Does the alpha-defensin lateral flow test ...
Type de document :
Compte-rendu et recension critique d'ouvrage
PMID :
Titre :
Does the alpha-defensin lateral flow test conserve its diagnostic properties in a larger population of chronic complex periprosthetic infections? Enlargement to 112 tests, from 42 tests in a preliminary study, in a reference center.
Auteur(s) :
de Saint Vincent, Benoît [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martinot, Pierre [Auteur]
Université Lille Nord (France)
Hôpital Roger Salengro [Lille]
Pascal, Adrien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Senneville, Eric [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Loiez, Caroline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Pasquier, Gilles [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)]
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Putman, Sophie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Migaud, Henri [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)]
Université Lille Nord (France)
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martinot, Pierre [Auteur]
Université Lille Nord (France)
Hôpital Roger Salengro [Lille]
Pascal, Adrien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Senneville, Eric [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Loiez, Caroline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Pasquier, Gilles [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)]
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Putman, Sophie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Migaud, Henri [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)]
Université Lille Nord (France)
Titre de la revue :
Orthopaedics & Traumatology: Surgery & Research
Orthopaedics and Traumatology - Surgery and Research
Orthopaedics and Traumatology - Surgery and Research
Pagination :
102912
Éditeur :
Elsevier
Date de publication :
2021-04-08
ISSN :
1877-0568
Mot(s)-clé(s) :
Periprosthetic infection
Synovasure
Alpha defensin
MSIS
Infection diagnosis
Bone and joint infection
Synovasure
Alpha defensin
MSIS
Infection diagnosis
Bone and joint infection
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
BackgroundDiagnosis of periprosthetic infection (PPI) is crucial for management of bone and joint infection. The preoperative gold-standard is joint aspiration, providing results after 2-14 days’ culture, with non-negligible ...
Lire la suite >BackgroundDiagnosis of periprosthetic infection (PPI) is crucial for management of bone and joint infection. The preoperative gold-standard is joint aspiration, providing results after 2-14 days’ culture, with non-negligible false negative rates due to the fragility of certain micro-organisms and/or prior antibiotic treatment. The Synovasure™ alpha-defensin lateral flow test (Zimmer, Warsaw, IN, USA) contributes within minutes to joint fluid diagnosis of almost all infectious agents, including in case of concomitant antibiotic therapy. Validity remains controversial, notably in complex microbiological situations: multi-operated patients, diagnostic doubt despite iterative sterile culture, long-course antibiotic therapy. We extended a prospective study reported in 2018, to determine whether the test maintained diagnostic value in a larger population, assessing 1) negative (NPV) and positive (PPV) predictive value, and 2) sensitivity and specificity.HypothesisSynovasure™ maintains NPV above 95% in a broader population of microbiologically complex suspected PPI.Material and methodsSynovasure™’s performance was assessed between October 2015 and October 2019 in 106 patients (112 tests) in complex diagnostic situations: 37 discordant cultures (discordant findings between 2 samples), 65 cases with clinically or biologically suspected infection but iterative sterile culture, 10 emergencies (requiring surgery, precluding antibiotic window, or mechanical failure in suspected infection), including 5 with ongoing antibiotic therapy for infection in another organ. Six tests were repeated in the same patient and same joint at >6 months’ interval for strong clinical suspicion of infection. The main endpoint was the MSIS score (MusculoSkeletal Infection Society, 2018).ResultsNPV was 98.8%, PPV 72.4%, sensitivity 95.5% and specificity 91%. Prevalence of infection was 19.6%. Only 1 of the 22 infected patients had negative Synovasure™ tests, compared to 81 of the 84 non-infected patients.ConclusionSynovasure™ is a reliable novel diagnostic test, contributing mainly to ruling out infection thanks to its strong NPV. The cost imposes sparing use, but medico-economic assessment would be worthwhile.Lire moins >
Lire la suite >BackgroundDiagnosis of periprosthetic infection (PPI) is crucial for management of bone and joint infection. The preoperative gold-standard is joint aspiration, providing results after 2-14 days’ culture, with non-negligible false negative rates due to the fragility of certain micro-organisms and/or prior antibiotic treatment. The Synovasure™ alpha-defensin lateral flow test (Zimmer, Warsaw, IN, USA) contributes within minutes to joint fluid diagnosis of almost all infectious agents, including in case of concomitant antibiotic therapy. Validity remains controversial, notably in complex microbiological situations: multi-operated patients, diagnostic doubt despite iterative sterile culture, long-course antibiotic therapy. We extended a prospective study reported in 2018, to determine whether the test maintained diagnostic value in a larger population, assessing 1) negative (NPV) and positive (PPV) predictive value, and 2) sensitivity and specificity.HypothesisSynovasure™ maintains NPV above 95% in a broader population of microbiologically complex suspected PPI.Material and methodsSynovasure™’s performance was assessed between October 2015 and October 2019 in 106 patients (112 tests) in complex diagnostic situations: 37 discordant cultures (discordant findings between 2 samples), 65 cases with clinically or biologically suspected infection but iterative sterile culture, 10 emergencies (requiring surgery, precluding antibiotic window, or mechanical failure in suspected infection), including 5 with ongoing antibiotic therapy for infection in another organ. Six tests were repeated in the same patient and same joint at >6 months’ interval for strong clinical suspicion of infection. The main endpoint was the MSIS score (MusculoSkeletal Infection Society, 2018).ResultsNPV was 98.8%, PPV 72.4%, sensitivity 95.5% and specificity 91%. Prevalence of infection was 19.6%. Only 1 of the 22 infected patients had negative Synovasure™ tests, compared to 81 of the 84 non-infected patients.ConclusionSynovasure™ is a reliable novel diagnostic test, contributing mainly to ruling out infection thanks to its strong NPV. The cost imposes sparing use, but medico-economic assessment would be worthwhile.Lire moins >
Langue :
Anglais
Vulgarisation :
Non
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Source :
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