NCT04583241

Brief Summary

There are more than one million (\> 40,000 cases per year in France) of osteoarticular infections (OAI) yearly in the world. The number of these infections is constantly increasing due to an increase in life expectancy associated with an increase in prosthesis fitting, as well as an increase in comorbid factors. These are severe pathologies associated with mortality (5%) and significant morbidity (40%), responsible for functional sequelae with an individual cost (prolonged hospitalization, altered quality of life, disability) and societal (sick leave, partial disability). or total, temporary or permanent) extremely high. In addition, reinfection rates within two years of treatment are high. The BJIs are a group of clinical entities that have in common the invasion and progressive destruction of bone and cartilage tissue by bacterial-like microorganisms. Staphylococcus spp is the main pathogen (\>50%) in BJI and is associated with particularly difficult to treat infections, with a high rate of chronicity and relapses, especially in case of implanted material. The difficulty in managing these infections is partly linked, on the one hand, to the fact that the pathogens are in "persistent" metabolic forms and in intracellular reservoirs which make them insensitive to conventional antibiotics and, on the other hand, the absence of reliable markers of the infection and above all of its clinical resolution, which complicates clinical trials. ESPRI-IOAC is a consortium of 4 partners (private-public) from Lyon area and which aims at:

  • studying the translational value of BJI preclinical models
  • identifying biomarkers of infection in preclinical models and at assessing them in a prospective study. The current study is part of the global ESPRI-IOAC consortium, and represent the clinical application. It is a prospective study of patients treated for BJI in the infectious disease department of the Hospices Civils de Lyon, La Croix-Rousse, for osteo-articular infections due to Staphylococcus aureus, or for simple mechanical revision or for cruciate ligament surgery, the objective of which is to highlight biomarkers of interest in the diagnosis of chronic BJI and, or predictive of the therapeutic response. The translational value of the experimental models used in the BJI will also be studied.

Trial Health

57
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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
28

participants targeted

Target at below P25 for all trials

Timeline
Completed

Started Nov 2020

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 5, 2020

Completed
7 days until next milestone

First Posted

Study publicly available on registry

October 12, 2020

Completed
2 months until next milestone

Study Start

First participant enrolled

November 27, 2020

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 26, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 26, 2022

Completed
Last Updated

June 23, 2022

Status Verified

June 1, 2022

Enrollment Period

1.2 years

First QC Date

October 5, 2020

Last Update Submit

June 17, 2022

Conditions

Keywords

BJIStaphylococcus aureusbiomarkers

Outcome Measures

Primary Outcomes (4)

  • Dosages of serum osteocalcin

    Comparison of dosages by ELISA test of serum osteocalcin between the patients with OAI and the "control" patients without OAI at the time of inclusion in order to demonstrate a marker or a combination of markers for OAI.

    At the time of surgery

  • Dosages of serum procollagen propeptide type 1

    Comparison of dosages by ELISA test of serum procollagen propeptide type 1 between the patients with OAI and the "control" patients without OAI at the time of inclusion in order to demonstrate a marker or a combination of markers for OAI.

    At the time of surgery

  • Dosages of serum cross-linked telopeptide of type 1 collagen

    Comparison of dosages by ELISA test of serum cross-linked telopeptide of type 1 collagen between the patients with OAI and the "control" patients without OAI at the time of inclusion in order to demonstrate a marker or a combination of markers for OAI.

    At the time of surgery

  • Dosages of serum periostin

    Comparison of dosages by ELISA test of serum periostin between the patients with OAI and the "control" patients without OAI at the time of inclusion in order to demonstrate a marker or a combination of markers for OAI.

    At the time of surgery

Study Arms (4)

BJI group

Patients with an BJI on material (prosthesis or other implant) infected by Staphylococcus aureus\* Patients are follow-up during two years after surgery. \*Diagnosis of staphylococcus aureus monoinfection realized a posteriori after surgery on bacteriological sample

Other: Constitution of serum bank at D0Other: Constitution of serum bank during follow-upOther: ELISA assays of serum markers of bone remodeling at D0Other: ELISA assays of serum markers of bone remodeling during follow-upOther: Analysis of bacterial gene expression at D0

Control Group With material

Patients with mechanical problems on implanted equipment (control cohort), without infection\* Patient of this group are follow-up until surgery. \*Diagnosis of staphylococcus aureus monoinfection realized a posteriori after surgery on bacteriological sample

Other: Constitution of serum bank at D0Other: ELISA assays of serum markers of bone remodeling at D0Other: Analysis of bacterial gene expression at D0

Group osteomyelitis

Patients with chronic osteomyelitis\* Patient of this group are follow-up until surgery. \*Diagnosis of staphylococcus aureus monoinfection realized a posteriori after surgery on bacteriological sample

Other: Constitution of serum bank at D0Other: ELISA assays of serum markers of bone remodeling at D0Other: Analysis of bacterial gene expression at D0

Control Group with cruciate ligament surgery

Patients having cruciate ligament surgery Patient of this group are follow-up until surgery.

Other: Constitution of serum bank at D0Other: ELISA assays of serum markers of bone remodeling at D0Other: Analysis of bacterial gene expression at D0

Interventions

Blood samples at Day 0 (day of surgery)

BJI groupControl Group With materialControl Group with cruciate ligament surgeryGroup osteomyelitis

Blood samples are obtained at week 2, week 6 post-surgery, at the end of antibiotherapy and 6 months post-surgery, only for patients with staphylococcus aureus monoinfection who are follow-up during two years.

BJI group

Assessment by ELISA assays of serum markers of bone remodelling: the osteocalcin (OC), the procollagen propeptide type 1 (PINP), the cross linked telopeptide of type 1 collagen (CTX1) and the periostin at Day 0 (day of surgery)

BJI groupControl Group With materialControl Group with cruciate ligament surgeryGroup osteomyelitis

Assessment by ELISA assays of serum markers of bone remodelling: the osteocalcin (OC), the procollagen propeptide type 1 (PINP), the cross linked telopeptide of type 1 collagen (CTX1) and the periostin at week 2, week 6 post-surgery, at the end of antibiotherapy and 6 months post-surgery, only for patients with staphylococcus aureus monoinfection who are follow-up during two years

BJI group

Assessement of bacterial gene expression on surgery residual tissue (bone tissue, joint fluid, fragment of prostheses) collected at Day 0 (day of the surgery)

BJI groupControl Group With materialControl Group with cruciate ligament surgeryGroup osteomyelitis

Eligibility Criteria

Age30 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients treated in the orthopedic surgery and infectious diseases departments of the Hospices Civils de Lyon, Croix-Rousse Hospital, for osteo-articular infections, due to Staphylococcus aureus, for simple mechanical revision or for cruciate ligament surgery.

You may qualify if:

  • Age ≥ 30 years old
  • Hospitalized in orthopedic surgery for one of these reasons:
  • A suspected infection or a documented proven infection with staphylococcus aureus on prosthesis or other orthopedic implant
  • A mechanical cause (absence of infection) on prosthesis or orthopedic implant
  • Documented chronic osteomyelitis due to staphylococcus aureus
  • Cruciate ligament surgery
  • Patient not subject to any legal protection measure
  • Patient who can be followed in the Infectious and Tropical Diseases Department, CRIOAC Lyon ("Centre de Référence des Infections Ostéo-Articulaires complexes" = reference centre of bone and joint infections in french), La Croix-Rousse for at least 6 months post-surgery
  • Patient who gave his no-opposition
  • Patient giving his consent to the creation of biological collections

You may not qualify if:

  • Polymicrobial infection
  • Known inflammatory disease
  • Hyperthyroidism
  • Cushing's disease
  • Osteomalacia
  • Renal osteodystrophy
  • Paget's disease
  • Malignant disease in progress
  • Multiple myeloma
  • Bone metastases
  • Ehlers-Danlos syndrome
  • Pregnant or lactating woman
  • Renal impairment (Creatinine clearance \<60 mL / min)
  • Trauma in the 6 months preceding surgery
  • Fracture in the 6 months preceding surgery
  • +2 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hôpital Croix Rousse

Lyon, 69004, France

Location

Biospecimen

Retention: SAMPLES WITH DNA

* Collection of serum : Blood samples are obtained at different times : Day 0 (day of surgery), and for patients with staphylococcus aureus monoinfection who are follow-up during two years, at week 2, week 6 post-surgery, at the end of antibiotherapy and 6 months post-surgery) * Tissue bank : Recovery of residual samples of bone tissue, joint fluid, fragment of prostheses the day of surgery

MeSH Terms

Conditions

Staphylococcal Infections

Condition Hierarchy (Ancestors)

Gram-Positive Bacterial InfectionsBacterial InfectionsBacterial Infections and MycosesInfections

Study Officials

  • Tristan FERRY, Pr

    Service Maladies Infectieuses et Tropicales, CRIOAC Lyon

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 5, 2020

First Posted

October 12, 2020

Study Start

November 27, 2020

Primary Completion

January 26, 2022

Study Completion

January 26, 2022

Last Updated

June 23, 2022

Record last verified: 2022-06

Locations