Catheter-associated Bloodstream Infections (CLABSI) Clinical Trial
Official title:
Biofilm Microbiome and Microbial DNA Load in Neonatal Catheter-associated Bloodstream Infections
Percutaneously Inserted Central Catheters (PICCs) are special tubes that are inserted into
blood vessels of premature babies (neonates) to give them nutrition and medications.
Sometimes these tubes get infected and they need to be removed. Also, the babies need to be
given medications to treat these infections (antibiotics). PICC infections in neonates are a
serious problem and we need to find new ways of detecting infections early so that we can
treat them promptly to avoid complications.
The purpose of this study is to understand what causes tube infections in neonates and to
develop a test to detect tube infections early to avoid complications.
Catheter-associated bloodstream infections (CLABSIs) are a significant component of
healthcare-associated infections (HAI),which are associated with significant mortality,
morbidity and healthcare costs. Neonates are at higher risk for CLABSIs than children or
adults and CLABSIs are seen more commonly in neonatal than pediatric or adult intensive care
units. Neonates, who develop CLABSIs, are not only at serious risk for mortality but also
long term neurodevelopmental impairment. CLABSIs are often caused by organisms colonizing the
skin and the most frequently isolated organisms are CONS, S. aureus and Candida.
The catheter biofilm microbiome, to our knowledge has not been investigated before.
Evaluation of biofilm microbial signatures and microbial DNA load is a novel strategy that
may permit earlier diagnosis of CLABSIs. Earlier detection may enable earlier targeted
therapy such as antimicrobial lock solutions and may facilitate preservation of catheters in
this vulnerable population. Catheter microbial DNA signatures or load may be useful
biomarkers to not only predict or diagnose infections but to monitor antibiotic therapy and
to confirm resolution of infection.
We will study 15 percutaneously inserted central catheters (PICC) each from neonates with
CLABSIs and those without. We will evaluate the bacterial microbiome by profiling V3-5 region
of the 16S rDNA, by PCR and pyrosequencing. We will correlate the catheter biofilm microbiome
with catheter tip cultures and the skin microbiome at the catheter entry site. We aim to
identify microbial signatures that predispose to dissemination of infection from catheter
biofilms leading to CLABSIs. Further, we will quantify microbial DNA load in blood from the
catheters at the time of removal, by real-time PCR of the bacterial 16S rDNA.
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