Performance of alpha-defensin lateral flow test after synovial fluid centrifugation for diagnosis of periprosthetic knee infection  

作　　者：Rodrigo Calil Teles Abdo Riccardo Gomes Gobbi Chilan Bou Ghosson Leite Sandra Gofinet Pasoto Elaine Pires Leon Ana Lucia Lei Munhoz Lima Eloisa Bonfa José Ricardo Pécora Marco Kawamura Demange 

机构地区：[1]Instituto de Ortopedia e Traumatologia,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,Sao Paulo 05403-010,Brazil [2]Division of Rheumatology,Faculdade de Medicina da Universidade de São Paulo,Sao Paulo 01246-903,Brazil

出　　处：《World Journal of Orthopedics》2021年第8期565-574,共10页世界骨科杂志（英文版）

基　　金：Supported by Fundação de AmparoàPesquisa do Estado de São Paulo.

摘　　要：BACKGROUND The quantitative alpha-defensin enzyme-linked immunosorbent assay(ELISA)demands a prior synovial fluid centrifugation,whereas this processing is not routinely required prior to the alpha-defensin lateral flow test.AIM To evaluate whether a prior synovial fluid centrifugation could lead the lateral flow performance to achieve comparable results to ELISA during periprosthetic joint infection(PJI)diagnosis.METHODS Fifty-three cases were included in this study:22 classified as PJI and 31 classified as aseptic cases,according to Musculoskeletal Infection Society 2013 criteria.Synovial fluid samples were submitted to centrifugation,and the supernatant was evaluated by ELISA and lateral flow tests.The sensitivity(SE),specificity(SP)and accuracy of each method were calculated as well as the agreement between those two methods.RESULTS In all of the 31 samples from aseptic patients,alpha-defensin ELISA and lateral flow tests showed negative results for infection.Regarding the 22 infected patients,the lateral flow test was positive in 19 cases(86.4%)and the ELISA was positive in 21(95.5%).Sensibility,SP and accuracy were,respectively,86.4%(95%CI:65.1%-97.1%),100%(95%CI:88.8%-100%)and 93.2%(95%CI:82.8%-98.3%)for the lateral flow test and 95.5%(95%CI:77.2%-99.9%),100%(95%CI:88.8%-100%)and 98.1%(95%CI:89.9%-100%)for ELISA.An agreement of 96.2%between those methods were observed.No statistical difference was found between them(P=0.48).CONCLUSION Alpha-defensin lateral flow test showed high SE,SP and accuracy after a prior synovial fluid centrifugation,achieving comparable results to ELISA.Considering the lower complexity of the lateral flow and its equivalent performance obtained in this condition,a prior centrifugation might be added as a valuable step to enhance the PJI diagnosis.

关 键 词：Alpha-defensin Alpha-defensin lateral flow Periprosthetic joint infection 

分 类 号：R684[医药卫生—骨科学]