Determining the accuracy of the leukocyte esterase reagent strip test in the rapid diagnosis of adult septic arthritis.

IF 2 4区医学 Q3 RHEUMATOLOGY

Advances in Rheumatology Pub Date : 2024-08-30 DOI:10.1186/s42358-024-00409-4

Peyman Mirghaderi, Mohammad-Taha Pahlevan-Fallahy, Jamil Mahmoudi, S M Javad Mortazavi

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引用次数: 0

Abstract

Backgrounds: Septic arthritis is a dangerous disease that occurs when microorganisms enter synovial fluid. It needs fast and accurate management; otherwise, it can harm the patient's life. Currently, the tests measure WBC and PMN in SF, so we hypothesized to use a proxy that is easier and faster to measure. Leukocyte esterase is an enzyme secreted by neutrophils that can be found in the synovial fluid of SA patients. In this study, we tried to investigate the sensitivity and specificity of leukocyte esterase in diagnosing septic arthritis.

Methods: We obtained synovial fluid samples from forty-six patients suspected of having septic arthritis and fifty-eight healthy individuals and measured the WBCs, ESR, CRP, PMN, glucose, and protein of SF in 2021. We also used the leukocyte esterase dipstick test to investigate the level of LE in synovial fluid for one minute.

Results: Based on clinical and paraclinical criteria, sixteen out of the forty-six patients were diagnosed with SA. When (++) was considered positive, the sensitivity and specificity of the LE dipstick test for the diagnosis of SA were 93.7% (95% CI: 81.8-100%) and 60% (95% CI: 42.4-77.5%, P = 0.000), respectively. When both (+) and (++) were considered positive, they were 100% and 43.3% (95% CI: 25.6-61.0% P = 0.000), respectively. All the patients in the control group had negative cultures and LE test readings (specificity = 100%).

Conclusion: The LE dipstick test can be a valuable diagnostic tool in the initial diagnosis of SA since it is affordable, fast, and reliable.

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确定白细胞酯酶试剂条检验在快速诊断成人化脓性关节炎中的准确性。

背景：化脓性关节炎是一种危险的疾病，当微生物进入滑液时就会发生。它需要快速、准确的治疗，否则会危及患者生命。目前的检测方法是测量 SF 中的 WBC 和 PMN，因此我们假设使用一种更容易、更快速测量的替代方法。白细胞酯酶是一种由中性粒细胞分泌的酶，可在 SA 患者的滑液中发现。本研究试图探讨白细胞酯酶在诊断化脓性关节炎方面的敏感性和特异性：方法：我们采集了 46 名疑似化脓性关节炎患者和 58 名健康人的滑液样本，并测定了 2021 年 SF 的白细胞、血沉、CRP、PMN、葡萄糖和蛋白质。我们还使用白细胞酯酶试纸检测滑液中一分钟白细胞酯酶的水平：根据临床和辅助临床标准，46 名患者中有 16 人被诊断为 SA。当(++)为阳性时，LE试纸检测对 SA 诊断的敏感性和特异性分别为 93.7% (95% CI: 81.8-100%) 和 60% (95% CI: 42.4-77.5%, P = 0.000)。当（+）和（++）均被视为阳性时，其阳性率分别为 100%和 43.3%（95% CI：25.6-61.0%，P = 0.000）。对照组所有患者的培养和LE检测读数均为阴性（特异性=100%）：LE滴定管检测是初步诊断SA的重要诊断工具，因为它价格低廉、快速可靠。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Rheumatology Medicine-Rheumatology

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

53 weeks

期刊介绍： Formerly named Revista Brasileira de Reumatologia, the journal is celebrating its 60th year of publication. Advances in Rheumatology is an international, open access journal publishing pre-clinical, translational and clinical studies on all aspects of paediatric and adult rheumatic diseases, including degenerative, inflammatory and autoimmune conditions. The journal is the official publication of the Brazilian Society of Rheumatology and welcomes original research (including systematic reviews and meta-analyses), literature reviews, guidelines and letters arising from published material.