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Carbapenem-Resistant Enterobacteriaceae InfectionNCT06051513

Efficacy and Safety of Colistimethate Sodium for Injection in The Treatment of Carbapenem-Resistant Enterobacteriaceae Infection

A study testing treatment with or without colistin in people with Carbapenem-Resistant Enterobacteriaceae Infection, run by Southeast University, China at 15 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Colistin can be used to treat the infection caused by carbapenem-resistant enterobacteriaceae(CRE). In China, patients diagnosed with Hospital-acquired-pneumonia (HAP)or bloodstream infection caused by CRE are recruited, and randomly assigned to two groups, and in one group the patients accept treatment with colistin… Read more about this study

Who is it for?
Ages 18 to 85 years
What is being tested?
treatment with or without colistin
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
404 participants
Where
15 sitesChina
Study dates
27 Nov 2023to 31 Dec 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients who can provide written informed consent or their informed consent can be provided by legal guardian
  • Patients who are hospitalized
  • Adults ≥18 years and ≤85 years of age
  • Patients suspected of or diagnosed with hospital-acquired pneumonia (HAP, in a patient hospitalised for more than 48 hours or developing within 7 days after discharge from a hospital) or bloodstream infection caused carbapenem-resistant enterobacteriaceae (CRE) based on the culture results of the sample collected 5 days before the randomization or rapid diagnostic detection.
  • Rapid testing of respiratory or blood specimens should be used to enable early identification of CRE infection pneumonia. Patients can be randomized based on the results of the rapid test while awaiting results of cultures from the local laboratory. However, if the sample does not grow CRE in the local microbiology laboratory culture, these patients will be withdrawn from the study drug treatment.
  • Patients with HAP should fulfil one of the following systemic signs: 1)Fever (temperature >38°C) or hypothermia (rectal/core temperature <35°C);2)White blood cell (WBC) count >10,000 cells/mm3, or WBC count <4500 cells/mm3, or >15% band forms and fulfil at least two of the following respiratory signs or symptoms:1)a new onset of cough (or worsening of cough);2)production of purulent sputum or endotracheal secretions;3)auscultatory findings consistent with pneumonia/pulmonary consolidation (e.g., rales, rhonchi, bronchial breath sounds, dullness to percussion, egophony);4)dyspnoea, tachypnoea or hypoxaemia (O2 saturation <90% or pO2 <60 mmHg while breathing room air).
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  • Patients with bloodstream infection should fulfil one of the following criterion:1)fever(≥38 ℃);2)chills;3)hypotension(systolic <90 mmHg, requiring vasopressors to maintain mean arterial pressure ≥60 mmHg,decreased by 30mmHg from baseline) ,and isolation of CRE from at least two blood culture collected from two different sites.
  • Respiratory or blood specimen obtained for culture within 5 days prior to randomization, and after the onset of signs and symptoms of HAP or bloodstream infection (ideally before receipt of any systemic antibiotics).
  • Patients whose APACHE II score is between 10 and 30.

Who cannot join

  • Patients who received polymyxin for more than 48 hours in the 72 hours prior to randomization.
  • Patients who received antibiotics more than 24 hours in the 72 hours prior to randomization, and after treatment,conditions of patients improved.
  • Patient with history of serious allergy, hypersensitivity (eg, anaphylaxis), or any serious reaction to Colistimethate Sodium for Injection or other ingredients of it.
  • Evidence of active concurrent pneumonia requiring additional antimicrobials treatment caused by Streptococcus pneumoniae,Haemophilus influenzae,Methicillin-resistant staphylococcus aureus,Vancomycin-resistant enterococcus,Mycoplasma pneumonia,Legionella pneumophila, respiratory syncytial virus, influenza virus, parainfluenza virus, Middle East Respiratory Virus, Mycobacteria, Aspergillus, Mucormycosis, Candida,etc. If these organisms are identified but it is deemed by the Investigator that no treatment is warranted and their presence does not significantly change the prognosis of the patient, then the patient may be considered for this study.
  • Patients who are diagnosed with primary lung cancer (including small cell lung cancer/non-small cell lung cancer patients) or other malignancy transferred to the lungs or other known post obstructive pneumonia. Patients who is known or suspected of active tuberculosis, cystic fibrosis, lung abscess, pyothorax or obstructive pneumonia.
  • Patients with hematological malignancy such as leukemia, lymphoma and multiple myeloma.
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  • Patients with lung/heart transplantation or stem cell transplantation.
  • Patient was immunocompromised and at risk of infection by opportunistic pathogens including, but not limited to the following:1) HIV (AIDS or CD4 <200). 2) chemoradiotherapy within 3 months prior to randomisation. 3) Immunosuppressive therapy including maintenance corticosteroids (0.5 mg/kg prednisone per day or other equivalent glucocorticoid). 4) Absolute neutrophil count <500/mm3.
  • Patients with chronic liver failure with portal hypertension, acute hepatic failure or acute decompensation of chronic hepatic failure.
  • Patients who participated in other clinical trials within three months.
  • Patient was pregnant or breastfeeding. If either urine or serum β-hCG test was positive, the patient was excluded.
  • Patient who have been previously enrolled in this study.
  • Patients who have condionts that may affect the trial.
  • Other conditions exist researchers thought are not suitable.

Trial locations and contacts

15 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Yingzi Huang, MD contact

+86-025-83262552

yz_huang@126.com

Jianfeng Xie, MD contact

+86-025-83262552

xie820405@126.com

15 sites in 1 country

China15 sites, 15 recruiting
  • Anhui Provincial People's Hospital

    Hefei, Anhui, 230000

    Aijun, Pan, +8613866668786

    Recruiting
  • The First Hospital of Anhui Medical University

    Hefei, Anhui, 230000

    Min Shao, +8615656065677

    Recruiting
  • Huai'an First People's Hospital

    Huai'an, Jiangsu, 223000

    Xiangcheng Zhang, +8615896169171

    Recruiting
  • Jinjiang Municipal Hospitall

    Jinjiang, Fujian, 362200

    Sen Lin, +8618065956302

    Recruiting
  • The First Hospital of Lianyungang

    Lianyungang, Jiangsu, 222000

    Suxia Liu, +8618961326708

    Recruiting
  • Zhongda Hospital Affiliated to Southeast University

    Nanjing, Jiangsu, 210000

    Yingzi Huang, +86-25-83262552, yz_huang@126.com

    Recruiting
  • Affiliated Hospital of Nantong University

    Nantong, Jiangsu, 226000

    Hongsheng Zhao, +8613962918910

    Recruiting
  • Suzhou Municipal Hospitial

    Suzhou, Jiangsu, 215000

    Liu Jun

    Recruiting
  • The First Affiliated Hospital of Soochow University

    Suzhou, Jiangsu, 215000

    Jun Jin, +8613806214010

    Recruiting
  • JiangsuTaizhou People's Hospital

    Taizhou, Jiangsu, 225300

    Jilu Ye, +8613852609309

    Recruiting
  • Wuxi No.2 People's Hospital

    Wuxi, Jiangsu, 214000

    Liang Luo, +8615961790376

    Recruiting
  • Xuzhou Central Hospital

    Xuzhou, Jiangsu, 221000

    Jiaqiong Li, +8618952170393

    Recruiting
  • Yancheng No.1 People's Hospital

    Yancheng, Jiangsu, 224000

    Genghua Mu, +8613815584925

    Recruiting
  • Northern Jiangsu People's Hospital

    Yangzhou, Jiangsu, 225000

    Ruiqiang Zheng, +8613952721411

    Recruiting
  • Yixing People's Hospital

    Yixing, Jiangsu, 214000

    Junjie Lu, +8613606157979

    Recruiting

Other trials in China

About this study

Official title: Colistimethate Sodium for Injection in The Treatment of Carbapenem-Resistant Enterobacteriaceae Infection:a Prospective, Open-label, Randomized Controlled, Multicenter Clinical Trial

Colistin can be used to treat the infection caused by carbapenem-resistant enterobacteriaceae(CRE). In China, patients diagnosed with Hospital-acquired-pneumonia (HAP)or bloodstream infection caused by CRE are recruited, and randomly assigned to two groups, and in one group the patients accept treatment with colistin, however in another group, the patients accept treatment without colistin. The efficacy and safety of the treatment between the two groups are compared.

Read the detailed description

The study will be conducted in accordance with good clinical practice and with the guidelines set out in the Declaration of Helsinki. After approval from local and national ethics committees, patients diagnosed with Hospital-acquired-pneumonia (HAP)or bloodstream infection caused by CRE from 14 centres in China will be recruited. All patients will be randomized to receive treatment with or without colistin in the ICU. The purpose of this study is to investigate the efficacy and safety of colistin when used to treat patients with CRE infection. The primary outcome is 14-day all cause mortality and the second outcomes include 14-day clinical cure rate, 14-day efficacy rate, ICU free days within 28 days after randomization,14-day microbiological cure rate,incidence of adverse events and severe adverse events in first 14 days, hospital mortality, 28-day all cause mortality, ICU mortality. Clopper-Pearson method is used to calculate the 95% confidence interval of mortality, Miettinen and Nurminen method is used to detect the difference between the two groups.

Being tested
treatment with or without colistin
Keywords
Colistimethate Sodium for Injection, Hospital-acquired pneumonia, Bloodstream infection, Carbapenem-resistant Enterobacteriaceae
Medical subject headings
Healthcare-Associated Pneumonia, Sepsis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • treatment with or without colistinDrug

    For patients in this treatment group, colistin based therapy is used. Colistin combined with metroperan or imipenem(MIC≤8mg/L),or colistin combined with tigecycline, or colistin combined with aminoglycosides (amikacin) are suggested to treat patients diagnosed with hospital-acquired pneumonia or bloodstream infection caused by carbapenem-resistant enterobacteriaceae. For patients in the control, best available treatment without colistin is uesed; Ceftazidime-avibactam, tigecycline combined with metroperan or imipenem(MIC≤8mg/L), tigecycline combined with aminoglycosides (amikacin) are suggested to treat patients diagnosed with hospital-acquired pneumonia or bloodstream infection caused by carbapenem-resistant enterobacteriaceae.

Study groups in NCT06051513
Study groupRoleWhat they receive
colistin groupExperimentalFor patients in this group, colistin based therapy is used. Colistin combined with metroperan or imipenem(MIC≤8mg/L),or colistin combined with tigecycline, or colistin combined with aminoglycosides (amikacin) are suggested to treat patients diagnosed with hospital-acquired pneumonia or bloodstream infection caused by carbapenem-resistant enterobacteriaceae. At the beginning of the intravenous use of Colistimethate Sodium for Injection,the load dose is 300mg CBA(about 9 million U),and after 12-24 hours,the first maintenance dose should be given. The daily maintenance dose was 300-360mg CBA(9 million-10.9 million U), divided into two times (1/12h), for each time, 0.5-1 hour is needed to complete the infusion. Drug: colistin, other name: Colistimethate Sodium for Injection
Receives: Drug: treatment with or without colistin
control groupActive comparatorFor patients in this group,best available treatment without colistin is used. Ceftazidime-avibactam, tigecycline combined with metroperan or imipenem(MIC≤8mg/L), tigecycline combined with aminoglycosides (amikacin) are suggested to treat patients diagnosed with hospital-acquired pneumonia or bloodstream infection caused by carbapenem-resistant enterobacteriaceae.Dose of other drugs are listed below: 1-2g meropenem should be given every 8 hours,1g Imipenem every 8 hours or 6 hours,0.8g Amikacin everyday,2.5g ceftazidime-avibactam every 8 hours. A load dose of 200mg tigecycline is needed, followed by 100mg every 12 hours.
Receives: Drug: treatment with or without colistin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 14-day all cause mortality

    the proportion of subjects who die within 14 days after randomization to the number of subjects in each group

    Measured: from randomization to day 14

Secondary outcomes (8)
  1. 14-day clinical cure rate

    the proportion of subjects who are thought as clinical effectiveness 14 days after randomization to the number of subjects in each group.

    Measured: from randomization to day 14

  2. 14-day efficacy rate

    the proportion of subjects of who are thought as recovery 14 days after randomization to the number of subjects in each group.

    Measured: from randomization to day 14

  3. ICU free days within 28 days after randomization

    days that patients are not treated in ICU within 28 days after randomization of each patient in each group. If the patient die within 28 days, it will be zero.

    Measured: from randomization to day 28

  4. 14-day microbiological cure rate

    the proportion of subjects of microbiological cure to the number of subjects in each group 14 days after randomization.

    Measured: from randomization to day 14

  5. incidence of adverse events and severe adverse events within first 28 days

    the proportion of patients who experience adverse events and severe adverse events within 14 days after randomization to the number of subjects in each group wihtin first 14 days

    Measured: from randomization to day 28

  6. hospital mortality

    the proportion of subjects who die when treated in hospital to the number of subjects in each group

    Measured: to be evaluated up to 90 days post randomization

  7. 28-day all cause mortality

    the proportion of subjects who die within 28 days after randomization to the number of subjects in each group

    Measured: from randomization to day 28

  8. ICU mortality

    the proportion of subjects who die in ICU to the number of subjects in each group

    Measured: to be evaluated up to 90 days post randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Sep 2023
  2. Study start27 Nov 2023
  3. Primary completion31 Dec 2025 (estimated)
  4. Study completion31 Dec 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
404 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06051513
Sponsor's protocol ID
COUNT-CRE
Status last verified
May 2025
First submitted
7 Sep 2023
Last updated
18 May 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Li X, Zhang C, Li J, Chen T, Xie J, Huang Y. Multicentre open-label randomised controlled trial comparing the efficacy and safety of colistin-based combination therapy with the best available therapy for treating hospital-acquired pneumonia or bloodstream infections caused by carbapenem-resistant Enterobacteriaceae (COUNT-CRE): a study protocol. BMJ Open. 2025 Jul 16;15(7):e092157. doi: 10.1136/bmjopen-2024-092157.

    PubMed 40669898

Questions about this trial

What is this clinical trial studying?

A study testing treatment with or without colistin in people with Carbapenem-Resistant Enterobacteriaceae Infection, run by Southeast University, China at 15 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 18 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Yingzi Huang, MD (+86-025-83262552, yz_huang@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

14-day all cause mortality (time frame: from randomization to day 14). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06051513, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2025.

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