Wastewater monitoring for antibiotic-resistant bacteria in nursing homes
Multicentre Study Analysing Wastewater to Monitor Bacterial Resistance to Antibiotics in Residential Care Homes for Elderly Dependent.
This project will test whether the amount of resistant bacteria in nursing home wastewater can indicate how many residents carry those bacteria.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 1600 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Nantes University Hospital Academic / other |
| Locations | 2 sites (Angers and 1 other locations) |
| Trial ID | NCT07234331 on ClinicalTrials.gov |
What this trial studies
This multicentre observational project collects wastewater from participating nursing homes and pairs those samples with stool-based carriage data from residents to model links between environmental concentrations and resident colonization with ESBL-producing and carbapenemase-producing Enterobacterales. Residents present on the day of sampling are enrolled with informed non-opposition or via a legal representative, and carriage prevalence is measured primarily by stool sampling. The primary outcome is a predictive model's fit and performance for estimating resident carriage from wastewater concentrations, with analyses accounting for facility-level factors and antibiotic use. The aim is to determine whether routine wastewater surveillance could serve as a non-invasive early warning system for antimicrobial resistance in long-term care facilities.
Who should consider this trial
Good fit: Ideal candidates are residents present on the day of sampling at a participating nursing home who can provide informed non-opposition themselves or via a legal representative, regardless of infection status or current antibiotic use.
Not a fit: People who do not live in a participating nursing home, or facilities without on-site wastewater collection, will not receive direct benefit from this surveillance approach.
Why it matters
Potential benefit: If successful, this approach could offer a low-burden, facility-level early warning system to detect and track antibiotic-resistant bacteria among nursing home residents.
How similar studies have performed: Wastewater-based surveillance has demonstrated promise for monitoring community-level antimicrobial resistance, but using wastewater to predict carriage prevalence within individual nursing homes is relatively novel and not yet widely validated.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Residents present on the day of sampling (D0 or D+1) in a facility selected during randomization, without criteria regarding length of stay in the facility, and whose health status on the day of the survey permits it; * Residents who, based on clinical criteria (including an MMSE greater than or equal to 20), are deemed by the nursing home team to be able to understand the issues of the study and to express an informed non-opposition; OR Residents who the nursing home team considers unable to express an informed non-objection but who have a legal representative, a trusted person, or a loved one capable of understanding the information and expressing an informed non-objection. Residents may be included regardless of the presence of infection, diarrheal stools, antibiotic use or any other treatment, or health status. Participants in this study may participate in other research projects concurrently. Exclusion Criteria: Health and medico-social facilities not considered nursing homes (e.g., FAM, MAS, etc.); * Residents whose health status is incompatible with performing the procedure on the day of the survey (e.g., end-of-life with comfort care); * Residents with a Mini Mental State Examination (MMSE) score of less than or equal to 20, or without an MMSE score but who, according to nursing home professionals, are unable to provide an informed non-objection and who do not have a legal representative, trusted person, or relative capable of receiving information and providing an informed non-objection; * Residents, regardless of their MMSE score, who refuse to have the sample taken on the day of the survey even if their legal repre
Where this trial is running
Angers and 1 other locations
- CHU d'Angers — Angers, France (Recruiting)
- CHU de Nantes — Nantes, France (Recruiting)
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.