone) during the hospitalization. | ||
| Ceftriaxone + Fluoroquinolone | ceftriaxone followed by fluoroquinolone (which is a common situation in clinical practice, Fluoroquinolone being prescribed after obtaining antibiogram). | ||
| Fluoroquinolones | fluoroquinolones (levofloxacin, ofloxacin, moxifloxacin or ciprofloxacin). | ||
| Reference | A third reference group will consist of patients hospitalized in the same services as the "case" patients but did not receive antibiotics (60 patients). They will have an idea of possible changes in flora during hospitalization without any antibiotics, for example due to horizontal transfer of resistant strains. This group will be composed of 60 patients who had not received antibiotics within 3 months before and not receiving for the duration of their participation. |
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| Measure | Description | Time Frame |
|---|---|---|
| Describe the changes in the composition of the gut microbial flora in relation to the initial flora (T0) in patients receiving antibiotics, by date of sampling, treatment received, dose, duration of therapy, ward, and duration of hospital stay. | The primary endpoint is the change in composition of the microbial flora in relation to the initial flora (T0), at the exit of the hospital or at the end of treatment if occurs while the patient is still hospitalized (bis T0, T1, T1 bis), 3 months after the end of treatment (T2) and one year after the end of treatment (T3). | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| A secondary endpoint is to describe the changes in the gut microbiota of hospitalized patients not receiving antibiotics. | 1 year |
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Inclusion criteria for the patients treated with antibiotics
Inclusion criteria for the patients in the reference group
Exclusion criteria
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| Name | Affiliation | Role |
|---|---|---|
| Victoire De Latours, Doctor | Assistance Publique - Hôpitaux de Paris | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Beaujon | Clichy | 92110 | France |
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| ID | Term |
|---|---|
| D001424 | Bacterial Infections |
| ID | Term |
|---|---|
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
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Stool samples will be collected on 4 separate days for patients treated with antibiotics:
T0: before treatment begins T1: at the end of treatment or discharge from the hospital T2: 3-6 months after the end of treatment T3: 10-14 months after the end of treatment For patients receiving sequentially ceftriaxone followed by a FQ, an additional sample will be collected at the end of ceftriaxone treatment.
In the reference group, stool samples will be collected:
T0: at inclusion in the study T1: at hospital discharge The purpose is to study the bacterial DNA contained in the stool. No analysis will be performed on the human patient DNA.
Changes in the gut microflora will be analysed by metagenomics deep sequencing performed by Dushko Ehrlich (INRA, France).