Ceja-Picazo SU, Fuentes-Figueroa S, Rivera-Villa AH, Hernández-Salgado AR, Torres-González R, Miguel-Pérez A, Hernández-García JA, Pérez-Atanasio JM

Language: Spanish
References: 24
Page: 198-202
PDF size: 226.83 Kb.

ABSTRACT

Background: The articular infection represents a challenge due to its complexity and its devastating effect when not treated promptly. We have various diagnostic studies: cultures, ESR, CRP, count of leukocytes, among others but none is specific, it takes more than 30 minutes to complete and require complex infrastructure. In this study we determine the sensitivity and specificity of the leukocyte esterase for detection of an infectious process joint in Mexican population. Material and methods: From November 2015 to April 2016 was obtained synovial fluid from patients with diagnosis of knee infection with or without implant and without infection with degenerative pathology of the knee. It assessed the sample through the COMBI-SCREEN 11SYS leukocyte esterase with reading colorimetric test at two minutes determining positive for infection: two crosses, the remainder of the sample was sent to culture. Results: We perform the test in 64 samples of synovial fluid of knee joint 19 diagnosed with infection and 45 without infection. Was obtained a sensitivity 100%, specificity of 88.24%, PPV 68.42% and PNV 100%, kappa index 0.753 using the program IBM SPSS Statistics 22, Python ver. 2.7. Conclusions: Leukocyte esterase is a fast, economical and effective to detect an infectious process against one inflammatory with high probability of success. This study showed an index of concordance 0.753 Kappa, proving to be reproducible so recommend be implemented in the emergency department at the national level.

REFERENCES

1. Nade S. Septic arthritis. Best Pract Res Clin Rheumatol. 2003; 17(2): 183-200.

2. Barton LL, Dunkle LM, Habib FH. Septic arthritis in childhood. A 13-year review. Am J Dis Child. 1987; 141(8): 898-900.

3. Parvizi J, Adeli B, Zmistowski B, Restrepo C, Greenwald AS. Management of periprosthetic joint infection: the current knowledge: AAOS exhibit selection. J Bone Joint Surg Am. 2012; 94(14): e104.

4. Schinsky MF, Della Valle CJ, Sporer SM, Paprosky WG. Perioperative testing for joint infection in patients undergoing revision total hip arthroplasty. J Bone Joint Surg Am. 2008; 90(9): 1869-75.

5. Rak M, Barlič-Maganja D, Kavčič M, Trebše R, Cőr A. Comparison of molecular and culture method in diagnosis of prosthetic joint infection. FEMS Microbiol Lett. 2013; 343(1): 42-8.

6. Berbari EF, Marculescu C, Sia I, Lahr BD, Hanssen AD, Steckelberg JM, et al. Culture-negative prosthetic joint infection. Clin Infect Dis. 2007; 45(9): 1113-9.

7. Donlan RM, Costerton JW. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002; 15(2): 167-93.

8. Jacovides CL, Parvizi J, Adeli B, Jung KA. Molecular markers for diagnosis of periprosthetic joint infection. J Arthroplasty. 2011; 26(6 Suppl): 99-103.e1.

9. Colvin OC, Kransdorf MJ, Roberts CC, Chivers FS, Lorans R, Beauchamp CP, et al. Leukocyte esterase analysis in the diagnosis of joint infection: can we make a diagnosis using a simple urine dipstick? Skeletal Radiol. 2015; 44(5): 673-7.

10. Parvizi J, Jacovides C, Antoci V, Ghanem E. Diagnosis of periprosthetic joint infection: the utility of a simple yet unappreciated enzyme. J Bone Joint Surg Am. 2011; 93(24): 2242-8.

11. Wetters NG, Berend KR, Lombardi AV, Morris MJ, Tucker TL, Della-Valle CJ. Leukocyte esterase reagent strips for the rapid diagnosis of periprosthetic joint infection. J Arthroplasty. 2012; 27(8 Suppl): 8-11.

12. Aggarwal VK, Tischler E, Ghanem E, Parvizi J. Leukocyte esterase from synovial fluid aspirate: a technical note. J Arthroplasty. 2013; 28(1): 193-5.

13. Tischler EH, Cavanaugh PK, Parvizi J. Leukocyte esterase strip test: matched for musculoskeletal infection society criteria. J Bone Joint Surg Am. 2014; 96(22): 1917-20.

14. Devillé WL, Yzermans JC, van Duijn NP, Bezemer PD, van der Windt DA, Bouter LM. The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy. BMC Urol. 2004; 4: 4.

15. Perry JL, Matthews JS, Weesner DE. Evaluation of leukocyte esterase activity as a rapid screening technique for bacteriuria. J Clin Microbiol. 1982; 15(5): 852-4.

16. Smalley DL, Dittmann AN. Use of leukocyte esterase-nitrate activity as predictive assays of significant bacteriuria. J Clin Microbiol. 1983; 18(5): 1256-7.

17. Chernow B, Zaloga GP, Soldano S, Quinn A, Lyons P, McFadden E, et al. Measurement of urinary leukocyte esterase activity: a screening test for urinary tract infections. Ann Emerg Med. 1984; 13(3): 150-4.

18. Chugh K, Agrawal Y, Goyal V, Khatri V, Kumar P. Diagnosing bacterial peritonitis made easy by use of leukocyte esterase dipsticks. Int J Crit Illn Inj Sci. 2015; 5(1): 32-7.

19. Azoulay E, Fartoukh M, Galliot R, Baud F, Simonneau G, Le Gall JR, et al. Rapid diagnosis of infectious pleural effusions by use of reagent strips. Clin Infect Dis. 2000; 31(4): 914-9.

20. Gal-Oz A, Kassis I, Shprecher H, Beck R, Bentur L. Correlation between rapid strip test and the quality of sputum. Chest. 2004; 126(5): 1667-71.

21. Jacobs JA, De Brauwer EI, Cornelissen EI, Drent M. Correlation of leukocyte esterase detection by reagent strips and the presence of neutrophils: a study in BAL fluid. Chest. 2000; 118(5): 1450-4.

22. Lebovics RS, Murthy VV, Karmen A. Leukocyte esterase activity in effusion fluid of patients with otitis media. Otolaryngol Head Neck Surg. 1993; 108(3): 248-50.

23. Matsuda M, Noda Y, Takemori Y. Novel diagnostic method of testing for Helicobacter pylori infection using the rapid leukocyte strip test, Leukostix. J Gastroenterol Hepatol. 2003; 18(10): 1196-201.

24. Coiffier G, Pollet S, Albert JD, Perdriger A, Guggenbuhl P, Chales G. Usefulness and limitations of rapid urine dipstick testing for joint-fluid analysis. Prospective single-center study of 98 specimens. Joint Bone Spine. 2013; 80(6): 604-7.