Use of leucocyte esterase reagent strips in the diagnosis or exclusion of prosthetic joint infection

The Bone & Joint Journal
R ShafafyA Guyot

Abstract

Infection is a leading indication for revision arthroplasty. Established criteria used to diagnose prosthetic joint infection (PJI) include a range of laboratory tests. Leucocyte esterase (LE) is widely used on a colorimetric reagent strip for the diagnosis of urinary tract infections. This inexpensive test may be used for the diagnosis or exclusion of PJI. Aspirates from 30 total hip arthroplasties (THAs) and 79 knee arthroplasties (KA) were analysed for LE activity. Semi-quantitative reagent strip readings of 15, 70, 125 and 500 white blood cells (WBC) were validated against a manual synovial white cell count (WCC). A receiver operating characteristic (ROC) curve was constructed to determine the optimal cut-off point for the semi-quantitative results. Based on established criteria, six THAs and 15 KAs were classified as infected. The optimal cut-off point for the diagnosis of PJI was 97 WBC. The closest semi-quantitative reading for a positive result was 125 WBC, achieving a sensitivity of 81% and a specificity of 93%. The positive and negative predictive values of the LE test strip were 74% and 95% respectively. The LE reagent strip had a high specificity and negative predictive value. A negative result may exclude PJI and n...Continue Reading

References

May 1, 1985·Journal of Clinical Microbiology·M A Pfaller, F P Koontz
Oct 1, 1984·Journal of Clinical Microbiology·K P Sawyer, L L Stone
Apr 24, 1981·JAMA : the Journal of the American Medical Association·R K KusumiC M Kunin
Jul 31, 1999·The Journal of Arthroplasty·C J Della ValleP E Di Cesare
Aug 2, 2002·Clinical Orthopaedics and Related Research·Daxes M BanitJames M Hartford
Sep 6, 2005·The Journal of Bone and Joint Surgery. American Volume·Paul E Di CesareChuan-ju Liu
Mar 21, 2006·International Orthopaedics·Alberto Francés BorregoLuis López-Durán Stern
Oct 11, 2007·The Journal of Arthroplasty·Robert L BarrackJavad Parvizi
Aug 5, 2008·The Journal of Bone and Joint Surgery. American Volume·Elie GhanemRobert L Barrack
Sep 3, 2009·The Journal of Bone and Joint Surgery. American Volume·Patrick M MorganRobert L Barrack
Jan 6, 2010·Clinical Orthopaedics and Related Research·Aaron J JohnsonMichael A Mont
Sep 3, 2010·The Journal of Bone and Joint Surgery. American Volume·Elie BerbariDouglas Osmon
Oct 1, 2010·Clinical Orthopaedics and Related Research·Margret OethingerThomas W Bauer
Jan 20, 2012·The Journal of Bone and Joint Surgery. American Volume·Javad ParviziElie Ghanem
May 23, 2012·The Journal of Arthroplasty·Nathan G WettersCraig J Della Valle
Aug 8, 2012·The Journal of Arthroplasty·Vinay K AggarwalJavad Parvizi
Dec 12, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Douglas R OsmonUNKNOWN Infectious Diseases Society of America
Mar 19, 2013·The Journal of Arthroplasty·Cody C WylesRobert T Trousdale
Oct 24, 2013·The Bone & Joint Journal·J ParviziA F Chen
Mar 19, 2014·The Journal of Infection·María Eugenia PortilloLluis Puig

❮ Previous
Next ❯

Citations

Sep 4, 2015·The Bone & Joint Journal·J Parvizi, F S Haddad
Oct 4, 2016·The Bone & Joint Journal·F S Haddad
Oct 24, 2017·The Journal of the American Academy of Orthopaedic Surgeons·Anas SalehCarlos A Higuera Rueda
Mar 21, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Sufian S AhmadSandro Kohl
May 2, 2018·The Journal of Bone and Joint Surgery. American Volume·Nora RenzAndrej Trampuz
Feb 10, 2018·BioMed Research International·Bernd Fink, Florian Sevelda
Apr 18, 2019·The Journal of Bone and Joint Surgery. American Volume·Alisina ShahiJavad Parvizi
Aug 15, 2017·JBJS Reviews·Daniel J GittingsNeil P Sheth
Jan 24, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Creighton C TubbBarbara Krause
Jan 1, 2021·The Bone & Joint Journal·Martin McNallyRihard Trebše
Feb 11, 2021·Journal of Clinical Medicine·Michael FuchsF Andrea Sass
Jun 3, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Katyayini SharmaRobin Patel
Jan 26, 2021·Clinical Orthopaedics and Related Research·Qing-Yuan ZhengGuo-Qiang Zhang

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.