The role of alpha defensin in prosthetic joint infection (PJI) diagnosis: a literature review

EFORT Open Reviews
Tommaso BonanzingaMaurilio Marcacci

Abstract

Prosthetic joint infection (PJI) management is not standardized worldwide and the outcome is frequently unsatisfactory.More and more arthroplasties are now being performed. An increasing number of highly virulent and antibiotic-resistant bacteria and an ageing population of patients presenting with many comorbidities make it necessary to focus on this important topic.Diagnosis of PJI remains challenging because the clinical signs and symptoms and elevation of systemic biomarkers (C-reactive protein, erythrocyte sedimentation rate) may be unclear.In the last few years, the clinical research has focused on synovial fluid biomarkers as a possible breakthrough in the complex scenario of PJI diagnosis.Synovial biomarkers have shown encouraging results and they should be used as diagnostic adjuncts to synovial white cell count and culture bacteriology. Synovial leukocyte esterase (LE) and synovial C-reactive protein (CRP) have been evaluated as good screening measures; however, the most promising synovial fluid biomarker in terms of sensitivity and specificity for PJI seems to be alpha defensin (AD).The laboratory-based alpha defensin enzyme-linked immunosorbent assay (ELISA) test demonstrated the highest ever reported accuracy for P...Continue Reading

References

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Citations

May 27, 2020·Journal of Bone and Joint Infection·Pascale BémerUNKNOWN Centre de Référence des Infections Ostéo-articulaires du Grand Ouest (CRIOGO) Study Team
Jul 28, 2019·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Isaac Majors, Vivek S Jagadale
Jan 23, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Benjamin F RicciardiEdward M Schwarz
Aug 14, 2020·AJR. American Journal of Roentgenology·Brian Y ChanMegan K Mills
Jul 15, 2020·Expert Review of Molecular Diagnostics·Eric SennevilleHenri Migaud

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Methods Mentioned

BETA
total hip arthroplasties
ESR
enzyme-linked immunosorbent assay
ELISA

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