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.

Public Health Relevance

Infections are common following surgery and it is critically important to identify infections quickly to allow simple antibiotics to be effective avoiding surgical readmissions. Avoiding surgical readmissions is critical because of the cost in terms of dollars and in terms of morbidity and mortality. Recognizing the serious nature of the problem, the Centers for Medicare & Medicaid Services (CMS) has started imposing significant penalties for surgical readmissions. Inflammation is the earliest physiologic marker of infection but to isolate the source of inflammation to infection requires local measurements to be made over time. We are developing novel technology for monitoring local inflammation over time to identify surgical site infections early.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21EB021456-01A1
Application #
9194914
Study Section
Bioengineering, Technology and Surgical Sciences Study Section (BTSS)
Program Officer
Lash, Tiffani Bailey
Project Start
2016-07-01
Project End
2018-04-30
Budget Start
2016-07-01
Budget End
2017-04-30
Support Year
1
Fiscal Year
2016
Total Cost
$243,000
Indirect Cost
$93,000
Name
Dartmouth College
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Khurshid, Hafsa; Friedman, Bruce; Berwin, Brent et al. (2017) Blood clot detection using magnetic nanoparticles. AIP Adv 7:056723