Improving the diagnosis of neurosurgical CSF infections
Research type
Research Study
Full title
Study of the feasibility and accuracy of Next Generation Sequencing , proteomics, transcriptomics and cytokine measurement for improving the diagnosis of neurosurgical cerebrospinal fluid infection.
IRAS ID
213305
Contact name
Michael Grffiths
Contact email
Clinicaltrials.gov Identifier
NA, NA
Duration of Study in the UK
4 years, 0 months, 28 days
Research summary
Cerebrospinal fluid is a natural liquid that bathes the brain and spine. Derangements in the production, circulation or reabsorption of CSF lead to a build-up of CSF within the brain- “Hydrocephalus”. Neurosurgeons insert temporary external or permanent internal drains (shunts) into the CSF spaces of patients with hydrocephalus to relieve the pressure.
One of the risks of these drains is infection. External drains have a higher risk (5-25%) of becoming infected as they connect the sterile CSF space with the outer environment. Approximately 6% of CSF shunts become infected.
Up to 25% of clinically infected shunts never have a positive laboratory test. In these cases, patients are treated on grounds of clinical suspicion. In the case of a CSF shunt this requires the removal of the infected shunt, placement of an external drain and treatment with antibiotics. Once infection has been cleared a later surgery is performed to reinsert a shunt if necessary.
Delayed or inappropriate surgical management can increase morbidity and mortality, particularly in children. Infection related shunt mortality is reported as high as 10.1% in some paediatric series. Children that survive have an increased risk of neurological disability and seizures, impaired cognitive function and poor school performance.
We plan to use CSF and blood samples from 3 sources;
• Salvaged CSF- infected CSF is stored as routine in the microbiology lab• Patients consented for research during The British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts multi-centre randomised controlled trial (the BASICS trial)
• Neurosurgical patients of any age requiring CSF sampling as part of their routine neurosurgical care in Alder Hey Children’s NHS Trust, The Walton Centre NHS Foundation Trust and the Royal Manchester Children’s Hospital
Using next generation sequencing, proteomics, transcriptomics and cytokine measurements we aim to develop CSF and blood tests to improve the diagnosis of neurosurgical CSF infection.
REC name
Wales REC 7
REC reference
16/WA/0263
Date of REC Opinion
16 Nov 2016
REC opinion
Further Information Favourable Opinion