The use of labelled leucocyte scintigraphy to evaluate chronic periprosthetic joint infections: a retrospective multicentre study on 168 patients

Autor: Pierre Payoux, Eric Bonnet, Jacques Monteil, Philippe Blanc, A.S. Salabert, Gérard Giordano
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Microbiology (medical)
Leucocyte scintigraphy
Male
medicine.medical_specialty
Prosthesis-Related Infections
Single Photon Emission Computed Tomography Computed Tomography
medicine.drug_class
medicine.medical_treatment
030106 microbiology
Antibiotics
Periprosthetic
Prosthesis
Joint infections
Scintigraphy
Gastroenterology
Sensitivity and Specificity
03 medical and health sciences
0302 clinical medicine
Medical microbiology
Predictive Value of Tests
Internal medicine
medicine
Leukocytes
Humans
Radiolabelled leucocytes
030212 general & internal medicine
Radionuclide Imaging
Aged
Retrospective Studies
medicine.diagnostic_test
business.industry
General Medicine
Perioperative
Infectious Diseases
Original Article
Female
Joints
Hip Prosthesis
Pathogens
business
Infection
Knee Prosthesis
Zdroj: European Journal of Clinical Microbiology & Infectious Diseases
ISSN: 1435-4373
0934-9723
Popis: Labelled leucocyte scintigraphy (LS) is regarded as helpful when exploring bone and joint infections. The aim of this study was to evaluate the utility of LS for the diagnosis of chronic periprosthetic joint infections (PJIs) in patients exhibiting arthroplastic loosening. One hundred sixty-eight patients were referred to centres for treatment of complex PJI. One hundred fifty underwent LS using 99mTc-HMPAO (LLS); 18 also underwent anti-granulocyte scintigraphy (AGS) and 13 additional SPECT with tomodensitometry imaging (SPECT-CT). The LS results were compared with bone scan data. For all, the final diagnoses were determined microbiologically; perioperative samples were cultured. LS values were examined, as well as sensitivity by microorganism, anatomical sites, and injected activity. LS results were also evaluated according to the current use of antibiotics or not. The sensitivity, specificity, and positive predictive value of LLS were 72%, 60%, and 80%, respectively. LLS performed better than did AGS. SPECT-CT revealed the accurate locations of infections. The sensitivity of LS was not significantly affected by the causative pathogen or the injected activity. No correlation was evident between the current antibiotic treatment and the LS value. The test was more sensitive for knee (84%) than hip arthroplasty (57%) but was less specific for knee (52% vs. 75%). Sensitivity and specificity of LLS varied by the location of infection bone scan provide no additional value in PJI diagnosis. Current antibiotic treatment seems to have no influence on LS sensitivity as well as labelling leukocyte activity or pathogens responsible for chronic PJI.
Databáze: OpenAIRE
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