NCT06556420

Brief Summary

Respiratory tract infections represent the most frequent infectious pathology in community environments and when of bacterial origin, imply a morbid state generally supported by a pathogenic bacterial species predominant on the commensal flora of the airways. Among the most frequent bacterial infections of the upper respiratory tract in pediatric age we find acute bacterial pharyngitis or pharyngotonsillitis caused by Streptococcus pyogenes (β-hemolytic group A), for which antimicrobial therapy is clearly indicated, and which manifests itself with an onset sudden fever. It should also be remembered that some forms of pharyngitis are caused by Chlamydia pneumoniae, Mycoplasma pneumoniae, Bordetella pertussis and Legionella, commonly responsible for lower respiratory tract infections but recently also associated with upper respiratory tract infections. In childhood, a viral or bacterial infection of the upper respiratory tract (in particular pharyngitis, laryngitis) can easily lead to an infection of the lower respiratory tract (pneumonia). In fact, the inflammatory process triggered by a previous infection, generally viral, determines an impairment of mucociliary clearance which facilitates the proliferation not only of pathogenic bacteria but also of the commensal bacterial flora, normally non-pathogenic. An altered local microbial flora can, therefore, contribute to the pathogenesis of new infections or itself be responsible for invasive infections. The microbiota of the upper airways may therefore be a further factor influencing the susceptibility, frequency and severity of acute respiratory diseases. The oropharyngeal microbiota is in fact made up of numerous bacterial species which, by colonizing this anatomical tract, interact with the mucosa of the pharynx and therefore with the immune system, contributing to the homeostasis of the upper respiratory tract and consequently also preserving the integrity of the lower respiratory tract. As observed for other anatomical sites, the composition of the oropharyngeal microbiota is conditioned by external events, among which we find the use of antibiotics or oral disinfectant drugs which can favor the development of pathogenic microorganisms. Characterizing the oropharyngeal microbiota in a state of acute and/or chronic respiratory infection could increase knowledge on the microbiological signature associated with such infections and ineffective antibiotic treatments. Greater knowledge of it, also with future corrective purposes, as has now been demonstrated for other body areas, could be of great help in reducing the risk of acute recurrent disease and/or chronic consequences.

Trial Health

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Trial Health Score

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

Enrollment
100

participants targeted

Target at P50-P75 for all trials

Timeline
3mo left

Started Sep 2024

Status
not yet recruiting

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

Study Progress86%
Sep 2024Aug 2026

First Submitted

Initial submission to the registry

July 30, 2024

Completed
17 days until next milestone

First Posted

Study publicly available on registry

August 16, 2024

Completed
1 month until next milestone

Study Start

First participant enrolled

September 15, 2024

Completed
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 15, 2025

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

August 15, 2026

Expected
Last Updated

August 16, 2024

Status Verified

August 1, 2024

Enrollment Period

11 months

First QC Date

July 30, 2024

Last Update Submit

August 13, 2024

Conditions

Keywords

microbiota faringeo, infezioni respiratorie

Outcome Measures

Primary Outcomes (1)

  • Evaluation of pharingeal microbiota

    Characterization of the pharyngeal microbiome (alpha and beta diversity, relative and differential abundances) in patients with symptoms attributable to respiratory infections

    24 months

Secondary Outcomes (1)

  • Differences in microbiota in patients with diverse respiratory infections

    24 months

Study Arms (3)

controls

patients with S. pyogenes infection

patients with other respiratory infections

Eligibility Criteria

Age0 Years - 20 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)
Sampling MethodProbability Sample
Study Population

Patients who access the Pediatric Emergency Department with respiratory symptoms attributable to acute respiratory infection attributable to a bacterial and/or viral nature (diagnosed through nasopharyngeal swab as per normal clinical practice), who have given their informed consent to participate in this study. Subjects accessing the Pediatric Emergency Department who will perform a nasopharyngeal swab, as per normal clinical practice, with a negative result will also be included in the study as controls, considering the same exclusion criteria reported below. Informed consent will therefore be acquired upon entry to the Pediatric Emergency Department and in relation to the outcome of the nasopharyngeal swab the subjects will then be stratified into groups.

You may qualify if:

  • age 0-20 years
  • signs and/or symptoms of acute respiratory tract infection such as cold, pharyngitis, laryngitis, tracheitis, otitis, epiglottitis, laryngotracheitis, bronchitis and pneumonia.

You may not qualify if:

  • antibiotic therapies in the last 30 days
  • treatments with prebiotics or probiotics in the last 60 days (in particular containing Streptococcus salivarius)
  • hormone therapies in the last 60 days
  • local therapies in the last 60 days
  • treatments with oral cavity disinfectants in the last 30 days
  • presence of other pre-existing or ongoing respiratory pathologies
  • current severe sepsis (sepsis criteria + organ dysfunction, peripheral hypoperfusion, hypotension)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Respiratory Tract Infections

Condition Hierarchy (Ancestors)

InfectionsRespiratory Tract Diseases

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

July 30, 2024

First Posted

August 16, 2024

Study Start

September 15, 2024

Primary Completion

August 15, 2025

Study Completion (Estimated)

August 15, 2026

Last Updated

August 16, 2024

Record last verified: 2024-08