Digestive Colonisation by Highly Resistant Bacteria (CODBAHRE)

Study Overview
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Brief Summary
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The aim of this study is to identify in hospitalized patients, the risk factors associated with the digestive colonisation by emergent extensively drug-resistant bacteria (eXDR), to optimize their detection and the medical care for carriers these patients

Detailed Description
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CODBAHRE is a french, regional study, involving 9 centers. Recruitment will take place in all the departments of the centers involved under the supervision of the Infection Control Team. All patients hospitalized more than 24 hours, on a given day are eligible for the protocol, except the patients unable to answer the questionnaire. After collecting the non-opposition of the patient, patients will be screened by rectal swab and a questionnaire will be completed. Each sample will be analyzed to detect eXDR carrying patients. The carrying patients will be followed during 6 months to estimate the proportion of the population which developped a bacterial infection. This information will be collected by a retrospective telephone survey of carrying patients.

Official Title
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Identification of New Highly Antibiotic-resistant Bacteria Carriage Risk Factors to Optimize the Detection and Medical Care for Carriers Patients

Conditions
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Risk Factor

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hospitalization of more than 24 hours Give his no objection Exclusion Criteria: Hospitalization in psychiatry Unwilling to participate
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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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk factors | Identification of risk factors for digestive colonisation by highly resistant bacteria Lifestyle questionnaire: environment, diet, medical history and result of the rectal swab | at inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of multidrug-resistant bacteria will be determined by the number of patients who have been detected at least one multidrug-resistant bacteria referred to the number of patients sampled | Number of patient carrying a Multidrug-resistant bacteria in Ile de France | 1 day | 
| Prevalence of co-carrying patients of eXDR and ESBL will be determined by the number of patients who carrying eXDR and ESBL referred to the number of patients sampled | Estimate the prevalence of co-carrying patients of eXDR and ESBL in the Ile de France | 1 day | 
| Prevalence will be determined by the number of patients who carrying at least one Multidrug-resistant bacteria referred to the number of patients sampled | Establish whether there are significant differences between hospital associated with the recruitment of these institutions. | 1 day | 
| Proportion of patients carrying eXDR who will develop an infection with the same germ referred to the number of eXDR carriers | Estimate the proportion of patients colonized by a eXDR who will develop an infection with the same germ. | 6 months | 
| Cross-transmission rate of eXDR | Number of cross transmissions during the study by comparing the eXDR bacteria genotypes in the same unit | 1 day | 
| Description of the association between strains (RAPD, infrared Biotyper, genome sequencing). | Identify possible links between strains | 16 months | 
| Description of resistance and virulence characteristics between strains (RAPD, infrared Biotyper, genome sequencing). | Characterize the resistance and virulence factors of certain strains. | 16 months | 
| Comparison of the frequency of positive presence of eXDR bacteria obtained between culture technic and molecular biology technic | Comparison culture vs molecular biology technics. | 16 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Clostridium difficile, Multidrug resistant bacteria, Risks factor, highly resistant bacteria, eXDR, ESBL