The aim of this study is to identify risk factors and prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria colonization among patients at high risk of STIs
The spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria have become a worldwide public health concern. Infection with MDR/XDR bacteria is associated with increased morbidity, increased risk of therapeutic failure and healthcare costs. The largest burden is from extended-spectrum betalactamase-producing enterobacteriaceae (ESBL) and carbapenem-resistant enterobacteriaceae (CRE). The World Health Organization (WHO) has considered the epidemic of MDR/XDR bacteria as a major health concern and has registered these bacteria in the "priory pathogens list." This list includes pathogens for which new antibiotics are urgently needed. Moreover, in their recent report on ESBL, the French National Authorities of Health (HAS) has recommended that additional studies be conducted to improve knowledge about colonization risk factors. Some risk factors have been already identified: antibiotic intake and travel to countries with high MCR/XDR bacteria prevalence; however, many others are poorly identified. Patients visiting the CeGIDD (free information, screening and diagnosis center for sexually transmitted infections) and those receiving pre-exposure prophylaxis (PrEP) to prevent HIV infection are more exposed to STIs (including methicillin-resistant staphylococcus aureus, MRSA) and receive antibiotics for STI treatment. Moreover, an increase of STIs has been recently observed in men who have sex with men and in patients receiving PrEP. As antibiotic use is likely considerably increased in this population, we anticipate a high proportion with MDR/XDR colonization. The objective of the "BMR-IST" study is to identify risk-factors (i.e. sexual behaviors, HIV status, antiretroviral PrEP, STIs, antibiotic use and travel to epidemic countries) of MDR/XDR bacteria colonization among patients at high risk of acquiring STIs and to determine the prevalence of MDR colonization in the studied population.
Study Type
OBSERVATIONAL
Enrollment
2,186
Inguinal samples using swab at cross-sectional visit
Anal samples using swab at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)
Fecal sample at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization)
CeGIDD and Infections Diseases Unit
Paris, France
Prevalence of ESBL and/or CRE colonization
Proportion of participants with ESBL and/or CRE colonization
Time frame: 0 months
Loss of ESBL and/or CRE colonization after 6 months
Proportion of ESBL and/or CRE colonized participants no longer colonized at 6 months
Time frame: 6 months
STI prevalence
Proportion of participants with an STIs
Time frame: 0 months
Prevalence of ESBL and/or CRE colonization in the HIV-negative MSM group
Proportion of HIV-negative MSM participants with ESBL and/or CRE colonization
Time frame: 0 months
Prevalence of ESBL and/or CRE colonization in the HIV-positive MSM group
Proportion of HIV-positive MSM participants with ESBL and/or CRE colonization
Time frame: 0 months
Prevalence of ESBL and/or CRE colonization in the PrEP group
Proportion of participants undergoing PrEP with ESBL and/or CRE colonization
Time frame: 0 months
Prevalence of ESBL and/or CRE colonization in those with previous antibiotic exposure
Proportion of participants having previous antibiotic exposure with ESBL and /or CRE colonization
Time frame: 0 months
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Patients will be asked questions on risk factors associated with MDR/XDR colonization at cross-sectional visit and at 6-month visit (for those with ESBL and/or CRE colonization