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InfectionNCT07370948

Study of the Antibiotic-resistance Profile of Enterobacterales Isolated From Rectal Mucosal Buffer of PrEP Subjects

An observational study of Infection, run by IRCCS Azienda Ospedaliero-Universitaria di Bologna at 1 site in Italy.

Recruiting

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

Sites and contacts
Official record
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Trial summary

The importance of the study lies mainly in expanding knowledge of the phenomenon of antibiotic resistance in subjects using PrEP, studying for the first time in this population the resistance phenotype in commensal Enterobacterales of the gastrointestinal tract. Read more about this study

Who is it for?
Ages 18 to 45 years
Conditions the study is for
Infection
How many people
200 participants
Where
1 siteItaly
Study dates
30 May 2025to 28 Feb 2026
Phase
Observational
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 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Study population: male and female subjects aged between 18 and 45 years who use PrEP and who go to the dedicated clinics of the Infectious Diseases Unit of the IRCCS - University Hospital of Bologna for normal check-ups/follow-ups Patients will be treated in accordance with their normal care process and the results of the study-specific laboratory analyses provided for by this protocol will in no way influence the diagnostic-therapeutic path of the patients.

Who may be able to join

  • age between 18 and 45 years
  • HIV-negative subjects undergoing an anorectal swab for Chlamydia trachomatis and Neisseria gonorrhoeae using NAAT as a normal diagnostic-assistance procedure provided for subjects using PrEP

Who cannot join

  • none

Trial locations and contacts

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

Claudio Foschi, MD contact

+39 0512144515

claudio.foschi2@unibo.it

Leonardo Calza, MD contact

leonardo.calza@unibo.it

Italy1 site, 1 recruiting
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna

    Bologna, Bologna, 40138

    Claudio Foschi, MD, +39 0512144515, claudio.foschi2@unibo.it

    Leonardo Calza, MD, leonardo.calza@unibo.it

    Recruiting

Other trials in Italy

About this study

The importance of the study lies mainly in expanding knowledge of the phenomenon of antibiotic resistance in subjects using PrEP, studying for the first time in this population the resistance phenotype in commensal Enterobacterales of the gastrointestinal tract.

The data obtained from this study could pave the way for potential surveillance and awareness programs for the critical and conscious use of antimicrobials in PrEP subjects in order to mitigate the problem of antibiotic resistance, which currently represents a real global challenge.

Read the detailed description

ENTERO-PrEP is an observational, single-center, cross-sectional, tissue study. Patient enrollment will be performed at dedicated clinics for the monitoring and follow-up of PrEP subjects at the Infectious Diseases Unit of the IRCCS - University Hospital of Bologna.

In these clinics, on a quarterly basis, PrEP subjects undergo, as a normal diagnostic-assistance path, laboratory tests to exclude the presence of STIs, including the search for Chlamydia trachomatis and Neisseria gonorrhoeae in genital (urine) and extra-genital samples (pharyngeal swab and anorectal swab).

Each patient will be recruited only once during one of the normal monitoring visits scheduled for subjects using PReP.

The study aims to isolate commensal Enterobacterales strains from the gastrointestinal tract starting from the same anorectal swab sent for the detection of C. trachomatis and N. gonorrhoeae, without the need to perform any additional sampling compared to the normal care routine. For each isolated Enterobacterales strain, the sensitivity/resistance to antimicrobials (antibiogram) will subsequently be studied using broth micro-dilution. Bacterial isolation and antibiogram will be performed at the Microbiology Unit of the IRCCS - University Hospital of Bologna.

Subjects who consent to participate in the study will be asked to complete, directly during the outpatient visit, a questionnaire with information relating to personal and behavioral habits in order to identify risk factors that could favor the presence of antibiotic-resistant Enterobacterales.

Conditions
Infection
Medical subject headings
Infections

What participants receive

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

Study groups in NCT07370948
Study groupRoleWhat they receive
male and female subjects aged between 18 and 45 years who use PrEPmale and female subjects aged between 18 and 45 years who use PrEP and who go to the dedicated clinics of the Infectious Diseases Unit of the IRCCS - University Hospital of Bologna for normal follow-up visits Patients will be treated in accordance with their normal care process and the results of the study-specific laboratory analyses provided for by this protocol will in no way influence the diagnostic-therapeutic path of the patients.

What is being measured

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

  1. Prevalence of antibiotic-resistant Enterobacterales strains

    Percentage of resistant strains out of the total strains isolated for each individual antimicrobial based on MICs obtained by a phenotypic antibiogram in broth micro-dilution, compared with criteria by EUCAST guidelines (www.eucast.org/).

    Measured: At enrolment

Secondary outcomes (1)
  1. Prevalence of antibiotic-resistant Enterobacterales strains

    Percentage of resistant strains out of the total strains isolated for each individual antimicrobial based on MICs obtained by a phenotypic antibiogram in broth micro-dilution, compared with criteria by EUCAST guidelines (www.eucast.org/).

    Measured: At enrolment

Timeline

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

  1. First posted27 Jan 2026
  2. Study start30 May 2025
  3. Primary completion15 Feb 2026 (estimated)
  4. Study completion28 Feb 2026 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Retrospective
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07370948
Sponsor's protocol ID
ENTERO-PrEP
Status last verified
Dec 2025
First submitted
17 Dec 2025
Last updated
27 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Williams ADN, Wood F, Gillespie D, Couzens Z, Hughes K, Hood K. The relationship between HIV pre-exposure prophylaxis, sexually transmitted infections, and antimicrobial resistance: a qualitative interview study of men who have sex with men. BMC Public Health. 2022 Nov 29;22(1):2222. doi: 10.1186/s12889-022-14645-0.

    PubMed 36447181
  • Van Dijck C, Laumen JGE, de Block T, Abdellati S, De Baetselier I, Tsoumanis A, Malhotra-Kumar S, Manoharan-Basil SS, Kenyon C, Xavier BB. The oropharynx of men using HIV pre-exposure prophylaxis is enriched with antibiotic resistance genes: A cross-sectional observational metagenomic study. J Infect. 2023 Apr;86(4):329-337. doi: 10.1016/j.jinf.2023.02.006. Epub 2023 Feb 9.

    PubMed 36764395
  • Vanbaelen T, Van Dijck C, De Baetselier I, Florence E, Reyniers T, Vuylsteke B, Jacobs BK, Kenyon C. Screening for STIs is one of the main drivers of macrolide consumption in PrEP users. Int J STD AIDS. 2021 Oct;32(12):1183-1184. doi: 10.1177/09564624211025940. Epub 2021 Jun 17. No abstract available.

    PubMed 34139924
  • Traeger MW, Schroeder SE, Wright EJ, Hellard ME, Cornelisse VJ, Doyle JS, Stoove MA. Effects of Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus Infection on Sexual Risk Behavior in Men Who Have Sex With Men: A Systematic Review and Meta-analysis. Clin Infect Dis. 2018 Aug 16;67(5):676-686. doi: 10.1093/cid/ciy182.

    PubMed 29509889
  • Quaife M, MacGregor L, Ong JJ, Gafos M, Torres-Rueda S, Grant H, Terris-Prestholt F, Vickerman P. Risk compensation and STI incidence in PrEP programmes. Lancet HIV. 2020 Apr;7(4):e222-e223. doi: 10.1016/S2352-3018(19)30333-9. Epub 2019 Nov 22. No abstract available.

    PubMed 31767536
  • Perez-Galera S, Bravo-Ferrer JM, Paniagua M, Kostyanev T, de Kraker MEA, Feifel J, Sojo-Dorado J, Schotsman J, Canton R, Daikos GL, Carevic B, Dragovac G, Tan LK, Raka L, Hristea A, Viale P, Akova M, Reguera JM, Valiente de Santis L, Torre-Cisneros J, Cano A, Roilides E, Radulovic L, Kirakli C, Shaw E, Falagas ME, Pintado V, Goossens H, Bonten MJ, Gutierrez-Gutierrez B, Rodriguez-Bano J; COMBACTE-CARE-EURECA Team. Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA). EClinicalMedicine. 2023 Feb 27;57:101871. doi: 10.1016/j.eclinm.2023.101871. eCollection 2023 Mar.

    PubMed 36895801
  • Ong JJ, Baggaley RC, Wi TE, Tucker JD, Fu H, Smith MK, Rafael S, Anglade V, Falconer J, Ofori-Asenso R, Terris-Prestholt F, Hodges-Mameletzis I, Mayaud P. Global Epidemiologic Characteristics of Sexually Transmitted Infections Among Individuals Using Preexposure Prophylaxis for the Prevention of HIV Infection: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019 Dec 2;2(12):e1917134. doi: 10.1001/jamanetworkopen.2019.17134.

    PubMed 31825501
  • Mogaka FO, Stewart J, Omollo V, Bukusi E. Challenges and Solutions to STI Control in the Era of HIV and STI Prophylaxis. Curr HIV/AIDS Rep. 2023 Oct;20(5):312-319. doi: 10.1007/s11904-023-00666-w. Epub 2023 Sep 26.

    PubMed 37751130
  • Miller WR, Arias CA. ESKAPE pathogens: antimicrobial resistance, epidemiology, clinical impact and therapeutics. Nat Rev Microbiol. 2024 Oct;22(10):598-616. doi: 10.1038/s41579-024-01054-w. Epub 2024 Jun 3.

    PubMed 38831030
  • McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, Sullivan AK, Clarke A, Reeves I, Schembri G, Mackie N, Bowman C, Lacey CJ, Apea V, Brady M, Fox J, Taylor S, Antonucci S, Khoo SH, Rooney J, Nardone A, Fisher M, McOwan A, Phillips AN, Johnson AM, Gazzard B, Gill ON. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016 Jan 2;387(10013):53-60. doi: 10.1016/S0140-6736(15)00056-2. Epub 2015 Sep 9.

    PubMed 26364263
  • Li H, Liu B, Li M, Shen M. Livestock and poultry breeding farms as a fixed and underestimated source of antibiotic resistance genes. Environ Sci Pollut Res Int. 2024 Aug;31(37):49916-49931. doi: 10.1007/s11356-024-34413-4. Epub 2024 Jul 25.

    PubMed 39052112
  • Laumen JGE, Van Dijck C, Abdellati S, De Baetselier I, Serrano G, Manoharan-Basil SS, Bottieau E, Martiny D, Kenyon C. Antimicrobial susceptibility of commensal Neisseria in a general population and men who have sex with men in Belgium. Sci Rep. 2022 Jan 7;12(1):9. doi: 10.1038/s41598-021-03995-1.

    PubMed 34997050
  • Kenyon C. Dual Azithromycin/Ceftriaxone Therapy for Gonorrhea in PrEP Cohorts Results in Levels of Macrolide Consumption That Exceed Resistance Thresholds by up to 7-Fold. J Infect Dis. 2021 Nov 16;224(9):1623-1624. doi: 10.1093/infdis/jiab178. No abstract available.

    PubMed 33822092
  • Huang KD, Amend L, Galvez EJC, Lesker TR, de Oliveira R, Bielecka A, Blanco-Miguez A, Valles-Colomer M, Ruf I, Pasolli E, Buer J, Segata N, Esser S, Strowig T, Kehrmann J. Establishment of a non-Westernized gut microbiota in men who have sex with men is associated with sexual practices. Cell Rep Med. 2024 Mar 19;5(3):101426. doi: 10.1016/j.xcrm.2024.101426. Epub 2024 Feb 15.

    PubMed 38366600
  • Cai S, Wang Z, Han X, Hu H, Quan J, Jiang Y, Du X, Zhou Z, Yu Y. The correlation between intestinal colonization and infection of carbapenem-resistant Klebsiella pneumoniae: A systematic review. J Glob Antimicrob Resist. 2024 Sep;38:187-193. doi: 10.1016/j.jgar.2024.04.013. Epub 2024 May 21.

    PubMed 38777180

Questions about this trial

What is this clinical trial studying?

An observational study of Infection, run by IRCCS Azienda Ospedaliero-Universitaria di Bologna at 1 site in Italy.

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 2 inclusion and 1 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 27 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. 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 Claudio Foschi, MD (+39 0512144515, claudio.foschi2@unibo.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prevalence of antibiotic-resistant Enterobacterales strains (time frame: At enrolment). 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 NCT07370948, which also lists 15 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 27 Jan 2026.

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