Abstract |
Infection is a leading indication for revision arthroplasty. Established criteria used to diagnose prosthetic joint infection (PJI) include a range of laboratory tests. Leucocyte esterase (LE) is widely used on a colorimetric reagent strip for the diagnosis of urinary tract infections. This inexpensive test may be used for the diagnosis or exclusion of PJI. Aspirates from 30 total hip arthroplasties ( THAs) and 79 knee arthroplasties (KA) were analysed for LE activity. Semi-quantitative reagent strip readings of 15, 70, 125 and 500 white blood cells (WBC) were validated against a manual synovial white cell count (WCC). A receiver operating characteristic (ROC) curve was constructed to determine the optimal cut-off point for the semi-quantitative results. Based on established criteria, six THAs and 15 KAs were classified as infected. The optimal cut-off point for the diagnosis of PJI was 97 WBC. The closest semi-quantitative reading for a positive result was 125 WBC, achieving a sensitivity of 81% and a specificity of 93%. The positive and negative predictive values of the LE test strip were 74% and 95% respectively. The LE reagent strip had a high specificity and negative predictive value. A negative result may exclude PJI and negate the need for further diagnostic tests.
|
Authors | R Shafafy, W McClatchie, K Chettiar, K Gill, R Hargrove, S Sturridge, A Guyot |
Journal | The bone & joint journal
(Bone Joint J)
Vol. 97-B
Issue 9
Pg. 1232-6
(Sep 2015)
ISSN: 2049-4408 [Electronic] England |
PMID | 26330590
(Publication Type: Evaluation Study, Journal Article)
|
Copyright | ©2015 The British Editorial Society of Bone & Joint Surgery. |
Chemical References |
- Biomarkers
- Reagent Strips
- leukocyte esterase
- Carboxylic Ester Hydrolases
|
Topics |
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Biomarkers
(blood)
- Carboxylic Ester Hydrolases
(blood)
- Colorimetry
(methods)
- Female
- Hip Prosthesis
(adverse effects)
- Humans
- Knee Prosthesis
(adverse effects)
- Leukocyte Count
- Male
- Predictive Value of Tests
- Prosthesis-Related Infections
(diagnosis, etiology, microbiology)
- Reagent Strips
- Reproducibility of Results
- Sensitivity and Specificity
- Synovial Fluid
(microbiology)
|