Diagnosis of Central Venous Catheter Infection
Research type
Research Study
Full title
Is the Presence of Bacterial Products in Urine Diagnostic of Central Venous Catheter Infection?
IRAS ID
152833
Contact name
Mark Wilkinson
Contact email
Sponsor organisation
Department of Research and Development
Research summary
Hospital acquired infections (HAIs) are among the major causes of death and morbidity in patients and represent a significant care burden to the NHS.
We recently revealed that 70% of patients in Intensive Care (ICU) have bacterial products; staphylococcal toxins, in their urine compared to only 18% in patients from other wards. We also found that the presence of toxins in urine correlated strongly with a diagnosis of infection.
We hypothesise that these elevated toxin levels are from bacteria causing HAIs and the most likely route for infection is from procedures carried out as a necessary part of their care, specifically the introduction of central venous catheters (Cave’s). CVCs are long, thin, tubes used to give medicines, fluids or nutrients to patients over a long period of time. A catheter is often inserted in the arm or chest through the skin into a large vein and threaded through this vein until it reaches the chest.
We propose that the presence of these toxins in urine can be used as a marker for CVC infection.
We will recruit 40 patients from ICU expected to remain for at least 48 hours and who require both central venous and a urinary catheters as part of their clinical management. We will take a nasal swab when the patient is admitted to ICU and examine it for bacteria. We will also take blood and urine samples at the same time and then, 6 hourly urine and 24 hourly blood samples over 48 hours. All blood and urine will be examined for bacterial toxins.
Later when the CVC line is removed a urine sample will be taken and the tip of the CVC line will be cut off. The CVC line tip will be examined for bacteria. Bacteria obtained from the swabs and CVC tips will be compared and toxins produced by these bacteria will be compared with those found in the blood and urine from the same patient. This will give an indication of whether the profile of toxins in the urine correlates with CVC being the source and/or nasal colonisation being the source.REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
14/YH/1064
Date of REC Opinion
4 Aug 2014
REC opinion
Further Information Favourable Opinion