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Photodisinfection for the Decolonization of Staphylococcus Aureus in Hemodialysis Patients

Primary Purpose

Staphylococcus Aureus Infection, MSSA Colonization

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
photodynamic therapy (Ondine: MRSAid™)
Sponsored by
McMaster University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Staphylococcus Aureus Infection focused on measuring Staphylococcus aureus; nare carriage

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patient is able to provide written informed consent. (If the patient is unable to provide written informed consent, the patient's legally accepted representative may provide written consent as approved by institution-specific guidelines)
  • Age ≥ 18
  • Currently undergoing hemodialysis and has hemodialysis catheter in-situ
  • Positive SA culture from anterior nare within 2 weeks of enrollment.
  • Have had no antibacterial therapy for any reason within the previous 7 days
  • Patient is willing and able to return for treatment and evaluation procedures scheduled throughout the course of this clinical study

Exclusion Criteria:

  • Patient has taken antibiotics in the last 7 days
  • Patient has taken an investigational medication in the last 30 days or is involved in a clinical study
  • Women who are pregnant, nursing or of child-bearing potential and not using a medically accepted, effective method of birth control (e.g., condom, hormonal contraceptive, indwelling intrauterine device, sexual abstinence)
  • Patient uses nasal medication that cannot be discontinued on the day of scheduled photodisinfection therapy.
  • Patient is on oxygen via nasal cannula
  • Patient has an active malignancy of any type by patient report, except for basal cell carcinoma
  • Patient's surgery involves the nasal or oral cavity (e.g. repair of deviated septum)
  • Patient has had surgery of the nasal tract or sinuses within the prior 3 months
  • Patient has a history of moderate to severe hypersensitivity reactions to methylene blue (mild rash is not a contraindication to enrollment)
  • Patient has active ulcerations of the nasal septum
  • Patient has nasal polyps
  • Patient has suspected or confirmed rhinosinusitis as evidenced by all three of the following:
  • Sneezing
  • Nasal congestion or rhinorrhea
  • Patient has suspected or confirmed sinusitis
  • Patient has suspected or confirmed upper respiratory infection as evidenced by at least one of the following symptoms:
  • Fever of up to 38 oC.
  • Sore throat, laryngitis
  • Post-nasal mucus, cough
  • Patient has any rapidly progressing disease or immediately life-threatening illness including acute hepatic failure, respiratory failure and septic shock
  • Patient has an immunocompromising illness including known infection with human immunodeficiency virus (HIV), AIDS, hematological malignancy and bone marrow transplantation, or immunosuppressive therapy including cancer chemotherapy, medications for prevention of organ transplantation rejection, imuran and the administration of corticosteroids equivalent to or greater than 40 mg of prednisone per day administered for more than 14 days
  • Patient is anticipated to receive any amount of potentially therapeutic antimicrobial therapy after collection of the pretreatment baseline culture and before administration of the study treatment
  • Patient has a current urinary catheter that will not be removed or anticipation of urinary catheter placement that will not be removed during the course of study treatment. (Clarification: Intermittent straight catheterization after the study treatment is acceptable.)
  • Patient has a concomitant infection requiring systemic antibiotic or antifungals at the time of assignment of patient number
  • Patient has any condition or circumstance that, in the opinion of the investigator, would compromise the safety of the patient or the quality of study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    single arm

    Arm Description

    This is a single arm, open label study. Subjects who meet eligibility criteria will be treated with photodisinfection therapy (MRSAid™).

    Outcomes

    Primary Outcome Measures

    The efficacy of PDT in nasal decolonization of S. aureus in hemodialysis patients by measuring number of participants with successful decolonization of S. aureus
    30 patients will be recruited. Success of decolonization will be determined by serial culture of nare swabs for S. aureus.

    Secondary Outcome Measures

    Full Information

    First Posted
    February 29, 2016
    Last Updated
    August 14, 2018
    Sponsor
    McMaster University
    Collaborators
    St. Joseph's Healthcare Hamilton
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02741869
    Brief Title
    Photodisinfection for the Decolonization of Staphylococcus Aureus in Hemodialysis Patients
    Official Title
    Photodisinfection for the Decolonization of Staphylococcus Aureus in Hemodialysis Patients
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2018
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Investigator moved locations.
    Study Start Date
    May 2016 (Anticipated)
    Primary Completion Date
    December 1, 2016 (Actual)
    Study Completion Date
    December 1, 2016 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    McMaster University
    Collaborators
    St. Joseph's Healthcare Hamilton

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of the study is to evaluate whether PDT (MRSAid™) is effective in eradicating SA from hemodialysis patients who are known to harbor this organism inside their nose.
    Detailed Description
    This is a medical research study is to eliminate Staphylococcus aureus (SA) (decolonization) from nares of patients who are colonized with this organism. Bacterial colonization of the anterior nares (inside of the nose) is believed to play an important role in the development of infection of central venous catheter, such as the line used for hemodialysis, and subsequent bloodstream infection. Photodynamic therapy (PDT) has been shown to be lethal against all classes of microorganisms: Gram-positive and, Gram-negative bacteria, fungi (fungus), viruses, parasites and even spores. In addition to the antimicrobial effects PDT also demonstrates an anti-inflammatory effect. The objective of this study is to evaluate the efficacy of PDT in nasal decolonization of S. aureus in hemodialysis patients

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Staphylococcus Aureus Infection, MSSA Colonization
    Keywords
    Staphylococcus aureus; nare carriage

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    single arm
    Arm Type
    Experimental
    Arm Description
    This is a single arm, open label study. Subjects who meet eligibility criteria will be treated with photodisinfection therapy (MRSAid™).
    Intervention Type
    Device
    Intervention Name(s)
    photodynamic therapy (Ondine: MRSAid™)
    Other Intervention Name(s)
    MRSAid™
    Intervention Description
    Photodisinfection using MRSAid™ for the decolonization of S. aureus in hemodialysis patients
    Primary Outcome Measure Information:
    Title
    The efficacy of PDT in nasal decolonization of S. aureus in hemodialysis patients by measuring number of participants with successful decolonization of S. aureus
    Description
    30 patients will be recruited. Success of decolonization will be determined by serial culture of nare swabs for S. aureus.
    Time Frame
    1 year

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patient is able to provide written informed consent. (If the patient is unable to provide written informed consent, the patient's legally accepted representative may provide written consent as approved by institution-specific guidelines) Age ≥ 18 Currently undergoing hemodialysis and has hemodialysis catheter in-situ Positive SA culture from anterior nare within 2 weeks of enrollment. Have had no antibacterial therapy for any reason within the previous 7 days Patient is willing and able to return for treatment and evaluation procedures scheduled throughout the course of this clinical study Exclusion Criteria: Patient has taken antibiotics in the last 7 days Patient has taken an investigational medication in the last 30 days or is involved in a clinical study Women who are pregnant, nursing or of child-bearing potential and not using a medically accepted, effective method of birth control (e.g., condom, hormonal contraceptive, indwelling intrauterine device, sexual abstinence) Patient uses nasal medication that cannot be discontinued on the day of scheduled photodisinfection therapy. Patient is on oxygen via nasal cannula Patient has an active malignancy of any type by patient report, except for basal cell carcinoma Patient's surgery involves the nasal or oral cavity (e.g. repair of deviated septum) Patient has had surgery of the nasal tract or sinuses within the prior 3 months Patient has a history of moderate to severe hypersensitivity reactions to methylene blue (mild rash is not a contraindication to enrollment) Patient has active ulcerations of the nasal septum Patient has nasal polyps Patient has suspected or confirmed rhinosinusitis as evidenced by all three of the following: Sneezing Nasal congestion or rhinorrhea Patient has suspected or confirmed sinusitis Patient has suspected or confirmed upper respiratory infection as evidenced by at least one of the following symptoms: Fever of up to 38 oC. Sore throat, laryngitis Post-nasal mucus, cough Patient has any rapidly progressing disease or immediately life-threatening illness including acute hepatic failure, respiratory failure and septic shock Patient has an immunocompromising illness including known infection with human immunodeficiency virus (HIV), AIDS, hematological malignancy and bone marrow transplantation, or immunosuppressive therapy including cancer chemotherapy, medications for prevention of organ transplantation rejection, imuran and the administration of corticosteroids equivalent to or greater than 40 mg of prednisone per day administered for more than 14 days Patient is anticipated to receive any amount of potentially therapeutic antimicrobial therapy after collection of the pretreatment baseline culture and before administration of the study treatment Patient has a current urinary catheter that will not be removed or anticipation of urinary catheter placement that will not be removed during the course of study treatment. (Clarification: Intermittent straight catheterization after the study treatment is acceptable.) Patient has a concomitant infection requiring systemic antibiotic or antifungals at the time of assignment of patient number Patient has any condition or circumstance that, in the opinion of the investigator, would compromise the safety of the patient or the quality of study

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Photodisinfection for the Decolonization of Staphylococcus Aureus in Hemodialysis Patients

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