Novel diagnostic markers for periprosthetic joint infection: a systematic review.

Autor: Schindler M; Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany., Walter N; Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany., Maderbacher G; Department of Orthopaedic Surgery, University Hospital of Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Germany., Sigmund IK; Nuffield Orthopaedic Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom., Alt V; Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany., Rupp M; Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany.
Jazyk: angličtina
Zdroj: Frontiers in cellular and infection microbiology [Front Cell Infect Microbiol] 2023 Jul 17; Vol. 13, pp. 1210345. Date of Electronic Publication: 2023 Jul 17 (Print Publication: 2023).
DOI: 10.3389/fcimb.2023.1210345
Abstrakt: Background: Identifying novel biomarkers that are both specific and sensitive to periprosthetic joint infection (PJI) has the potential to improve diagnostic accuracy and ultimately enhance patient outcomes. Therefore, the aim of this systematic review is to identify and evaluate the effectiveness of novel biomarkers for the diagnosis of PJI.
Methods: We searched the MEDLINE, EMBASE, PubMed, and Cochrane Library databases from January 1, 2018, to September 30, 2022, using the search terms "periprosthetic joint infection," "prosthetic joint infection," or "periprosthetic infection" as the diagnosis of interest and the target index, combined with the term "marker." We excluded articles that mentioned established biomarkers such as CRP, ESR, Interleukin 6, Alpha defensin, PCT (procalcitonin), and LC (leucocyte cell count). We used the MSIS, ICM, or EBJS criteria for PJI as the reference standard during quality assessment.
Results: We collected 19 studies that analyzed fourteen different novel biomarkers. Proteins were the most commonly analyzed biomarkers (nine studies), followed by molecules (three studies), exosomes (two studies), DNA (two studies), interleukins (one study), and lysosomes (one study). Calprotectin was a frequently analyzed and promising marker. In the scenario where the threshold was set at ≥50-mg/mL, the calprotectin point-of-care (POC) performance showed a high sensitivity of 98.1% and a specificity of 95.7%.
Conclusion: None of the analyzed biomarkers demonstrated outstanding performance compared to the established parameters used for standardized treatment based on established PJI definitions. Further studies are needed to determine the benefit and usefulness of implementing new biomarkers in diagnostic PJI settings.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Schindler, Walter, Maderbacher, Sigmund, Alt and Rupp.)
Databáze: MEDLINE