scholarly journals Presepsin: A potential biomarker of PJI? A comparative analysis with known and new infection biomarkers

2017 ◽  
Vol 31 ◽  
pp. 039463201774935 ◽  
Author(s):  
Monica Gioia Marazzi ◽  
Filippo Randelli ◽  
Marco Brioschi ◽  
Lorenzo Drago ◽  
Carlo Luca Romanò ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Joint Infection ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Reactive Protein ◽  
Diagnosis And Prognosis ◽  
Diagnostic Potential ◽  
Potential Biomarker ◽  
No Gold Standard

There is still no “gold standard” for the diagnosis and prognosis of post-operative periprosthetic joint infection (PJI). Among serum biomarkers, an emerging molecule is presepsin, the soluble fraction of CD14, recently described in other settings as a powerful diagnostic tool to detect sepsis at different degrees of severity. The aim of this study was to investigate the diagnostic and prognostic value of presepsin in PJI. A total of 30 patients with PJI and 30 patients without PJI were enrolled. Presepsin, C-reactive protein (CRP), serum interleukin (IL)-6, triggering receptor expressed on myeloid cells 1 (TREM-1), CCL2, matrix metalloproteinase 9 (MMP-9), CD163, osteopontin (OPN), and toll-like receptor 2 (TLR2) were measured at different times after surgery. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker. Presepsin showed greater diagnostic value than CRP and IL-6; CD163, TREM-1, and MMP-9 had very low diagnostic potential. Presepsin, OPN, CCL2, suPAR, and TLR2 all decreased significantly with increasing time of recovery after surgery in PJI patients. Presepsin can be considered a useful tool for the diagnosis and clinical monitoring of PJI and can be backed by a panel of new inflammatory markers involved in monocyte-/macrophage-mediated inflammatory responses, such as OPN, CCL2, TLR2, and suPAR.

scholarly journals Globulin and Albumin To Globulin Ratio Precisely Diagnose Periprosthetic Joint Infection and Determine The Timing of Second-Stage Reimplantation

2021 ◽  
Author(s):  
Guangqian Shang ◽  
Zhixuan Fei ◽  
Hao Xu ◽  
Yingzhen Wang ◽  
Shuai Xiang
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Failure Group ◽  
Reactive Protein ◽  
Second Stage ◽  
Diagnostic Values ◽  
Albumin To Globulin Ratio

Abstract Background Periprosthetic joint infection (PJI) is one of the most challenging complication of total joint arthroplasty (TJI). An early and accurate diagnosis of PJI is associated with better treatment outcomes. However, whether the platelet-related markers and globulin-related markers can be used to assist the diagnosis of PJI remains elusive. Methods 206 patients underwent revision hip or knee arthroplasty in our institution were divided into two groups: 79 patients in PJI group and 127 patients in aseptic failure group. The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet-related markers including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT) and PLT to MPV raito (PMR) and globulin-related markers, such as globulin, albumin to globulin ratio (AGR), and PLT to AGR ratio were compared. The diagnostic value was measured using area under the curve (AUC) after constructing receiver operating characteristic (ROC) curves. The potential of each marker for determining the timing of second-staged reimplantation was also evaluated. Results Significantly increased levels of ESR, CRP, PLT, PCT, PMR, GLB, and PLT to AGR ratio were identified in PJI group, while decreased levels of MPV and AGR were also found. The diagnostic values of all platelet-related markers and GLB were considered as fair, and good diagnostic values of AGR and PLT to AGR ratio were found, which were comparable to those of ESR and CRP. The levels of GLB and AGR can also be used to predict negative culture result and the timing of second-stage reimplantation. Conclusions Globulin and albumin to globulin ratio were found to have good diagnostic values for PJI, and they can precisely predict the culture results and persistent infection.

scholarly journals Globulin and albumin to globulin ratio precisely diagnose periprosthetic joint infection and determine the timing of second-stage reimplantation

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Guangqian Shang ◽  
ZhiXuan Fei ◽  
Hao Xu ◽  
Yingzhen Wang ◽  
Shuai Xiang
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Failure Group ◽  
Reactive Protein ◽  
Second Stage ◽  
Diagnostic Values ◽  
Albumin To Globulin Ratio

Abstract Background Periprosthetic joint infection (PJI) is one of the most challenging complications of total joint arthroplasty (TJI). An early and accurate diagnosis of PJI is associated with better treatment outcomes. However, whether the platelet-related markers and globulin-related markers can be used to assist the diagnosis of PJI remains elusive. Methods A total of 206 patients who underwent revision hip or knee arthroplasty in our institution were divided into two groups: 79 patients in PJI group and 127 patients in aseptic failure group. The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet-related markers including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT) and PLT to MPV ratio (PMR) and globulin-related markers such as globulin (GLB), albumin to globulin ratio (AGR) and PLT to AGR ratio were compared. The diagnostic value was measured using area under the curve (AUC) after constructing receiver operating characteristic (ROC) curves. The potential of each marker for determining the timing of second-staged reimplantation was also evaluated. Results Significantly increased levels of ESR, CRP, PLT, PCT, PMR, GLB and PLT to AGR ratio were identified in PJI group, while decreased levels of MPV and AGR were also found. The diagnostic values of all platelet-related markers and GLB were considered as fair, and good diagnostic values of AGR and PLT to AGR ratio were found, which were comparable to those of ESR and CRP. The levels of GLB and AGR can also be used to predict negative culture result and the timing of second-stage reimplantation. Conclusions Globulin and albumin to globulin ratio were found to have good diagnostic values for PJI, and they can precisely predict the culture results and persistent infection.

scholarly journals Pre-analytical and analytical confounders of serum calprotectin as a biomarker in rheumatoid arthritis

2019 ◽  
Vol 58 (1) ◽  
pp. 40-49
Author(s):  
Lieve Van Hoovels ◽  
Bert Vander Cruyssen ◽  
Laura Bogaert ◽  
Stefanie Van den Bremt ◽  
Xavier Bossuyt
Keyword(s):  
Rheumatoid Arthritis ◽  
Infectious Disease ◽  
Disease Activity ◽  
Clinical Performance ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Healthy Controls ◽  
Reactive Protein ◽  
Diagnosis And Prognosis ◽  
Edta Plasma

Abstract Background There is a need for additional biomarkers to assist in the diagnosis and prognosis of rheumatoid arthritis (RA). The aim of our study was to evaluate the (pre-analytical, analytical and clinical) performance of serum calprotectin as a marker of inflammation in RA. Methods The study population included 463 rheumatologic patients (including 111 RA patients and 352 controls) who for the first time consulted a rheumatologist, 20 healthy controls and 27 patients with an infectious disease. Calprotectin was measured (using four different assays) in serum or in serum and EDTA plasma (healthy controls and infectious disease group). For rheumatologic patients, results for C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were available. Results Results for blood calprotectin were assay- and matrix-dependent, with higher values found in serum than in plasma. Serum calprotectin was higher in RA patients than in rheumatologic diseased controls and in healthy controls. Serum calprotectin was lower in RA patients than in patients with an infectious disease. Serum calprotectin was associated with disease activity (DAS score). The area under the curve (AUC) to discriminate RA from controls was 0.756 for CRP, 0.714 for ESR and 0.726–0.783 for calprotectin. Conclusions Our data document that calprotectin measurement is assay- and matrix-dependent. Serum calprotectin is associated with disease activity. Additional (prospective) studies are warranted to further evaluate the prognostic and diagnostic value of blood calprotectin measurements.

scholarly journals Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Cheng Li ◽  
Christina Ojeda Thies ◽  
Chi Xu ◽  
Andrej Trampuz
Keyword(s):  
Meta Analysis ◽  
Joint Infection ◽  
Protein A ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Combined Method ◽  
C Reactive Protein ◽  
Single Marker Analysis ◽  
Gold Standard Method ◽  
Reactive Protein

Abstract Background Because there is no single gold standard method for the diagnosis of periprosthetic joint infection (PJI), the combination of valuable methods to evaluate infection appears to achieve a better diagnostic result. The objective of the present study was to evaluate the diagnostic value of serum interleukin (IL)-6 and C-reactive protein (CRP) for the diagnosis of PJI. Methods PubMed, Embase, and the Web of Science databases were searched for articles describing PJI diagnosis using serum IL-6 and CRP published between January 1990 and December 2019. Results Eight studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% confidence interval [CI], 0.80−0.88) for the combined method (serum IL-6 and CRP) in series and parallel approaches, 0.87 (95% CI, 0.82−0.90) for IL-6, and 0.84 (95% CI, 0.79−0.88) for CRP. The pooled specificity was 0.85 (95% CI, 0.82−0.88) for the combined method, 0.83 (95% CI, 0.79−0.87) for IL-6, and 0.83 (95% CI, 0.79−0.87) for CRP. The combined method had the highest value for the area under the curve (0.9453), followed by IL-6 (0.9237) and CRP (0.9074). Subgroup analyses showed that the sensitivity of the combined method in parallel tests was higher than that in IL-6 or CRP (94% vs. 89% and 84%, respectively). Serial testing of the combined method showed increased specificity compared to a single indicator (96% vs. 83% and 80%). Conclusion The combination of serum IL-6 and CRP was a reliable tool for the diagnosis of periprosthetic hip and knee infection, demonstrating a better diagnostic accuracy than single marker analysis.

scholarly journals Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections?

2020 ◽  
Author(s):  
Cheng Li ◽  
Cristina Ojeda Thies ◽  
Chi Xu ◽  
Andrej Trampuz
Keyword(s):  
Meta Analysis ◽  
Joint Infection ◽  
Protein A ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Sample Collection ◽  
Combined Method ◽  
C Reactive Protein ◽  
Gold Standard Method ◽  
Reactive Protein

Abstract Background: Because there is no single gold-standard method for the diagnosis of periprosthetic joint infection (PJI), the combination of valuable methods to evaluate infection seems to achieve a better diagnostic result. The objective of the present study was to evaluate the diagnostic value of serum interleukin (IL)-6 and C-reactive protein (CRP) for the diagnosis of PJI.Methods: PubMed, Embase, and the Web of Science databases were searched for articles describing PJI diagnosis using serum IL-6 and CRP published between January 1990 and December 2019.Results: Eight studies were included in the meta-analysis. The pooled sensitivity was 0.79 (95% confidence interval [CI]: 0.73 to 0.83) for the combined method (serum IL-6 and CRP), 0.87 (95% CI: 0.82 to 0.91) for IL-6 and 0.83 (95% CI: 0.78 to 0.87) for CRP . The pooled specificity was 0.92 (95% CI: 0.89 to 0.95) for the combined method, 0.85 (95% CI: 0.81 to 0.88) for IL-6, and 0.83 (95% CI: 0.79 to 0.87) for CRP. The combined method had the highest value for the area under the curve (0.9688), followed by IL-6 (0.9259) and CRP (0.9139). Subgroup analyses showed that restricting antibiotic treatment before sample collection may improve specificity.Conclusion: The combination of serum IL-6 and CRP was a reliable tool for the diagnosis of PJI, and it had a better diagnostic accuracy than testing with a single marker, especially when samples were collected without antibiotic therapy. Additional research is needed.

scholarly journals The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Dacheng Zhao ◽  
Jinwen He ◽  
Xingwen Wang ◽  
Xiaobing Zhao ◽  
Yayi Xia ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Characteristic Curve ◽  
Joint Infection ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Reactive Protein ◽  
Joint Infections ◽  
Implant Retention ◽  
Sensitivity Specificity

Abstract Background Fibrinogen (FIB) has been found to be a promising marker in diagnosing periprosthetic joint infection (PJI), however, the value of FIB in predicting reinfection of PJI is unknown. The purpose of this study was to evaluate the value of FIB in predicting reinfection after debridement, antibiotics, and implant retention (DAIR) for PJI. Methods We retrospectively analyzed the clinical data of patients who were diagnosed with PJI and underwent DAIR from 2013 to 2019. The levels of the FIB, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured before DAIR. After DAIR, patients were followed and reinfections were identified. For both acute and chronic PJI, the predictive value of FIB was evaluated by calculating the sensitivity, specificity, and area under the curve (AUC) of the receiver operating characteristic curve (ROC), and was compared with traditional inflammatory markers including ESR and CRP. Results The expression of FIB differed between patients reinfected and those not reinfected in both acute and chronic PJI (p < 0.05). In patients who underwent DAIR for acute PJI, the sensitivity and specificity of FIB were 81.82 and 83.33%, respectively, which were significantly higher than that of CRP (sensitivity, 72.73%; specificity, 50%; p < 0.05), while the specificity was higher than that of ESR (specificity, 41.67%; p < 0.05). In patients who underwent DAIR for chronic PJI, the sensitivity and specificity of FIB were 80.00 and 66.66%, respectively, which were significantly higher than that of CRP (sensitivity, 53.33%; specificity, 66.66%; p < 0.05) and ESR (sensitivity was 66.00%; specificity, 16.66%; p < 0.05). The ROC curves showed that FIB demonstrated the highest AUC among the biomarkers in both acute and chronic PJI. Conclusion FIB is a promising indicator in predicting reinfection after DAIR for both acute and chronic PJI, and it seems to perform better than ESR and CRP.

scholarly journals Combined serum and synovial C-reactive protein tests: a valuable adjunct to the diagnosis of chronic prosthetic joint infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hai Wang ◽  
Leilei Qin ◽  
Jiawei Wang ◽  
Ning Hu ◽  
Wei Huang
Keyword(s):  
Predictive Value ◽  
Joint Infection ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Combined Model ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Valuable Adjunct ◽  
Serum Crp

Abstract Background Diagnosis of periprosthetic joint infection (PJI), especially chronic PJI, is very confusing and challenging. The value of C-reactive protein (CRP) in infectious diseases has been recognized, but the diagnostic value of CRP in chronic PJI is unknown. Our aim was to investigate the diagnostic value of synovial CRP in chronic PJI and to explore the role of combined serum and synovial CRP in distinguishing chronic PJI from aseptic failure after knee and hip arthroplasties. Methods We prospectively enrolled patients scheduled to have a revision surgery for chronic PJI or aseptic loosening from January 2019 to December 2020, in which synovial CRP was additionally measured along with routine preoperative diagnostic serum ((ESR, CRP) and synovial (PMN%) biomarkers. The receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker to determine diagnostic efficacy. Results There were no statistically significant differences between the infection (n = 39) and aseptic (n = 58) groups, including 61 hips and 36 knees. The synovial CRP levels were significantly higher in the infection group than in the aseptic group (median: 9.93 mg/l vs 3.58 mg/l; p < .001). The optimal cut-off value for detecting chronic PJI of Synovial fluid (SF) CRP was of 7.26 mg/l with a sensitivity of 84.62%, a specificity of 93.10%. The combined model I (Serum CRP > 10.2 mg/l OR SF CRP > 7.26 mg/l) had a negative predictive value (NPV) of 96.67%, and a sensitivity of 97.44%. The combined model II (Serum CRP > 10.2 mg/l AND Synovial CRP > 7.26 mg/l) led to a specificity of 1, and a positive predictive value (PPV) of 1. Conclusions The present study demonstrated that the combination of serum and synovial CRP can be used as an adjunct to the diagnosis of chronic PJI.

scholarly journals Combined Serum and Synovial C-Reactive Protein Tests: An Economical and Efficient Adjunct to the Diagnosis of Chronic Prosthetic Joint Infection

2021 ◽  
Author(s):  
Hai Wang ◽  
Leilei Qin ◽  
Jiawei Wang ◽  
Ning Hu ◽  
Wei Huang
Keyword(s):  
Predictive Value ◽  
Demographic Data ◽  
Joint Infection ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Combined Model ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Serum Crp

Abstract Background Diagnosis of Periprosthetic joint infection (PJI) is very complex and challenging, especially for chronic PJI. The value of C-reactive protein (CRP) in infectious diseases has been recognized, but the diagnostic value of CRP in chronic PJI is unknown. Our objective was to investigate the effectiveness of synovial CRP in chronic PJI and to determine the optimal combination of serum and synovial CRP in distinguishing chronic PJI from aseptic failure after knee and hip arthroplasties. Methods From January 2018 to December 2019, we prospectively included patients scheduled to have a revision surgery for chronic PJI or aseptic loosening of an implant, in which synovial CRP was additionally measured along with routine preoperative diagnostic serum and synovial biomarkers. The receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker to determine diagnostic efficacy. Results There were no statistically significant differences in demographic data among the 97 cases we eventually included. the synovial CRP levels were significantly higher in the infection group than in the aseptic group (median: 19 mg/l vs. 9.25 mg/l; p = .001). The optimal cut-off value for detecting chronic PJI of synovial CRP was of 7.26 mg/l with a sensitivity of 84.62%, a specificity of 93.10%. The combined model I (Serum CRP > 10.2 mg/l OR SF CRP > 7.2 6 mg/l) had a negative predictive value (NPV) of 96.67%, and a sensitivity of 97.44%. The combined model II (Serum CRP > 10.2 mg/l AND Synovial CRP > 7.26 mg/l) led to a specificity of 1, and a positive predictive value (PPV) of 1. Conclusion The present study demonstrated that the combination of serum and synovial CRP can be used as an adjunct to the diagnosis of chronic PJI.

scholarly journals Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections?

2020 ◽  
Author(s):  
Cheng Li ◽  
Cristina Ojeda Thies ◽  
Chi Xu ◽  
Andrej Trampuz
Keyword(s):  
Meta Analysis ◽  
Joint Infection ◽  
Protein A ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Combined Method ◽  
C Reactive Protein ◽  
Single Marker Analysis ◽  
Gold Standard Method ◽  
Reactive Protein

Abstract Background: Because there is no single gold standard method for the diagnosis of periprosthetic joint infection (PJI), the combination of valuable methods to evaluate infection appears to achieve a better diagnostic result. The objective of the present study was to evaluate the diagnostic value of serum interleukin (IL)-6 and C-reactive protein (CRP) for the diagnosis of PJI.Methods: PubMed, Embase, and the Web of Science databases were searched for articles describing PJI diagnosis using serum IL-6 and CRP published between January 1990 and December 2019.Results: Eight studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% confidence interval [CI]: 0.80−0.88) for the combined method (serum IL-6 and CRP) in series and parallel approaches, 0.87 (95% CI: 0.82−0.90) for IL-6, and 0.84 (95% CI: 0.79−0.88) for CRP. The pooled specificity was 0.85 (95% CI: 0.82−0.88) for the combined method, 0.83 (95% CI: 0.79−0.87) for IL-6, and 0.83 (95% CI: 0.79−0.87) for CRP. The combined method had the highest value for the area under the curve (0.9453), followed by IL-6 (0.9237) and CRP (0.9074). Subgroup analyses showed that the sensitivity of the combined method in parallel tests was higher than IL-6 or CRP (94% vs. 89% and 84%, respectively). Serial testing of the combined method showed increased specificity compared to a single indicator (96% vs. 83% and 80%).Conclusion: The combination of serum IL-6 and CRP was a reliable tool for the diagnosis of periprosthetic hip and knee infection, demonstrating a better diagnostic accuracy than single marker analysis. However, further research is required to confirm current results.

scholarly journals Sphingolipid Analysis Indicate Lactosylceramide as a Potential Biomarker of Inflammatory Bowel Disease in Children

Biomolecules ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 1083
Author(s):  
Aleksandra Filimoniuk ◽  
Agnieszka Blachnio-Zabielska ◽  
Monika Imierska ◽  
Dariusz Marek Lebensztejn ◽  
Urszula Daniluk
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
High Performance ◽  
Area Under The Curve ◽  
Study Groups ◽  
Diagnostic Value ◽  
Serum Samples ◽  
Specificity And Sensitivity ◽  
Potential Biomarker ◽  
Inflammatory Bowel

An altered ceramide composition in patients with inflammatory bowel disease (IBD) has been reported recently. The aim of this study was to evaluate the concentrations of sphingolipids in the serum of treatment-naive children with newly diagnosed IBD and to determine the diagnostic value of the tested lipids in pediatric IBD. The concentrations of sphingolipids in serum samples were evaluated using a quantitative method, an ultra-high-performance liquid chromatography-tandem mass spectrometry in children with Crohn’s disease (CD) (n=34), ulcerative colitis (UC) (n = 39), and controls (Ctr) (n = 24). Among the study groups, the most significant differences in concentrations were noted for C16:0-LacCer, especially in children with CD compared to Ctr or even to UC. Additionally, the relevant increase in C20:0-Cer and C18:1-Cer concentrations were detected in both IBD groups compared to Ctr. The enhanced C24:0-Cer level was observed only in UC, while C18:0-Cer only in the CD group. The highest area under the curve (AUC), specificity, and sensitivity were determined for C16:0-LacCer in CD diagnosis. Our results suggest that the serum LacC16-Cer may be a potential biomarker that distinguishes children with IBD from healthy controls and differentiates IBD subtypes. In addition, C20:0-Cer and C18:0-Cer levels also seem to be closely connected with IBD.

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