Leukocyte esterase test and alpha-defensin test have similar accuracy for the diagnosis of periprosthetic joint infection

Yu, Baozhan; Li, Rui; Fu, Jun; Chai, Wei; Hao, Libo; Chen, Jiying

doi:10.1007/s00264-020-04903-4

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…Synovial fluid WBC and %PMN are perhaps the best preoperative diagnostic test methods 21 with consistently high specificities (WBC: 88% to 93%; %PMN: 80% to 95%). [21][22][23][24][25] In addition, alpha-defensin showed good specificities (86% to 98%) [26][27][28][29][30][31] in the literature and may, therefore, confirm infection. It is important to note that the results of these parameters are not valid in patients with adverse local tissue reactions, haematomas, or acute inflammatory arthritis or gout as mentioned in the practical guidelines of the EBJIS for the diagnosis of PJI.…”

Section: Discussionmentioning

confidence: 96%

Diagnosing periprosthetic joint infections

Sigmund

Luger

Windhager

et al. 2022

Bone & Joint Research

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Aims This study evaluated the definitions developed by the European Bone and Joint Infection Society (EBJIS) 2021, the International Consensus Meeting (ICM) 2018, and the Infectious Diseases Society of America (IDSA) 2013, for the diagnosis of periprosthetic joint infection (PJI). Methods In this single-centre, retrospective analysis of prospectively collected data, patients with an indicated revision surgery after a total hip or knee arthroplasty were included between 2015 and 2020. A standardized diagnostic workup was performed, identifying the components of the EBJIS, ICM, and IDSA criteria in each patient. Results Of 206 included patients, 101 (49%) were diagnosed with PJI with the EBJIS definition. IDSA and ICM diagnosed 99 (48%) and 86 (42%) as infected, respectively. A total of 84 cases (41%) had an infection based on all three criteria. In 15 cases (n = 15/206; 7%), PJI was present when applying only the IDSA and EBJIS criteria. No infection was detected by one definition alone. Inconclusive diagnoses occurred more frequently with the ICM criteria (n = 30/206; 15%) compared to EBJIS (likely infections: n = 16/206; 8%) (p = 0.029). A better preoperative performance of the EBJIS definition was seen compared with the ICM and IDSA definitions (p < 0.001). Conclusion The novel EBJIS definition identified all PJIs diagnosed by any other criteria. Use of the EBJIS definition significantly reduced the number of uncertain diagnoses, allowing easier clinical decision-making. Cite this article: Bone Joint Res 2022;11(9):608–618.

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Section: Discussionmentioning

confidence: 96%

Diagnosing periprosthetic joint infections

Sigmund

Luger

Windhager

et al. 2022

Bone & Joint Research

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“…Joint synovial fluid analysis has developed substantially such as leucocyte counts, percentage of polymorphonucleocytes (PMN%), and CRP, which show sensitivities of 0.89, 0.89 and 0.85, respectively 52 . Recently novel biomarkers such as leucocyte‐esterase test and α‐Defensin test revealed a sufficient diagnostic accuracy, especially α‐Defensin test with an extremely accuracy 53,54 . The gold standard is still based on bacterial culture, which has to be conducted for 3–14 days for fastidious organisms 55 .…”

Section: Discussionmentioning

confidence: 99%

“…52 Recently novel biomarkers such as leucocyte-esterase test and α-Defensin test revealed a sufficient diagnostic accuracy, especially α-Defensin test with an extremely accuracy. 53,54 The gold standard is still based on bacterial culture, which has to be conducted for 3-14 days for fastidious organisms. 55 Currently, about three to five distinct intraoperative tissue samples has to be collected.…”

Section: Areas Of Research Focusmentioning

confidence: 99%

Global Cluster Analysis and Network Visualization in Prosthetic Joint Infection: A Scientometric Mapping

Dong

Mei

et al. 2023

Orthopaedic Surgery

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Objective Prosthetic joint infection (PJI) is the main reason of failure of total joint arthroplasty (TJA). This study aimed to investigate the global trends and network visualization in research of PJI. Methods Publications in PJI search during 1980–2022 were extracted from the Science Citation Index‐Expanded of Web of Science Core Collection database (WoSCC). The source data was investigated and analyzed by bibliometric methodology. For network visualization, VOS viewer and R software was used to perform bibliographic coupling, co‐citation, co‐authorship and co‐occurrence analysis and to predict the publication trends in PJI research. Results There were 7288 articles included. The number of publications and relative research interests increased gradually per year globally. The USA made the highest contributions in the world and with the highest H‐index and the most citations. Journal of Arthroplasty published the highest number of articles in this area. The Mayo Clinic, Thomas Jefferson University (Rothman Institute), Hospital Special Surgery and the Rush University were the most contributive institutions by network visualization. Included studies were divided into four clusters: bacterial pathogenic mechanism and antibacterial drugs study, TJA complications, risk factors and epidemiology of PJI, diagnosis of PJI, and revision surgical management. More articles in PJI could be published over the next few years. Conclusion The number of publications about PJI will be increasing dramatically based on the global trends and network visualization. The USA made the highest contributions in PJI. Diagnosis and revision management may be the next hot spots in this field.

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“…LE strip test is a point of care test that can be performed intraoperatively while using as little as 1 mL of synovial fluid. The LE strip test was originally developed for the identification of urinary tract infections and has demonstrated its accuracy in the diagnosis of the PJI and has been subsequently integrated into the ICM criteria [ 13 , 36 , 37 ].…”

Section: Methodsmentioning

confidence: 99%

Current relevance of biomarkers in diagnosis of periprosthetic joint infection: an update

Tripathi,

Tarabichi,

Parvizi

et al. 2023

Arthroplasty

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With a significant rise in the number of arthroplasty procedures performed worldwide, the increasing revision burden posed by periprosthetic joint infection (PJI) is a matter of growing concern. In spite of various attempts to diagnose PJI, there are no defined tests that can be called a gold standard. Given the importance of early diagnosis in PJI, newer tests and biomarkers have been introduced to improve cumulative diagnostic accuracy. Novel biomarkers like calprotectin, lipocalcin, monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet-to-mean platelet volume ratio have demonstrated a potential as diagnostic biomarkers for PJI. This article discusses the relevance of available and newly described diagnostic biomarkers to provide a perspective on the practical applicability in current medical practice, as well as highlights some recent advances in biomarkers for the diagnosis of PJI.

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Leukocyte esterase test and alpha-defensin test have similar accuracy for the diagnosis of periprosthetic joint infection

Cited by 11 publications

References 18 publications

Diagnosing periprosthetic joint infections

Diagnosing periprosthetic joint infections

Global Cluster Analysis and Network Visualization in Prosthetic Joint Infection: A Scientometric Mapping

Current relevance of biomarkers in diagnosis of periprosthetic joint infection: an update

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