A Rapid Differential Diagnostic Method for Detection of Post-Neurosurgical Infections

This work pertains to the application of a biochemical assay with the purpose of monitoring for and early discovery of an active bacterial infection through direct sampling and rapid testing of the Cerebrospinal Fluid (CSF). A diagnostic device is described and evaluated, which aids in quickly discerning, verifying, or ruling out active infection at the injury site. We have applied it on post-neurosurgical wounds, the state of which, due to their complexity, is challenging to determine with certainty, using conventional means. Infection is the successful invasion and degeneration of the body tissue by pathogenic microorganisms. Even successfully performed invasive treatments are susceptible to infections that may not be discovered until severe complications arise. The primary sampling access to the brain for diagnostic purposes is via the CSF, which is also highly valuable for the present end. Notwithstanding this possibility, it is difficult to distinguish between cases with aseptic inflammation and meningitis, despite available methods such as cell counting, culture, and protein analysis. Therefore, current treatment options rely mainly on broad and/or prophylactic measures with few options for monitoring the results. Under normal circumstances, the body reacts immediately to infection in an immune-competent host. The initial event of the body defense is the recruitment of neutrophils to the injury site, where inflammation induces increased permeability of vessels, development of edema, and increased internal pressure inside the afflicted tissue. The brains constrained, well-protected intracranial environment has the disadvantage that swelling of the brain early causes increased pressure, which potentially exerts irreversible damaging effects on the brain tissues. Septic and aseptic inflammations and related hemorrhages that cause increased intracranial pressure are important reasons for invasive interventions to decrease the pressure. Infection is a major cause of inflammation, swelling, and increased intracranial pressure. Timely diagnosis of infection and eliminating the causative pathogens is strongly related to survival and recovery. Therefore, a prompt diagnosis of infection is essential for the immediate and appropriate initiation of antibiotic therapy and monitoring treatment effects. Further diagnostic procedures are used to identify the specific bacterial pathogens and optimize the treatment. Early discovery of infections and proper antibiot