PO250 Study of the feasibility and accuracy of next generation sequencing, proteomics, transcriptomics and cytokine measurement for improving the diagnosis of neurosurgical cerebrospinal fluid infection

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Abstract

Inserting neurosurgical shunts/drains (EVD) for hydrocephalus places patients at risk of nosocomial meningitis. Approximately 6% of shunts become infected.External drains have a 5%–25% risk of infection. Up to 25% of clinically infected shunts never have a positive laboratory test. In the case of a shunt, this requires the removal of the infected shunt, placement of an EVD and treatment with antibiotics. Once infection has been cleared the shunt is reinserted. Delayed or inappropriate surgical management can increase morbidity and mortality. 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. 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.We plan to use CSF and blood samples from 3 sources;

• Stored neurosurgical CSF

• The British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts multi-centre randomised controlled trial (the BASICS trial) CSF and blood samples

• Neurosurgical patients requiring CSF sampling during routine neurosurgical care in Alder Hey Children’s NHS Trust, The Walton Centre and the Royal Manchester Children’s Hospital

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