Necrotizing Bacterial Dermohypodermitis-necrotizing Fasciitis Mono- or Multi-microbial Streptococcus Beta-haemolytic

Study Overview
=================
Brief Summary
-----------------
The aim of the study is to evaluate streptococcal carriage by swab, pharyngeal, anal and perineal in patients with DHBN-FN, in the entourage living under the same roof as well as patients with erysipelas The main hypothesis is the major role of chronic porting of patients and entourage in DHBN-FN to SBH. Indeed, the chronic pharyngeal / anal / perineal carriage could be a gateway following a transient bacteremia for a DHBN-FN. The transmission of germs from the surrounding to the patient plays a major role: At the gateway level in the case of exogenous DHBN-FN At the origin of chronic carriage in the case of endogenous DHBN-FN Transmission of germs from the patient to the surrounding area also plays an important role in increasing the risk of invasive SBH infections in the surrounding area.

Official Title
-----------------
Necrotizing Bacterial Dermohypodermitis-necrotizing Fasciitis (DHBN-FN) Mono- or Multi-microbial Streptococcus Beta-haemolytic: Study of Carriage in Patients and Their Entourage

Conditions
-----------------
Streptococcus Infection

Intervention / Treatment
-----------------
* Other: DHBN-FN arm
* Other: Control arm (Erysipelas)


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patient: Major patient hospitalized for a DHBN-FN or erysipelas (clinical diagnosis determined at the entrance). Signed informed consent. Case contact person of major age living under the same roof as a patient who has had a DHBN-FN. Signed informed consent Exclusion Criteria: Patient: Minor patient Immunosuppressed patient: active hematology, poorly controlled HIV, neutropenia (PNN <1000 / mm3). Patient under guardianship or curatorship Patient deprived of liberty by judicial or administrative decision Patient not affiliated to a social security scheme and not a beneficiary of such a scheme Case contact Minor person Person under tutorship or curatorship Person deprived of liberty by judicial or administrative decision Person not affiliated with a social security

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: DHBN-FN arm<br>Recruitment is planned in traditional hospitalization for DHBN-FN patients. Evaluation of streptococcal carriage by swab, pharyngeal, anal and perineal in patients hospitalized for a DHBN-FN at the end of hospitalization and 1 month after discharge from hospital during the reassessment consultation. Swabs made by the dermatologist. The carriage of streptococcus in patients living under the same roof as patients with DHBN-FN will be evaluated by pharyngeal swab, anal and perineal. If the family accepts, the carriage of streptococcus in persons living under the same roof as patients with DHBN-FN will be evaluated by pharyngeal, anal and perineal swab in consultation. These swabs will be made within 10 days of diagnosis of DHBN-FN of the index | Other: DHBN-FN arm<br>* DHBN-FN will be evaluated by pharyngeal swab, anal and perineal. If the family accepts, the carriage of streptococcus in persons living under the same roof as patients with DHBN-FN will be evaluated by pharyngeal, anal and perineal swab in consultation. These swabs will be made within 10 days of diagnosis of DHBN-FN of the index<br>|
| Active Comparator: Control arm (Erysipelas)<br>Recruitment is planned in traditional hospitalization for patients with erysipelas. The carriage of streptococcus in patients with erysipelas will be evaluated by pharyngeal, anal and perineal swab on day 0 (admission). | Other: Control arm (Erysipelas)<br>* The carriage of streptococcus in patients with erysipelas will be evaluated by pharyngeal, anal and perineal swab on day 0 (admission).<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of beta-hemolytic streptococcus in patients with DHBN-FN | Evaluation of streptococcal carriage by swab, pharyngeal, anal and perineal in patients hospitalized for a DHBN-FN . Swabs made by the dermatologist. The detection of beta-hemolytic streptococcus will be made by culture | Day 0 | 
| Rate of beta-hemolytic streptococcus in patients with DHBN-FN | Evaluation of streptococcal carriage by swab, pharyngeal, anal and perineal in patients hospitalized for a DHBN-FN . Swabs made by the dermatologist. The detection of beta-hemolytic streptococcus will be made by culture | 1 month after hospitalization discharge | 
| Rate of beta-hemolytic streptococcus in patients with DHBN-FN | Evaluation of streptococcal carriage by swab, pharyngeal, anal and perineal in patients hospitalized for a DHBN-FN . Swabs made by the dermatologist. The detection of beta-hemolytic streptococcus will be made by culture | Day 30 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of SBH carriage at the time of diagnosis |  | Day 0, Day 10 | 
| Sites of SBH carriage at the time of diagnosis |  | Day 0, Day 10 | 
| Rate of beta-hemolytic streptococcus in patients with erysipelas | The carriage of streptococcus in patients with erysipelas will be evaluated by pharyngeal, anal and perineal swab on day 0. | Day 0 | 
| Rate of beta-hemolytic streptococcus in patients living under the same roof as patients with DHBN-FN | The carriage of streptococcus in persons living under the same roof as patients with DHBN-FN will be evaluated by pharyngeal, anal and perineal swab in consultation. These swabs will be made within 10 days of diagnosis of DHBN-FN of the index. | Up to 10 Days | 
| Main factors of streptococcal virulence | Analyze the main factors of streptococcal virulence by Streptococcal genome sequencing | Day 0, Day 10 |