Antibiotic resistance in the PICU (The ARCTIC study)
Research type
Research Study
Full title
Infection prevention and its impact on Antimicrobial Resistance in CriTically Ill Children (The ARCTIC study)
IRAS ID
268237
Contact name
Nazima Pathan
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge
Clinicaltrials.gov Identifier
268237, IRAS
Duration of Study in the UK
1 years, 6 months, 31 days
Research summary
Young children, particularly those with severe and complex disease, are at significant risk of secondary infection by
antimicrobial resistant bacteria. The gut microbiome, comprising of trillions of normally beneficial bacteria, is a
reservoir of antimicrobial resistance genes and often the source of healthcare-associated infection (HAI). In critically ill adults, evidence suggests selective decontamination of the digestive tract (SDD) reduces HAIs and improves survival. The effects of both standard and SDD-enhanced infection on antimicrobial resistance gene carriage following critical illness are unclear. We have been commissioned by the NIHR(HTA) to undertake a pilot clinical trial evaluating feasibility of SDD in critically ill children (called the Paediatric Infection Control in Critical Illness, PICNIC, trial). The trial infrastructure allows us to efficiently study
the dynamics of antimicrobial resistance in critically ill children.
We will recruit children enrolled to PICNIC in order to provide greater depth of insight on antimicrobial resistance and combine culture-based methods with molecular (metagenomic) profiling to examine antimicrobial resistance gene carriage in the faecal and oropharyngeal microbiomes during and 3 months after critical illness. An understanding of whether SDD results in significant or sustained increases in antimicrobial resistance will inform the rationale for a future definitive clinical trial. We will use the data from this study to guide the development of a more personalised approach to SDD-enhanced infection control and the development of age-appropriate microbiota-based interventions to clear resistant bacteria in the intestinal microbiome.REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
20/SW/0057
Date of REC Opinion
2 Nov 2020
REC opinion
Further Information Favourable Opinion