Non-Invasive Local Diagnosis of Surgical Infections

手术感染的非侵入性局部诊断

• 批准号: 9112858
• 负责人: ERIC H LEDET
• 金额: $ 22.76万
• 依托单位: RENSSELAER POLYTECHNIC INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-17 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9112858
• 关键词: Accounting; Acute; Animals; Antibiotics; Antibodies; Antigen Targeting; Antigens; Bacteria; Bilateral; Binding; Cells; Clinical; Complication; Data; Detection; Diagnosis; Diagnostic; Diaphyses; Drainage procedure; Early Diagnosis; Early treatment; Electronics; Erythema; Excision; Foreign Bodies; Formulation; Fracture; Gel; Harvest; Health; Healthcare; Histologic; Histology; Hydrogels; Impaired wound healing; Implant; Infection; Inpatients; Left; Measures; Microbial Biofilms; Modeling; Modification; Monitor; Morbidity - disease rate; Needles; New Zealand; Operative Surgical Procedures; Orthopedic Surgery procedures; Orthopedics; Oryctolagus cuniculus; Pathologic; Postoperative Pain; Postoperative Period; Predisposition; Property; Public Health; Randomized; Sensitivity and Specificity; Site; Specificity; Staphylococcus aureus; Stimulus; Surface; Suspension substance; Suspensions; Swelling; Symptoms; System; Technology; Testing; Time; United States; White Blood Cell Count procedure; Wireless Technology; Wound Infection; antigen antibody binding; base; combat; cost; crosslink; implantable device; implanted sensor; improved outcome; in vivo; inflammatory marker; instrument; macrophage; microorganism; monocyte; mortality; neutrophil; new technology; response; sensor; tibia; tool; treatment group

 DESCRIPTION (provided by applicant): Surgical site infections (SSI) have become a major public health concern. The presence of a foreign body (implant) significantly increases susceptibility to infection as pathologic microorganisms compete with local host cells to adhere to the surface of surgical implants. This is particularly relevant in orthopedic surgery where more than 2.5 million devices are implanted annually in the United States alone. Strategies to diagnose and treat SSI are critically important in combating this increasingly difficult public health issue. In this project we will implement a novel technology for non-invasively diagnosing acute post-operative infections. The diagnostic system is based on our simple, inexpensive, wireless, implantable sensor platform. The small sensors are integrated with implants requiring minimal or no alteration to the implant itself. To detect infections, we will incorporate an antige-sensitive hydrogel in our simple sensor system which is sensitive to antigens produced by Staphylococcus aureus (the most common microorganism in orthopedic infections). This non-invasive economical diagnostic tool which facilitates early diagnosis of SSI has the potential to "disrupt" current SSI treatment paradigms, reduce costs, improve outcomes, and reduce readmissions. Because of its simplicity, small size, and minimal cost, the proposed system is highly translational. Ultimately, the sensors have the potential to reduce the morbidity and mortality associated with surgical site infection. In this project, we will fabricate antigen-sensitive hydrogels and optimize their sensitivity to antigens associated with S. aureus to achieve our target properties. We will test the hydrogels in solutions containing purified antigens, then in culture. Using candidate hydrogels, we will fabricate wireless sensors which incorporate multiple formulations of the hydrogel and test them in solution and in culture. S. aureus-sensitive sensors will then be tested in vivo in an implant infection model. Sensor sensitivity and specificity will be determined.

 描述（由申请人提供）：手术部位感染（SSI）已成为一个主要的公共卫生问题。异物（植入物）的存在显著增加了感染的易感性，因为病理微生物与局部宿主细胞竞争粘附在外科植入物表面。这在骨科手术中尤其重要， 仅在美国每年就有超过250万个装置被植入。诊断和治疗SSI的策略在应对这一日益困难的公共卫生问题方面至关重要。 在这个项目中，我们将实施一种新的技术，用于非侵入性诊断急性术后感染。该诊断系统基于我们简单、廉价、无线、可植入的传感器平台。小传感器与植入物集成，需要对植入物本身进行最小或不进行改变。为了检测感染，我们将在我们的简单传感器系统中加入抗原敏感的水凝胶，该系统对金黄色葡萄球菌（骨科感染中最常见的微生物）产生的抗原敏感。这种非侵入性的经济诊断工具有助于SSI的早期诊断，有可能“破坏”当前SSI治疗模式，降低成本，改善结局，并减少再入院。由于其简单，小尺寸，和最小的成本，所提出的系统是高度平移。最终，传感器有可能降低与手术部位感染相关的发病率和死亡率。 在这个项目中，我们将制造抗原敏感的水凝胶，并优化其对与S相关的抗原的敏感性。aureus以实现我们的目标属性。我们将在含有纯化抗原的溶液中测试水凝胶，然后在培养物中测试。使用候选水凝胶，我们将制造无线传感器，其中包含多种水凝胶配方，并在溶液和培养中进行测试。S.然后在植入物感染模型中对金敏感传感器进行体内测试。将确定传感器灵敏度和特异性。