The usefulness of fast point-of-care tests detecting calprotectin in synovial fluid for diagnosing periprosthetic joint infections

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease Pub Date : 2025-06-06 DOI:10.1016/j.diagmicrobio.2025.116942

Katarzyna Prokop , Rafał Mazur , Aleksandra Grajek , Piotr Sypień , Dariusz Grzelecki

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引用次数: 0

Abstract

Objective

Among different, recently investigated biomarkers calprotectin (CLP) is one of the most promising indicator of periprosthetic joint infections (PJI). This study aims to evaluate the optimal cut-off values and efficacy of two (strip and cassette), semi-quantitative point-of-care (POC) tests detecting CLP for diagnosing chronic PJI.

Methods

A total number of 98 patients (38 with PJI and 60 operated on due to aseptic reasons) were included in the analysis. All synovial fluid samples were tested off-label (synovial fluid samples were tested with tests dedicated to fecal samples) with two semiquantitative tests dedicated to CLP determination: (1) Actim® Calprotectin (strip) and (2) Accu-Tell® Calprotectin (cassette). The same cut-off values for both tests were possible to determine. Based on the calculated thresholds sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing chronic PJI were calculated with statistical methods.

Results

For the Actim® Calprotectin (strip), for a positive result (≥+) sensitivity was 97.4 % (95 %CI=86.2–99.9), specificity was 81.7 % (95 %CI=69.6–99.9), PPV was 77 % (95 %CI=66.3–85.2) and NPV was 98 % (95 %CI=87.6-99.7). For the Accu-Tell® Calprotectin (cassette) test, for a positive result, (≥+) sensitivity, specificity, PPV, and NPV were 89.5 % (95 %CI=75.2–97.1), 90 % (95 %CI=79.5-96.2), 85 % (95 %CI=72.5–92.4), and 93.1 % (95 %CI=84.2–97.2), respectively.

Conclusion

Both POC CLP tests have very good accuracy with off-label use on synovial fluid samples. After validation and adaptation these tests for liquid samples (synovial fluid), we believe these tests may be valuable support in routine clinical practice, especially in POC conditions.

查看原文本刊更多论文

快速点护理试验检测滑液钙保护蛋白对诊断假体周围关节感染的有用性

目的在众多生物标志物中，钙保护蛋白（calprotectin， CLP）是最有前途的假体周围关节感染（PJI）指标之一。本研究旨在评估两种（试纸和盒式）半定量护理点（POC）检测CLP诊断慢性PJI的最佳临界值和疗效。方法98例患者（PJI 38例，无菌原因手术60例）纳入分析。所有滑液样品均在标签外进行测试（滑液样品采用专用于粪便样品的测试），使用两种专用于CLP测定的半定量测试：(1)Actim®Calprotectin（试纸）和(2)Accu-Tell®Calprotectin（盒式）。可以确定两种试验的相同临界值。根据计算的阈值，采用统计学方法计算诊断慢性PJI的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）。结果Actim®钙保护蛋白（试条）阳性结果（≥+）的敏感性为97.4% (95% CI=86.2 ~ 99.9)，特异性为81.7% (95% CI=69.6 ~ 99.9)， PPV为77% (95% CI=66.3 ~ 85.2)， NPV为98% （95% CI=87.6 ~ 99.7）。对于Accu-Tell®Calprotectin（盒式）试验，阳性结果（≥+）的敏感性、特异性、PPV和NPV分别为89.5% （95% CI= 75.2-97.1）、90% （95% CI=79.5-96.2）、85% （95% CI= 72.5-92.4）和93.1% （95% CI= 84.2-97.2）。结论两种POC - CLP试验在滑膜液样品超说明书使用时具有很好的准确性。在对液体样本（滑液）进行验证和调整后，我们相信这些测试可能在常规临床实践中提供有价值的支持，特别是在POC条件下。

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

Diagnostic microbiology and infectious disease 医学-传染病学

CiteScore

5.30

自引率

3.40%

发文量

149

审稿时长

56 days

期刊介绍： Diagnostic Microbiology and Infectious Disease keeps you informed of the latest developments in clinical microbiology and the diagnosis and treatment of infectious diseases. Packed with rigorously peer-reviewed articles and studies in bacteriology, immunology, immunoserology, infectious diseases, mycology, parasitology, and virology, the journal examines new procedures, unusual cases, controversial issues, and important new literature. Diagnostic Microbiology and Infectious Disease distinguished independent editorial board, consisting of experts from many medical specialties, ensures you extensive and authoritative coverage.