Novel Techology for Early Indentification of Surgical Infections

摘要： 手术后感染很常见。迅速识别感染以避免感染是至关重要的 并发症包括再入院、植入物失败或败血症。及早发现使培养物有时间 跑和简单的抗生素才是有效的。医疗保险和医疗补助服务中心认识到严重的 这是问题的本质，并于2015年开始对手术再入院处以重罚。此外, 早期治疗增加了外科植入物和假体存活的可能性，因为它们 如果感染发生，通常必须移除或更换。 炎症是感染的最早的生理标志，但其来源是多方面的，局部炎症 对于正常的伤口愈合是必要的。然而，手术部位的感染可能与正常情况有所区别。 通过监测手术部位局部炎症的性质和时间进程来实现伤口愈合。 伤口愈合引起的炎症和低水平的细菌感染在几个小时内开始出现，并逐渐减弱 完全在手术后几天内完成，此时伤口愈合的增殖期开始。 感染引起的炎症单调增加，并可达到比正常愈合高得多的水平。所以 我们认为，通过精确跟踪两个局部炎症标志物，可以及早识别感染： 细胞因子IL-6和局部体温。我们建议使用新的磁性纳米颗粒探针来比较 正常愈合与感染时局部IL-6浓度和体温的变化。我们假设 随着时间的推移，测量这些炎症标志物的局部水平将有助于检测外科感染。 这项新技术可能会导致一种廉价、简单的早期护理点测量系统 外科感染的检测和治疗。

Abstract: Infections are common following surgery. It is critically important to identify infections quickly to avoid complications including readmission, implant failure or sepsis. Early detection allows time for cultures to be run and simple antibiotics to be effective. The Centers for Medicare & Medicaid Services recognize the serious nature of the problem and in 2015 started imposing significant penalties for surgical readmissions. In addition, early treatment enhances the probability that surgical implants and prosthetics remain viable because they usually have to be removed or replaced if infection takes hold. Inflammation is the earliest physiologic marker of infection, but it has many sources, and local inflammation is necessary for normal wound healing. Surgical site infection, however, may be distinguishable from normal wound healing by monitoring the character and time course of local inflammation at the surgical site. Inflammation from wound healing and low levels of bacterial infection begins within hours and abates completely within a few days after surgery, when the proliferative phase of wound healing begins. Inflammation from infection increases monotonically and can reach far higher levels than normal healing. So we believe that infection can be identified early by precisely tracking two local markers of inflammation: cytokine IL-6 and local temperature. We propose to use novel magnetic nanoparticle probes to compare changes in the local concentration of IL-6 and temperature for normal healing vs. infection. We hypothesize that measuring the local level of these inflammatory markers over time will aid detection of surgical infection. This novel technology may lead to an inexpensive, simple, point of care measurement system for early detection and treatment of surgical infections.