Septic arthritis is difficult to diagnose because clinical presentations overlap with non infectious causes and laboratory, imaging, synovial and blood tests are insensitive. Although relatively uncommon, septic arthritis can be severely destructive to joints so the impetus is to give treatment without delay, often prior to a definitive diagnosis. This means patients can undergo invasive procedures, hospital admissions and antibiotics unnecessarily. This brings attendant risks in expanding antibiotic resistance and expense. This study aims to identify biomarkers in blood, urine and synovial fluid that are unique to patients with septic arthritis in order to aid in the rapid and accurate stratification of the acute joint presentation.
Primary objective: To identify blood, urine and synovial fluid biomarkers that are unique to patients with septic arthritis.
Secondary Objective: To determine, through whole genome sequencing of bacterial isolates, whether they are unique to septic arthritis and if there are any molecular signatures associated with a poor structural and systemic prognosis.
Sample: Adults presenting to the Emergency department with likely septic arthritis in one joint or more.
Target: 100
Trail design: Cross sectional proof of concept study
Honorary Professor of Emergency Medicine & Clinical Director of the Emergency Department
Honorary Professor of Emergency Medicine & Clinical Director of the Emergency Department
Lead Research Nurse
Senior Research Nurse
Research Nurse
Clinical Trial Assistant
Research Project Manager
Senior Research Nurse
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.
Diagnostics devices play an important part in the clinical assessment of a patient’s health and treatment. The purpose of the study is the evaluation of a new diagnostic platform developed by LumiraDx. The evaluation is focused around various biomarkers useful in the emergency settings.
Collection of venous and capillary blood samples for the evaluation of new diagnostic devices for cardiovascular conditions