Huang Z, Zhang Z, Li M, Li W, Fang X, Zhang W. Synovial Fluid Neutrophil Gelatinase-Associated Lipocalin Can be Used to Accurately Diagnose Prosthetic Joint Infection.
Int J Infect Dis 2022;
123:170-175. [PMID:
35987468 DOI:
10.1016/j.ijid.2022.08.009]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND
Neutrophil gelatinase-associated lipocalin (NGAL)1 in synovial fluid (SF) may have potential diagnostic value for prosthetic joint infection (PJI). The purpose of this study was to study (1) the diagnostic performance of SF-NGAL level for diagnosing PJI and (2) the impact of prior antibiotic use on the SF-NGAL levels.
METHODS
Consecutive patients who needed hip or knee revision surgery were included prospectively from January 2017 to September 2018. The patients were divided into the PJI group and the aseptic failure (AF) group. An enzyme-linked immunosorbent assay was used to determine the SF-NGAL level.
RESULTS
Fifty of 78 included patients were diagnosed with PJI. The median SF-NGAL level was 3633 ng/ml (interquartile range (IQR), 1332-10737) in the PJI group and 26.8 ng/ml (IQR, 12.4-52.5) in the AF group (p < 0.0001). When the SF-NGAL threshold was 263 ng/ml, the AUC was 0.98, the sensitivity was 92.9%, and the specificity was 98%. The median level was 5779 ng/ml (IQR, 1425-13072) in the antibiotic group and 2590 ng/ml (IQR, 932-8970) in the nonantibiotic group (p = 0.1).
CONCLUSION
SF-NGAL level can be used as a diagnostic indicator of PJI. The use of antibiotics prior to sampling does not affect the SF-NGAL level.
Collapse