Imaging bacterial infection with 99mTc-ciprofloxacin (Infecton)

Abstract

Aims: The diagnosis of deep seated bacterial infections, such as intra-abdominal abscesses, endocarditis, and osteomyelitis, can be difficult and delayed, thereby compromising effective treatment. This study assessed the efficacy of a new radioimaging agent, Tc-99m ciprofloxacin (Infecton), in accurately detecting sites of bacterial infection. Methods: Eight hundred and seventy nine patients with suspected bacterial infection underwent Infecton imaging and microbiological evaluation. The sensitivity and specificity of Infecton in detecting sites of bacterial infection were determined with respect to Centres of Disease Control, World Health Organisation, and Dukes's criteria. Results: Five hundred and seventy four positive and 295 negative images were produced. These included 528 true positives, 46 false positives, 205 true negatives and 90 false negatives, giving an overall sensitivity of 85.4% and a specificity of 81.7% for detecting infective foci. Sensitivity was higher (87.6%) in microbiologically confirmed infections. Conclusions: Infecton is a sensitive technique, which aids in the earlier detection and treatment of a wide variety of deep seated bacterial infections. The ability to localise infective foci accurately is also important for surgical intervention, such as drainage of abscesses. In addition, serial imaging with Infecton might be useful in monitoring clinical response and optimising the duration of antimicrobial treatment.

Patient and Personnel Radiation Exposure in Sentinel Lymph Node Practice

“…İlk olarak, steril enflamasyonu, bakteriyel enfeksiyondan ayırt etmede kullanılabileceği önerilmiş ancak doğrulanamamıştır. Enfeksiyon tanısında hassas olup özgüllüğünün oldukça yüksek bulunduğu çalışmalar vardır (56,57). Etkinliği ile ilgili tartışmalı sonuçlar ile ilgili olarak, siprofoksazine dirençli bakteri, biyo-film, lezyon içinde yetersiz sayıda canlı bakteri bulunması, görüntüleme öncesi benzer antibiyotik ile tedavi görmüş olması ve farklı çalışmalardaki radyo-siprofloksazin işaretlenmesinde farklı kitlerin kullanılması gibi olası nedenler sayılabilir (58,59).…”

Diagnostic value of 99mTc-ethambutol scintigraphy in tuberculosis: compared to microbiological and histopathological tests

“…99m Tc-ciprofloxacin can be a more specific radiopharmaceutical for bacterial infection imaging, because it is taken up by living bacteria and it inactivates DNA gyrase [5,[19][20][21]. Unfortunately 99m Tc-ciprofloxacin cannot differentiate TB from other bacterial infection, since ciprofloxacin acts as a broad-spectrum antibiotic that can be taken up by any living bacteria [19][20][21][22][23][24]. 99m Tc-INH has been developed to image TB, but clinically is not widely use [25].…”

Development and Prospects of Dedicated Tracers for the Molecular Imaging of Bacterial Infections

“…[152][153][154][155][156][157][158] However, also critical results have been reported; e.g. significant accumulation in noninfected prosthetic joints and the inability to discriminate between infected and aseptic osteoarticular disease in patients.…”