Background: A leukocyte esterase (LE) test is inexpensive and provides real-time information about patients suspected of periprosthetic joint infections (PJIs). The 2018 International Consensus Meeting (ICM) recommends it as a diagnostic tool with a 2+ cutoff. There is still a lack of data revealing LE utility versus the ICM 2018 criteria for PJI.
Methods: This is a retrospective study of patients who underwent revision total hip and total knee arthroplasty at a single institution between March 2009 and December 2019. All patients underwent joint aspiration before the arthrotomy, and the LE strip test was performed on aspirated joint fluid. PJI was defined using the 2018 ICM criteria.
Results: As per the 2018 ICM criteria, 78 patients were diagnosed with chronic PJI and 181 were not infected. An LE test with a cutoff of ≥1+ had a sensitivity of 0.744, a specificity of 0.906, a positive predictive value of 0.773, an accuracy of 0.825 (95% confidence interval 0.772-0.878), and a negative predictive value of 0.891. The positive likelihood ratio (LR+) was 7.917. Using an LE cutoff of 2 + had a sensitivity of 0.513, a specificity of 1.000, and an accuracy of 0.756 (95% confidence interval-0.812).
Conclusion: LE is a rapid and inexpensive test which can be performed at the bedside. Its performance is valuable as per ICM criteria. Based on the findings of this study and the given cohort, we suggest using the cutoff of LE1+ (result = negative or trace) as a point of care test to exclude infection, whereas LE at 2 + threshold has near absolute specificity for the diagnosis.
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http://dx.doi.org/10.1016/j.arth.2021.03.006 | DOI Listing |
Klin Padiatr
December 2024
Neonatology, Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey.
Objectives: Urinary tract infections (UTI) are the most common occult infections in infants under three months of age with high fever, caused by various pathogens, and can progress with different symptoms from mild to severe. We planned to explore and compare pathogen-specific systemic inflammatory indices, urinalysis, and radiological findings in newborns.
Methods: The retrospective study included preterm and term neonates with single pathogen growth of≥50.
Afr J Reprod Health
October 2024
Department of Gynecology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.
Bol Med Hosp Infant Mex
November 2024
Unidad de Investigación en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico City.
Pediatrics
December 2024
Division of Hospital Medicine, University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio.
Background: The objective of this study was to compare the accuracy of available tests for pyuria, including newer automated tests, and to examine the implications of requiring them for the diagnosis of urinary tract infections (UTIs).
Methods: We included children between 1 and 36 months of age undergoing bladder catheterization for suspected UTIs who presented to 1 of 3 pediatric centers. Using a positive urine culture result as the reference standard, we compared the sensitivity of 5 modalities for assessing pyuria at the cutoffs most often used clinically for detecting children with a positive culture result: leukocyte esterase on a dipstick, white blood cell (WBC) count on manual microscopy with and without using a hemocytometer, automated WBC enumeration using flow cytometry, and automated WBC enumeration using digital imaging with particle recognition.
Orthop Traumatol Surg Res
November 2024
Centre de Référence Pour le Traitement des Infections Ostéo-Articulaires Complexes (CRIOAC), Avenue du Professeur-Emile-Laine, 59037 Lille-Tourcoing, France; Université Lille-Hauts de France, 59000 Lille, France; Service Universitaire des Maladies Infectieuses et du Voyageur, Hôpital Dron, 59200, Tourcoing, France.
Introduction: Osteoarticular infections (OAI) after prosthetic surgery have serious functional and economic consequences. Rapid tests for alpha-defensin (TAD) and leukocyte esterase (TLE) are two intra-articular markers involved in the diagnosis of OAIs. TLE cannot be applied in the presence of blood unless centrifugation is used, but the rate of "non-application" of the test for this reason is unknown in complex microbiological situations (discordant or negative puncture, ongoing antibiotic treatment).
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