Using Microbial Genomics to Elucidate the Source of Central-line Associated Bloodstream Infections
| Status: | Recruiting |
|---|---|
| Conditions: | Infectious Disease |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 4/17/2018 |
| Start Date: | November 2014 |
| End Date: | December 2019 |
| Contact: | Erin Halpin, MSN, RN |
| Email: | erin.halpin@childrens.harvard.edu |
| Phone: | 857-218-4585 |
Central line-associated bloodstream infections (CLABSIs) are the most common
healthcare-associated infection in children and are associated with morbidity and mortality.
This study will attempt to identify the source of bloodstream infections (BSIs) in children
with CLABSI because we hypothesize that many of the BSIs that are currently classified as
CLABSIs are actually laboratory-confirmed bloodstream infections (LCBI) that may be a result
of mucosal barrier injury (MBI), also known as MBI-LCBI. In order to study this, we will
isolate bacteria from multiple body sites of children that have BSI in order to compare these
bacteria to the strain growing in their blood using whole-genome DNA sequencing. We will also
evaluate biomarkers of MBI of the respiratory tract and GI tract.
healthcare-associated infection in children and are associated with morbidity and mortality.
This study will attempt to identify the source of bloodstream infections (BSIs) in children
with CLABSI because we hypothesize that many of the BSIs that are currently classified as
CLABSIs are actually laboratory-confirmed bloodstream infections (LCBI) that may be a result
of mucosal barrier injury (MBI), also known as MBI-LCBI. In order to study this, we will
isolate bacteria from multiple body sites of children that have BSI in order to compare these
bacteria to the strain growing in their blood using whole-genome DNA sequencing. We will also
evaluate biomarkers of MBI of the respiratory tract and GI tract.
This is a prospective cohort pilot study at Boston Children's Hospital (BCH) that will
explore the source of presumed CLABSI, which we believe may actually have multiple possible
sources including MBI. We plan to enroll all inpatient children at BCH who meet the Centers
for Disease Control and Prevention (CDC) definition of MBI-LCBI as well as children who meet
the criteria for CLABSI without MBI. For all enrolled patients, we will collect samples from
the oral cavity, respiratory tract, skin, and stool. These samples will be cultured in order
to see if the same microbial species and strain(s) growing from the blood also grow from
these other sites. Cultures will then have isolated colonies selected for whole-genome DNA
sequencing to allow assessment of genomic diversity between body sites. Stool and blood
samples will be tested for markers of MBI. All patient enrollment and sample collection will
be done at BCH.
explore the source of presumed CLABSI, which we believe may actually have multiple possible
sources including MBI. We plan to enroll all inpatient children at BCH who meet the Centers
for Disease Control and Prevention (CDC) definition of MBI-LCBI as well as children who meet
the criteria for CLABSI without MBI. For all enrolled patients, we will collect samples from
the oral cavity, respiratory tract, skin, and stool. These samples will be cultured in order
to see if the same microbial species and strain(s) growing from the blood also grow from
these other sites. Cultures will then have isolated colonies selected for whole-genome DNA
sequencing to allow assessment of genomic diversity between body sites. Stool and blood
samples will be tested for markers of MBI. All patient enrollment and sample collection will
be done at BCH.
Inclusion Criteria:
- Hospitalized at Boston Children's Hospital
- Central venous catheter of any type including peripherally inserted central catheters
(PICC) in any location.
- Laboratory-confirmed bloodstream infection (LCBI) diagnosed by a clinical blood
culture growing certain Gram-negative rods
Exclusion Criteria:
- Patients with CDC-defined secondary bloodstream infections
We found this trial at
1
site
300 Longwood Ave
Boston, Massachusetts 02115
Boston, Massachusetts 02115
(617) 355-6000
Principal Investigator: Gregory Priebe, MD
Phone: 617-355-7327
Boston Children's Hospital Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care....
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