Integration of Raman Spectroscopy and Optical Coherence Tomography (RS-OCT) for In-Vivo Identification of Bacterial Otitis Media

拉曼光谱和光学相干断层扫描 (RS-OCT) 的集成用于细菌性中耳炎的体内鉴定

• 批准号: 9976514
• 负责人: Stephen A Boppart
• 金额: $ 61.55万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-11 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9976514
• 关键词: Age; Ambulatory Care Facilities; Antibiotic Resistance; Antibiotic Therapy; Antibiotics; Appearance; Bacteria; Bacterial Antibiotic Resistance; Bacterial Infections; Biochemical; Blinded; Caring; Child; Childhood; Chronic; Clinical; Clinical Data; Clinical Research; Clinical Trials; Color; Coupled; Custom; Data; Data Analyses; Decision Making; Detection; Development; Diagnosis; Diagnostic; Disease; Ear; Earache; Ensure; Fiber; Fingerprint; Future; Growth; Health; Human; Illinois; Image; In Vitro; Infection; Institutional Review Boards; Intervention; Knowledge; Liquid substance; Measurement; Measures; Medical; Methods; Microbial Biofilms; Monitor; Mucous Membrane; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Otitis Media; Otitis Media with Effusion; Otoscopes; Pathologic; Patient observation; Patients; Performance; Positioning Attribute; Protocols documentation; Raman Spectrum Analysis; Randomized; Recurrence; Reproducibility; Research; Sampling; Scanning; Sensitivity and Specificity; Series; Site; Speed; Study Subject; Surface; System; Testing; Therapeutic Intervention; Time; Treatment Efficacy; Treatment Protocols; Treatment outcome; Tube; Tympanic membrane; Tympanostomy; Universities; Virus Diseases; Visual; Visualization; base; clinical Diagnosis; clinical research site; design; ear infection; effusion; image guided; imaging detection; imaging system; improved; in vivo; microorganism; middle ear; pathogenic virus; pediatric patients; pediatrician; point of care; point-of-care diagnostics; rapid detection; real-time images; standard of care; technological innovation; tool; wasting

PROJECT SUMMARY Otitis media (middle ear infection) is a highly prevalent disease, especially in young children. It has been documented that more than 75% of children will have at least one episode of otitis media (OM) by age 3, and many children will have recurrent or chronic OM. In most cases, diagnosis of an ear infection is performed based on the appearance of the tympanic membrane and presence of fluid via an otoscope. In the absence of a method to identify bacterial infections, broad-spectrum antibiotics are prescribed without definitive knowledge of whether i) an active infection present, and ii) whether it is a bacterial infection (versus a viral infection). Previous clinical data also suggests that antibiotic therapy is only effective for one-third of OM patients, with two thirds of cases likely caused by antibiotic resistant bacteria, or more likely, viral pathogens, resulting in a misdirected expense of more than $700 million, annually. Therefore, there is a clear and urgent need for a point-of-care diagnostic tool to determine the presence of an active infection and whether an infection is bacterial in origin. Further, if we can distinguish the bacterial species present, unnecessary administration of broad-spectrum antibiotics can be eliminated, thus improving the efficacy of treatment and management of this highly prevalent disease. This proposal seeks to fulfill this unmet need by developing integrated Raman Spectroscopy-Optical Coherence Tomography (RSOCT) for the real-time detection and bacterial differentiation of pathological microorganisms in the middle ear. The scientific premise of the proposed research is that OCT can be used for image-guided placement of the RS probing beam, as well as visualization of any biofilm affixed to the tympanic membrane which would be indicative of a bacterial infection. This imaging system will be coupled with Raman spectroscopy for a more direct assessment of any biofilm and/or effusion by determining the presence of OM-causing bacteria and speciation via its biochemical fingerprint. The overall objective of the project will be accomplished by technological innovation and integration, followed by a series of systematic in vitro, ex vivo, and in vivo human studies with rigorous data analysis methods outlined in the specific aims. This research will have a profound impact on how we diagnose and care for these common ear infections. Most importantly, this project will provide critical data (identifying specific bacterial species) to monitor the development of antibiotic resistance, to reduce the overuse of antibiotics, and ultimately, to efficiently improve the health of patients.

项目摘要 中耳炎（中耳感染）是一种高度流行的疾病，尤其是在幼儿中。已经 记录了超过75%的儿童在3岁时至少有一次中耳炎（OM）发作， 许多儿童会有复发性或慢性OM。在大多数情况下，耳部感染的诊断是基于 通过耳镜检查鼓膜外观和液体的存在。在缺乏方法的情况下 为了识别细菌感染，广谱抗生素的处方没有明确的知识， i）存在活动性感染，和ii）是否是细菌感染（相对于病毒感染）。既往临床 数据还表明，抗生素治疗仅对三分之一的OM患者有效，三分之二的病例 可能是由抗生素耐药细菌引起的，或者更可能是病毒病原体，导致错误的费用 每年超过7亿美元。因此，对床旁诊断有明确且迫切的需求 用于确定活动性感染的存在以及感染是否是细菌性的工具。此外，如果我们 可以区分存在的细菌种类，不必要的广谱抗生素的管理， 消除，从而提高治疗和管理这一高度流行疾病的功效。这 一项提案试图通过开发集成的拉曼光谱-光学相干来满足这一未满足的需求 层析成像（RSOCT），用于实时检测和细菌分化的病理微生物， 中耳。提出研究的科学前提是OCT可以用于图像引导 放置RS探测光束，以及观察附着在鼓膜上的任何生物膜 这可能是细菌感染的迹象该成像系统将与拉曼光谱学相结合 通过确定引起OM的细菌的存在，更直接地评估任何生物膜和/或积液 和物种形成的能力。该项目的总体目标将通过以下方式实现： 技术创新和整合，随后进行了一系列系统的体外，离体和体内人体 具体目标中概述了严格的数据分析方法。这项研究将产生深远的影响。 影响我们如何诊断和护理这些常见的耳部感染。最重要的是，该项目将提供 关键数据（识别特定细菌物种），以监测抗生素耐药性的发展， 抗生素的过度使用，最终有效改善患者的健康。