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Recruiting NCT06058819

Validation of Biomarkers Performance to Reduce Antibiotics overUse in newBorns With Suspected Clinical Signs of InfectionS

— Observational Neonatal Late Onset Sepsis

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Newborns suspected of Infections.
Who it may be relevant to
Registry conditions: Neonatal Late Onset Sepsis. Basic parameters: 7 Days — 14 Days · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
France
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Overview

Late-onset neonatal sepsis (LOS), occurring in newborn of at least 7 days of life, is frequently observed in Neonatal Intensive Care Units (NICUs) and potentially severe (mortality, neurologic and respiratory impairments). Despite its high prevalence, a reliable diagnostic remains difficult. Currently, nonspecific clinical signs that might be related to other neonatal conditions such as prematurity and birth defects, are used to determine the diagnosis of LOS. Laboratory results of biological markers, such as C-Reactive Protein (CRP) and Procalcitonin (PCT) are often delayed in comparison with LOS onset. Blood culture results are too late and lack sensitivity. This explains why excessive antibiotic use is observed in a large proportion of NICU hospitalized newborns. This results in an increased antibiotic resistance, microbiota modification, neonatal complications (pulmonary, ophthalmologic and neurologic) and mortality. A previous study (EMERAUDE) aimed to identify new biomarkers to early exclude the diagnosis of LOS, in order to limit antibiotic overuse. This study including 230 neonates revealed high performances of IL6, IL10, NGAL and combinations of PCT/IL10 and PTX3/NGAL. The main objective of the present study will be to validate the performances of these biomarkers in another cohort. The secondary objectives will be to explore transcriptomic biomarkers and salivary biomarkers.

Interventions

  • Diagnostic test Newborns suspected of Infections
    This study will include NICU newborns of at least 7 days of life with suggestive signs of neonatal sepsis. The results will be extrapolated to this same population.

Primary outcome measures

  • Diagnosis of late onset sepsis [Time frame: 72 hours maximum after inclusion]

Eligibility criteria

Inclusion criteria

  • Patient hospitalized in the NICU of one of the two recruiting centers at the time of inclusion
  • Patients aged ≥ 7 days
  • Patients weighted ≥ 500 g the day of blood sample
  • patients with suggestive signs of LOS including at least one of the following:Fever > 38°C; tachycardia > 160bpm; capillary refill time > 3 seconds; grey and/or pale skin complexion; apnea/ bradycardia syndrome, bloating; vomiting; rectal bleeding; hypotonia; lethargy; seizures without other obvious cause; increased ventilatory support and/or increased FiO2; cutaneous rash; inflammation at the needle-puncture site of the central venous catheter; or any other condition for which the clinician suspected an infection
  • patients with a standard of care blood sampling, including at least a blood culture;

Exclusion criteria

  • Patient treated with antibiotics for a bacteriologically confirmed infection at the time of sampling or within 48 hours prior to sampling
  • Patient who underwent surgery within the previous 7 days
  • Patients vaccinated within the previous 7 days
  • Patient who received treatment with systemic corticosteroid therapy in the 48 hours prior to sampling
  • Patient with severe combined immunodeficiency
  • Opposition from parent(s)/guardian(s)

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model
Cohort

Study locations

France · 3 centers
  • neonatal Intensive care unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, France — Bron
  • Hôpital Couple-Enfant - CHU Grenoble Alpes — Grenoble
  • Neonatal intensive care unit, Hôpital femme-maternité — Nantes

Identifiers

NCT: NCT06058819 · 69HCL23_0633

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗