Clinical Outcomes in Patients With Infection by Resistant Microorganism

Study Overview
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Brief Summary
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The goal of this individual patient data meta-analysis is to estimate the attributed and the associated health burden related to bloodstream infections, pneumonia, skin and soft tissue infections, surgical site infections and urinary tract infections, caused by target drug-resistant pathogens, in high income countries. The main question[s] it aims to answer are: Are common infections caused by drug-resistant pathogens associated with an increased health burden, when compared with individuals with the same infection caused by a susceptible strain (attributed burden)? Are common infections caused by drug-resistant pathogens associated with an increase health burden, when compared with individuals without the infection under study (associated burden)?

Official Title
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Clinical Outcomes in Patients With Infection by Resistant Microorganism

Conditions
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Pneumonia, Bloodstream Infection, Urinary Tract Infections, Skin Infection, Surgical Site Infection, Staphylococcus Aureus, Klebsiella Pneumonia, Escherichia Coli, Enterococcus Faecium Infection, Acinetobacter Infections, Pseudomonas Aeruginosa

Intervention / Treatment
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* Other: Pathogen resistant phenotype


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals of all ages Individuals with hospital acquired, community acquired, or healthcare associated infections Individuals treated at hospital level, community, or long-term care facilities Individuals with the targeted pathogen, resistance phenotype, and infection site combinations under study Exclusion Criteria: Individuals with infections in the following systems: central nervous system, genital system, pelvic infections and head and neck infections Individuals with the following specific primary infections: endocarditis, upper respiratory tract infections, lung abscess Individuals with bacterial infections not included in the table of pathogens of interest, polymicrobial infections except for intraabdominal infections, fungal infections, parasitic infections, viral infections, mycobacterial infections, sexually transmitted diseases, and zoonotic infections
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Drug-resistant pathogen<br>Individuals of all ages with the target pathogen, resistance phenotype, and infection site combinations as follows: P. aeruginosa, carbapenems resistant: BSI A. baumannii, carbapenems resistant: BSI E. coli, 3rd generation cephalosporins resistant: BSI and UTI K. pneumoniae, 3rd generation cephalosporins resistant: BSI K. pneumoniae, carbapenems resistant: BSI S. aureus, methicillin resistant: BSI, pneumonia, SSI and SSTI E faecium, vancomycin resistant: BSI Enterobacterales, 3rd generation cephalosporins resistant: BSI | Other: Pathogen resistant phenotype<br>* Drug resistant phenotype of the target pathogen under study<br>|
| Drug-susceptible pathogen<br>Individuals of all ages with the target pathogen, susceptible phenotype, and infection site combinations as follows: P. aeruginosa, carbapenems susceptible: BSI A. baumannii, carbapenems susceptible: BSI E. coli, 3rd generation cephalosporins susceptible: BSI and UTI K. pneumoniae, 3rd generation cephalosporins susceptible: BSI K. pneumoniae, carbapenems susceptible: BSI S. aureus, methicillin susceptible: BSI, pneumonia, SSI and SSTI E faecium, vancomycin susceptible: BSI Enterobacterales, 3rd generation cephalosporins susceptible: BSI | Other: Pathogen resistant phenotype<br>* Drug resistant phenotype of the target pathogen under study<br>|
| No infection<br>Individuals of all ages without the infection under study | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Death any time after infection, during the follow-up time of the original study. | Through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with ICU admission | Need for an admission in ICU setting for more than 24 hours after infection onset. | Through study completion, an average of 1 year | 
| Number of participants with clinical cure | Absence of symptoms after completion of an antibiotic treatment course. | Through study completion, an average of 1 year | 
| Number of participants with microbiological cure | No isolation of the causal microorganisms after completion of an antibiotic treatment course. | Through study completion, an average of 1 year | 
| Number of participants with recurrence of infection | Infection with the same organism after more than two weeks of the initial infection. | Through study completion, an average of 1 year | 
| Number of participants with superinfection | Other infections different from the one under assessment. | Through study completion, an average of 1 year | 
| Number of participants with cognitive impairment / disability | Impairment is any temporal or permanent loss of function; disability is a restriction or inability to perform a normal activity resulting from an impairment. Assessed using Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Mental State Examination (MMSE) or Trail Making Test (TMT). | Through study completion, an average of 1 year |