We are excited to open for recruitment this week for our trial of a novel way to prevent early urinary tract infection (UTI) in acute SCI.
This trial follows our recent clinical audit of bladder health and management of traumatic SCI patients at RPH and FSH, published in Spinal Cord and demonstrating the importance of preventing UTIs in the first days and weeks after injury. Neurological disruption to the bladder immediately compromises the integrity of the bladder lining, greatly increasing susceptibility to infection. Early UTIs are particularly detrimental to the ongoing urological and general health of individuals with SCI.
We are testing the use of glycosaminoglycans, or “GAGs”, naturally present as an important protective layer of the bladder lining. When compromised, such as after a SCI, this layer can be replenished by directly instilling GAGs into the bladder via a catheter. This approach has been shown to be safe and effective in preventing recurrent UTI in other patient populations, but has not yet been tested in acute SCI.
The trial assesses the safety and feasibility of commencing bladder instillations of GAGs in patients with SCI by day 10 following injury, before UTIs get a chance to take hold. Patients receive treatments at Royal Perth Hospital initially, and then at Fiona Stanley Hospital during the rehabilitation phase. We will observe trends in the rates of UTI and other bladder health measures, in comparison to untreated patients. Findings will go towards planning a larger multi centre trial using this approach.
Thank you to our clinical colleagues in ICU, Trauma, Orthopaedics and Rehab, and to the wonderful individuals with SCI we have been working with. Your valuable guidance and input has helped us get this far. We are determined to keep working with you to make a tangible difference to SCI health outcomes, in WA and beyond.