HIV Infections Clinical Trial
Official title:
Risk-factors for Multidrug-resistant (MDR) and Extensively Drug-resistant (XDR) Bacteria Colonization Among Patients at High Risk of STIs
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.
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