Accuracy of different diagnostic tests for early, delayed and late prosthetic joint infection
| Autor: | M A Alonso-Aguirre, Concepción Fariñas-Álvarez, María Carmen Fariñas, C. Garcés-Zarzalejo, Marta Fernández-Sampedro, Carlos Salas-Venero, Luis Martínez-Martínez |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Delayed Diagnosis Prosthesis-Related Infections medicine.medical_treatment 030106 microbiology lcsh:Infectious and parasitic diseases 03 medical and health sciences Sonication 0302 clinical medicine Medical microbiology Synovial Fluid Medicine Synovial fluid Humans lcsh:RC109-216 Prospective Studies Prospective cohort study Arthroplasty Replacement Knee Aged Aged 80 and over 030222 orthopedics Bacteriological Techniques Receiver operating characteristic business.industry Diagnostic Tests Routine Prosthetic joint infection Diagnostic test Middle Aged Arthroplasty Surgery Infectious Diseases C-Reactive Protein ROC Curve Histopathology Female business Research Article |
| Zdroj: | BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-8 (2017) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-017-2693-1 |
| Popis: | Background A combination of laboratory, histopathological and microbiological tests for diagnosis of prosthetic joint infection (PJI) have been strongly recommended. This study aims to characterize the accuracy of individual or group tests, such as culture of sonicate fluid, synovial fluid and peri-implant tissue, C-reactive protein (CRP) and histopathology for detection of early, delayed and late PJI. Methods A prospective study of patients undergoing hip or knee arthroplasty from February 2009 to February 2014 was performed in a Spanish tertiary health care hospital. The diagnostic accuracy of the different methods was evaluated constructing receiver-operating-characteristic (ROC) curve areas. Results One hundred thirty consecutive patients were included: 18 (13.8%) early PJI, 35 (27%) delayed PJI and 77 (59.2%) late PJI. For individual parameters, the area under the ROC curve for peri-implant tissue culture was larger for early (0.917) than for delayed (0.829) and late PJI (0.778), p = 0.033. There was a significantly larger difference for ROC area in the synovial fluid culture for delayed (0.803) than for early (0.781) and late infections (0.679), p = 0.039. The comparison of the areas under the ROC curves for the two microbiological tests showed that sonicate fluid was significantly different from peri-implant tissue in delayed (0.951 vs 0.829, p = 0.005) and late PJI (0.901 vs 0.778, p = 0.000). The conjunction of preoperative parameters, synovial fluid culture and CRP, improved the accuracy for late PJI (p = 0.01). The conjunction of histopathology and sonicate fluid culture increased the area under ROC curve of sonication in early (0.917 vs 1.000); p = 0.06 and late cases (0.901 vs 0.999); p |
| Databáze: | OpenAIRE |
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