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Neonatal InfectionInSPIReNCT03371056

Maternal- Fetal Infection

A study testing Bacteriological analyses on clinical samples performed with swabs in people with Neonatal Infection, run by Assistance Publique - Hôpitaux de Paris at 3 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the protocol is to validate a novel point of care multiplex system to detect and characterize microorganisms responsible for neonatal sepsis, as well as biomarkers of infection, from a simple vaginal sample, in order to improve the prevention of perinatal bacterial infections. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Neonatal Infection
What is being tested?
Bacteriological analyses on clinical samples performed with swabs
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,569 participants
Where
3 sitesFrance
Study dates
28 Aug 2018to 30 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

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 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pregnant woman,
  • Gestational age over 22 SA,
  • Patient agreeing to sign informed consent,
  • Patient aged at least 18 years old,
  • Patient with health insurance,
  • Singleton, twin or multiple pregnancy.

Who cannot join

  • Fetal death or non-viable fetus,
  • maternal age under 18,
  • Patient unable to express her consent,
  • Patient under guardianship.

Trial locations and contacts

3 sites in 1 country.

France3 sites
  • Hopital Louis Mourier

    Colombes, 92700

  • Hôpital Cochin

    Paris, 75014

  • Hopital Bichat

    Paris, 75018

Other trials in France

About this study

Official title: Innovative Strategies for Perinatal Infectious Risk Reduction

The purpose of the protocol is to validate a novel point of care multiplex system to detect and characterize microorganisms responsible for neonatal sepsis, as well as biomarkers of infection, from a simple vaginal sample, in order to improve the prevention of perinatal bacterial infections.

Read the detailed description

Early-onset neonatal sepsis (EOS) is a major global public health challenge. Prevention during pregnancy and delivery, early diagnosis and treatment of perinatal infections are essential to avoid EOS. Risk factors for include prematurity, maternal Group B streptococcus (GBS) colonization, premature rupture of membranes (PROM), and chorioamnionitis. Screening and intrapartum antimicrobial prophylaxis administered to GBS-colonized women has reduced early onset GBS infections. However, other pathogens are frequently involved in EOS following preterm PROM and preterm birth (PTB), such as Gram-negative bacteria and Staphylococci, which are not covered by penicillin prophylaxis. The prevalence of neonatal infection arising from antibiotic-resistant bacteria is increasing, thus the challenge is to eliminate the widespread unnecessary use of broad-spectrum antibiotics to treat non-infected infants, while recognizing when antibiotics are truly needed. Rapid diagnostic test(s) to detect and quantify specifically pathogens in vaginal samples, could be a major breakthrough. Several rT- PCR ( reverse Transcriptase Polymerase Chain Reaction) tests are on the market, however so far no test is able to detect, quantify and characterize in terms of antibiotic resistance and virulence genes, a range of pathogens.

A novel multiplex platform, using microfluidics technology, is under development by Elvesys, Inc in France. This platform will be able to offer results within 15 minutes on-site.

In addition, the study of the vaginal microbiome may identify signatures associated with a risk of maternal-fetal infection, particularly in case of PROM or PTB. Advanced sequencing technology and metagenomics will be used to characterize these signatures, and may lead to further markers to be included in the point-of-care test. Finally, biomarkers of inflammation will be detected, including IL-6 (Interleukin).

In this study, the InSPIRe platform will be compared in the laboratory to conventional microbiological and immunological detection.

Four groups of pregnant women will be recruited in prospective cohorts : uneventful pregnancies, term PROM, preterm labor and preterm PROM.

The purpose of the InSPIRe project is to improve the prevention of perinatal bacterial infections, with the novel Elvesys point of care system to rapidly detect and characterize microorganisms responsible for neonatal sepsis from a single vaginal sample.

Being tested
Bacteriological analyses on clinical samples performed with swabs
Keywords
Neonatal infections, maternal-fetal infection, group B streptococcus, vaginal sample, antibiotic prophylaxis, bacterial resistance

What participants receive

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

  • Bacteriological analyses on clinical samples performed with swabsBiological

    Bacteriological analyses will be performed to assess the InSPIRe kit

Study groups in NCT03371056
Study groupRoleWhat they receive
Woman at low risk of infectionExperimentalWomen with systematic vaginal sample for detection of GBS will be included.
Receives: Biological: Bacteriological analyses on clinical samples performed with swabs
Woman with high risk of infection > 37 SAExperimentalWomen with premature rupture of membranes (> 12 hours before labor) but > 37 SA will be included.
Receives: Biological: Bacteriological analyses on clinical samples performed with swabs
Women with premature rupture of membranes (<37SA)ExperimentalWoman with high risk of infection <37SA
Receives: Biological: Bacteriological analyses on clinical samples performed with swabs
Women with premature delivery or premature delivery threatExperimentalWoman with high risk of infection <37SA and Women with premature delivery or premature delivery threat
Receives: Biological: Bacteriological analyses on clinical samples performed with swabs

What is being measured

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

  1. Presence of Streptococcus B

    Measured: Day 0

  2. Presence of Streptococcus B

    Measured: until 20 weeks

Secondary outcomes (15)
  1. Maternal fetal infection

    Infection is proved if at least a sample, generally sterile, is positive to a germ in association with a positive clinical, biological or radiologic sign of infection such as C-reactive protein or chest radiography.

    Measured: until 20 weeks + 3 days

  2. A positive bacteriological result in the vaginal sample

    A positive result is defined as the presence of one of the subsequent germ in the bacteriological culture:

    • Escherichia coli (E. coli)
    • Streptococcus pneumoniae,
    • Group A Streptococcus
    • Haemophilus ssp (influenzae, parainfluenzae)
    • Staphylococcus aureus
    • Streptococcus milleri group
    • Enterococcus faecalis
    • Other Gram-negative bacilli type enterobacteria (Klebsiella pneumonia, Proteus mirabilis)
    • Anaerobics (Prevotella sp, bacteroid fragilis)

    Measured: Day 0

  3. A positive bacteriological result in the vaginal sample

    A positive result is defined as the presence of one of the subsequent germ in the bacteriological culture:

    • Escherichia coli (E. coli)
    • Streptococcus pneumoniae,
    • Group A Streptococcus
    • Haemophilus ssp (influenzae, parainfluenzae)
    • Staphylococcus aureus
    • Streptococcus milleri group
    • Enterococcus faecalis
    • Other Gram-negative bacilli type enterobacteria (Klebsiella pneumonia, Proteus mirabilis)
    • Anaerobics (Prevotella sp, bacteroid fragilis)

    Measured: until 20 weeks

  4. Vaginal dysmorphism

    Defined by lactobacillus's decrease or loss in association with the spread of anaerobic flora.

    Measured: day 0

  5. Vaginal dysmorphism

    Defined by lactobacillus's decrease or loss in association with the spread of anaerobic flora.

    Measured: until 20 weeks

  6. Antibiotic resistance

    Highlighted by a resistant profile in bacteriological culture for various classes of antibiotics such as β-lactamines, macrolides or aminoamides.

    Measured: Day 0

  7. Antibiotic resistance

    Highlighted by a resistant profile in bacteriological culture for various classes of antibiotics such as β-lactamines, macrolides or aminoamides.

    Measured: until 20 weeks

  8. Highlighting specific virulence markers

    Like GBS clone CC17, Enterobacteriaceae that produce capsular antigen type K1. By usual molecular techniques.

    Measured: Day 0

  9. Highlighting specific virulence markers

    Like GBS clone CC17, Enterobacteriaceae that produce capsular antigen type K1. By usual molecular techniques.

    Measured: until 20 weeks

  10. Maternal local biomarkers definition

    Presence or lack of RNA sequences and/or human specific protein detected by RT-PCR or ELISA-PCR depending on the presence or lack of a proved or suspected maternal fetal infection.

    Measured: Day 0

  11. Maternal local biomarkers definition

    Presence or lack of RNA sequences and/or human specific protein detected by RT-PCR or ELISA-PCR depending on the presence or lack of a proved or suspected maternal fetal infection.

    Measured: until 20 weeks

  12. Bacteriological signature definition

    Presence or lack of specific bacteriological sequences detected by global sequencing and metagenomics analyses

    Measured: Day 0

  13. Bacteriological signature definition

    Presence or lack of specific bacteriological sequences detected by global sequencing and metagenomics analyses

    Measured: until 20 weeks

  14. Chorioamnionitis

    Clinical or paraclinical factors associated with risk of chorioamnionitis or maternal fetal infection such as prematurity, clinical signs (maternal fever, fetal tachycardia, increase in C-reactive protein, hyperleukocytosis, pus-like amniotic fluid) , oligohydramnios (defined by the greatest cistern < 25 mm); increase in pro-calcitonin in umbilical cord ok histological signs of placental inflammation.

    Clinical chorioamnionitis is defined as a maternal fever> 39° (in one shot) with no other cause or >38°(confirmed) in association with abnormal fetal heartbeat (>160/min exceeding 10 min), maternal hyperleukocytosis (>15000/mm3 without corticotherapy) or pus-like amniotic fluid.

    Histological chorioamnionitis is defined by the presence of neutrophil polynuclears in amnion or chorion in association with the presence of neutrophil polynuclears in umbilical cord blood vessels.

    Measured: Day 0

  15. Chorioamnionitis

    Clinical or paraclinical factors associated with risk of chorioamnionitis or maternal fetal infection such as prematurity, clinical signs (maternal fever, fetal tachycardia, increase in C-reactive protein, hyperleukocytosis, pus-like amniotic fluid) , oligohydramnios (defined by the greatest cistern < 25 mm); increase in pro-calcitonin in umbilical cord ok histological signs of placental inflammation.

    Clinical chorioamnionitis is defined as a maternal fever> 39° (in one shot) with no other cause or >38°(confirmed) in association with abnormal fetal heartbeat (>160/min exceeding 10 min), maternal hyperleukocytosis (>15000/mm3 without corticotherapy) or pus-like amniotic fluid.

    Histological chorioamnionitis is defined by the presence of neutrophil polynuclears in amnion or chorion in association with the presence of neutrophil polynuclears in umbilical cord blood vessels.

    Measured: until 20 weeks

Timeline

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

  1. First posted13 Dec 2017
  2. Study start28 Aug 2018
  3. Primary completion30 Aug 2023
  4. Study completion30 Dec 2023

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
Screening
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
There are 4 pre-specified groups
Masking
None (open label)
Enrolment
2,569 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03371056
Sponsor's protocol ID
K170907J
Acronym
InSPIRe
Status last verified
Mar 2026
First submitted
7 Dec 2017
Last updated
3 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Joubrel C, Tazi A, Six A, Dmytruk N, Touak G, Bidet P, Raymond J, Trieu Cuot P, Fouet A, Kerneis S, Poyart C. Group B streptococcus neonatal invasive infections, France 2007-2012. Clin Microbiol Infect. 2015 Oct;21(10):910-6. doi: 10.1016/j.cmi.2015.05.039. Epub 2015 Jun 5.

    PubMed 26055414
  • Dussaux C, Senat MV, Bouchghoul H, Benachi A, Mandelbrot L, Kayem G. Preterm premature rupture of membranes: is home care acceptable? J Matern Fetal Neonatal Med. 2018 Sep;31(17):2284-2292. doi: 10.1080/14767058.2017.1341482. Epub 2017 Jul 6.

    PubMed 28612662
  • Kayem G, Batteux F, Girard N, Schmitz T, Willaime M, Maillard F, Jarreau PH, Goffinet F. Predictive value of vaginal IL-6 and TNFalpha bedside tests repeated until delivery for the prediction of maternal-fetal infection in cases of premature rupture of membranes. Eur J Obstet Gynecol Reprod Biol. 2017 Apr;211:8-14. doi: 10.1016/j.ejogrb.2017.01.013. Epub 2017 Jan 12.

    PubMed 28160689
  • Lorthe E, Ancel PY, Torchin H, Kaminski M, Langer B, Subtil D, Sentilhes L, Arnaud C, Carbonne B, Debillon T, Delorme P, D'Ercole C, Dreyfus M, Lebeaux C, Galimard JE, Vayssiere C, Winer N, L'Helias LF, Goffinet F, Kayem G. Impact of Latency Duration on the Prognosis of Preterm Infants after Preterm Premature Rupture of Membranes at 24 to 32 Weeks' Gestation: A National Population-Based Cohort Study. J Pediatr. 2017 Mar;182:47-52.e2. doi: 10.1016/j.jpeds.2016.11.074. Epub 2017 Jan 9.

    PubMed 28081890
  • Delorme P, Goffinet F, Ancel PY, Foix-L'Helias L, Langer B, Lebeaux C, Marchand LM, Zeitlin J, Ego A, Arnaud C, Vayssiere C, Lorthe E, Durrmeyer X, Sentilhes L, Subtil D, Debillon T, Winer N, Kaminski M, D'Ercole C, Dreyfus M, Carbonne B, Kayem G. Cause of Preterm Birth as a Prognostic Factor for Mortality. Obstet Gynecol. 2016 Jan;127(1):40-48. doi: 10.1097/AOG.0000000000001179.

    PubMed 26646125
  • Plainvert C, El Alaoui F, Tazi A, Joubrel C, Anselem O, Ballon M, Frigo A, Branger C, Mandelbrot L, Goffinet F, Poyart C. Intrapartum group B Streptococcus screening in the labor ward by Xpert(R) GBS real-time PCR. Eur J Clin Microbiol Infect Dis. 2018 Feb;37(2):265-270. doi: 10.1007/s10096-017-3125-2. Epub 2017 Oct 29.

    PubMed 29082442
  • Six A, Firon A, Plainvert C, Caplain C, Bouaboud A, Touak G, Dmytruk N, Longo M, Letourneur F, Fouet A, Trieu-Cuot P, Poyart C. Molecular Characterization of Nonhemolytic and Nonpigmented Group B Streptococci Responsible for Human Invasive Infections. J Clin Microbiol. 2016 Jan;54(1):75-82. doi: 10.1128/JCM.02177-15. Epub 2015 Oct 21.

    PubMed 26491182

Questions about this trial

What is this clinical trial studying?

A study testing Bacteriological analyses on clinical samples performed with swabs in people with Neonatal Infection, run by Assistance Publique - Hôpitaux de Paris at 3 sites in France.

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 6 inclusion and 4 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: finished, as of the sponsor's last update on 3 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in France. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Presence of Streptococcus B (time frame: Day 0). The study lists 2 primary outcomes in all. 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 NCT03371056, which also lists 7 linked publications.

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 3 Apr 2026.

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