S. Aureus, Skin and Soft Tissue Infections

Study Overview
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Brief Summary
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Methicillin-resistant Staphylococcus aureus (MRSA) is reported as one of the main causative pathogen of community acquired SSTIs. In the USA, high prevalence of MRSA among Skin and soft tissue infections (SSTIs) is known to be due to the spread of the USA300 clone [Moran et al. 2006]. Among S. aureus SSTIs infections in Europe, data regarding the prevalence of MRSA in SSTIs and the causative genotypes remain scarce. The paucity of literature on the prevalence of MSSA, MRSA and PVL-producing S. aureus strains in SSTI in Europe is probably due to the fact that culture and antimicrobial susceptibility testing is not a routine component of SSTI management. Setting-up a prospective multi-centre study involving patients presenting to emergency departments with SSTIs in several European countries would allow drawing a picture on the role and the respective contribution of MSSA, MRSA and PVL-producing S. aureus strains as a cause of SSTIs. However, the roles of emergency rooms and local policies with regard to performing microbiological analysis after surgical drainage of SSTIs vary between countries. In order to evaluate the feasibility of such multicenter European study, we aim at performing a pilot study based on few European clinical laboratories (five to seven) which will: i) evaluate the prevalence of MSSA, MRSA and S. aureus PVL-positive strains in community-acquired SSTIs; and ii) determine molecular characteristics of the isolated strains. The main objectives of this pilot study are to collect some preliminary information on the role of S. aureus in SSTIs and to determine factors that need to be harmonized or taken into consideration for the set-up a larger prospective cross-sectional study involving more European countries with several centers per country to cover different geographical areas per country.

Official Title
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Prevalence of S. Aureus Among Patients Presenting With Skin and Soft Tissue Infections: a Multi-centre Pilot Study in Europe

Conditions
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Skin and Soft Tissue Infections (SSTIs)

Intervention / Treatment
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* Other: Collecting samples from all patients presenting with SSTIs requiring drainage


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - All patients (adults and children) presenting to emergency department with purulent skin and soft tissue infections (SSTIs) of less than one week duration are eligible Exclusion Criteria: - Patients (adults and children) presenting to emergency department with OTHERS type of infections than SSTIs

Ages Eligible for Study
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Minimum Age: 1 Day
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group MSSA<br> | Other: Collecting samples from all patients presenting with SSTIs requiring drainage<br>* The study will be conducted by microbiology laboratories. Before the start of the study, each participating laboratory will send an information letter to its corresponding emergency departments to increase vigilance of clinicians in collecting samples from all patients presenting with SSTIs; this will improve the level of inclusion. Each participating lab will also insure connection to local representation of the project for ethical clearance, collection of clinical data and SSTI specimen.<br>|
| Group MRSA<br> | Other: Collecting samples from all patients presenting with SSTIs requiring drainage<br>* The study will be conducted by microbiology laboratories. Before the start of the study, each participating laboratory will send an information letter to its corresponding emergency departments to increase vigilance of clinicians in collecting samples from all patients presenting with SSTIs; this will improve the level of inclusion. Each participating lab will also insure connection to local representation of the project for ethical clearance, collection of clinical data and SSTI specimen.<br>|
| Group PVL-negative strains<br> | Other: Collecting samples from all patients presenting with SSTIs requiring drainage<br>* The study will be conducted by microbiology laboratories. Before the start of the study, each participating laboratory will send an information letter to its corresponding emergency departments to increase vigilance of clinicians in collecting samples from all patients presenting with SSTIs; this will improve the level of inclusion. Each participating lab will also insure connection to local representation of the project for ethical clearance, collection of clinical data and SSTI specimen.<br>|
| Group PVL-positive strains<br> | Other: Collecting samples from all patients presenting with SSTIs requiring drainage<br>* The study will be conducted by microbiology laboratories. Before the start of the study, each participating laboratory will send an information letter to its corresponding emergency departments to increase vigilance of clinicians in collecting samples from all patients presenting with SSTIs; this will improve the level of inclusion. Each participating lab will also insure connection to local representation of the project for ethical clearance, collection of clinical data and SSTI specimen.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of staphylococcus aureus strains among all clinical SSTIs collected during the study. |  | after a 3 month period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of MSSA, MRSA strains among all clinical SSTIs collected during the study |  | after a 3 month period | 
| Percentage of PVL-positive strains among all clinical SSTIs collected during the study |  | after a 3 month period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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SSTIs, Methicillin-resistant Staphylococcus aureus (MRSA), Methicillin susceptible Staphylococcus aureus (MSSA), the toxin Panton-Valentine Leukocidin (PVL), Emergency Departments