Metagenomics for diagnosis of UTI in elderly hospitalised patients

  • Research type

    Research Study

  • Full title

    Describing the distribution of metagenomic sequencing results in older hospitalised patients with and without a urinary tract infection.

  • IRAS ID

    319146

  • Contact name

    Rachael Dean

  • Contact email

    rachael.dean@nnuh.nhs.uk

  • Sponsor organisation

    Norfolk and Norwich University Hospital

  • Duration of Study in the UK

    2 years, 7 months, 3 days

  • Research summary

    Aim: to carry out a new test, called metagenomic sequencing (MGS), for identifying bacteria responsible for urinary tract infections (UTIs) in older people requiring admission to hospital and generate a hypothesis for how results should be interpreted to diagnose UTI in this group.

    Background: UTIs are a common reason for older people to come to hospital. Effective treatment relies on identifying the bacteria responsible and the antibiotic needed to treat it. Current tests cannot always identify bacteria responsible for UTIs. This makes diagnosis difficult, and many patients receive treatment with antibiotics unnecessarily. MGS works by extracting all bacterial DNA directly from urine. We can analyse the DNA using computer programmes to identify all the types of bacteria present. By comparing the results of older hospitalised patients with a UTI to those without, we can determine which types of bacteria are responsible for infection and therefore the ones that need treatment with antibiotics.

    Design: We will collect urine from older hospitalised adults with and without a UTI from a single UK hospital. We will use MGS to identify all the types of bacteria in each patient’s urine sample and compare results with those from standard diagnostic tests, in this case, urine microscopy and culture. We will answer the following questions: Which types of bacteria were in the UTI group, the non-UTI group or both? Did the types of bacteria found in the UTI group match the types of bacteria found by standard diagnostic tests? Could the new test predict which antibiotics can be used to treat the UTI? We will use results to generate a hypothesis for how metagenomic sequencing results should be interpreted to predict UTI in older hospitalised patients. The results will inform the design of a larger case-control study in which the hypothesis can be tested using statistical methods.

  • REC name

    Wales REC 5

  • REC reference

    23/WA/0354

  • Date of REC Opinion

    2 Jan 2024

  • REC opinion

    Favourable Opinion