High-Performance Liquid Chromatography as a Novel Method for the Determination of α-Defensins in Synovial Fluid for Diagnosis of Orthopedic Infections

Melicherčík, Pavel; Klapková, Eva; Kotaška, Karel; Jahoda, D; Landor, I; Čeřovský, Václav

doi:10.3390/diagnostics10010033

Cited by 12 publications

(9 citation statements)

References 25 publications

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“…In our study, statistically significant differences between these groups were demonstrated. A similar result was described by Melicherčík et al 13 . These authors studied this marker in the synovial fluid of 157 patients diagnosed with different joint infections, such as periprosthetic joint infection (PJI) and infectious arthritis, as well as arthrosis, reactive arthritis, and rheumatoid arthritis.…”

Section: Discussionsupporting

confidence: 90%

Alpha-defensins determination in different types of synovial fluid and parallel collected serum samples by ELISA

Kušnierová¹,

Bystroňová²,

Walder³

et al. 2021

BIOMED PAP

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Section: Discussionsupporting

confidence: 90%

Alpha-defensins determination in different types of synovial fluid and parallel collected serum samples by ELISA

Kušnierová¹,

Bystroňová²,

Walder³

et al. 2021

BIOMED PAP

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“…An overall accuracy of 94.9, 93% sensitivity, and 96% specificity were found. The novel test did not seem to be influenced by concurrent antibiotic therapy, blood contamination, or low-virulence organisms, even though two false positive results were reported in case of rheumatoid arthritis (which may false the measurement similar to reports in other alpha-defensin available tests) 31,37 . In that study, patients undergoing early revision in the first 8 post-operative weeks were excluded.…”

Section: Discussionmentioning

confidence: 66%

“…The importance of a quantitative assay for alpha-defensins measurement, as the laboratory-based immunoassay, can be deduced by the finding that also in non-infective conditions (e.g. inflammatory arthritis), low levels of alpha-defensins can be found 31 . This study also presents some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the ELISA is expensive, and time-consuming, while the lateral flow test has less accuracy and is also costly [16][17][18][19][20][21][22][23][24][25][26][27] . Novel diagnostic tests for detection of alpha-defensins in synovial fluids have been recently proposed with interesting results 28,30,31 . Among these, the method based on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is expected to be readily introduced in the clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Acute peri-prosthetic joint infection: improving diagnosis through the novel alpha-defensins test

Iorio

Viglietta²,

Mazzà³

et al. 2022

Lo Scalpello

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Background. The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has recently been proposed as novel alpha-defensins test for diagnosis of peri-prosthetic joint infections (PJIs). The aim of the current study is to assess the diagnostic accuracy of alpha-defensins MALDI-TOF MS in case of acute PJIs. Methods. This prospective study included a series of 10 consecutive patients affected by PJIs according to the 2018 MSIS criteria. Synovial fluids were assessed for routine synovial fluid tests and alpha-defensins measurement with MALDI-TOF MS. Sensitivity, specificity, positive, and negative predictive values (PPV and NPV) were assessed. Results. Six females and 4 males with acute PJIs were included. The mean age was 72.5 (range 67-79), and the mean time elapsed from primary arthroplasty to PJIs was 52 days (range 13-90). Eight TKA and 2 THA were evaluated. The involved bacteria were Staphylococcus aureus in 4 patients, coagulase-negative Staphylococcus species in 3 patients, Enterococcus species in 3 patients, and Pseudomonas aeruginosa in 1 patient. Three cases were characterized by polymicrobial infection. The MALDI-TOF alpha-defensin test correctly identified all 10 patients with acute PJIs. According to the current preliminary results the MALDI-TOF assay showed a 100% sensitivity, specificity, PPV, and NPV. Conclusions. The novel alpha-defensins MALDI-TOF MS test showed promising results with high sensitivity and specificity in the diagnosis of acute PJIs. The reliability of the test in case of acute PJI could allow surgeons to manage the infection with a less invasive procedure with several advantages for patients. The findings of the present study seemed to confirm that the novel assay, which needs only few milliliters of sample, provides rapid results, and has substantial cost-effectiveness, and thus may be a useful diagnostic tool in clinical practice, even in case of acute PJIs. Further studies are needed to confirm these results on a larger series of patients.

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“…38 Promising relatively new tests, like synovial alpha defensin, also require more research in native joint arthritis to further establish their usefulness. 44 These future directions can provide a shift to a new reference standard, and create an improved pathway for diagnosing bacterial arthritis of a native joint.…”

Section: Discussionmentioning

confidence: 99%

What are the best diagnostic tests for diagnosing bacterial arthritis of a native joint?

Walinga

Stornebrink

Langerhuizen

et al. 2021

The Bone & Joint Journal

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Aims This study aimed to answer two questions: what are the best diagnostic methods for diagnosing bacterial arthritis of a native joint?; and what are the most commonly used definitions for bacterial arthritis of a native joint? Methods We performed a search of PubMed, Embase, and Cochrane libraries for relevant studies published between January 1980 and April 2020. Of 3,209 identified studies, we included 27 after full screening. Sensitivity, specificity, area under the curve, and Youden index of diagnostic tests were extracted from included studies. We grouped test characteristics per diagnostic modality. We extracted the definitions used to establish a definitive diagnosis of bacterial arthritis of a native joint per study. Results Overall, 28 unique diagnostic tests for diagnosing bacterial arthritis of a native joint were identified. The following five tests were deemed most useful: serum ESR (sensitivity: 34% to 100%, specificity: 23% to 93%), serum CRP (sensitivity: 58% to 100%, specificity: 0% to 96%), serum procalcitonin (sensitivity: 0% to 100%, specificity: 68% to 100%), the proportion of synovial polymorphonuclear cells (sensitivity: 42% to 100%, specificity: 54% to 94%), and the gram stain of synovial fluid (sensitivity: 27% to 81%, specificity: 99% to 100%). Conclusion Diagnostic methods with relatively high sensitivities, such as serum CRP, ESR, and synovial polymorphonuclear cells, are useful for screening. Diagnostic methods with a relatively high specificity, such as serum procalcitonin and synovial fluid gram stain, are useful for establishing a diagnosis of bacterial arthritis. This review helps to interpret the value of various diagnostic tests for diagnosing bacterial arthritis of a native joint in clinical practice. Cite this article: Bone Joint J 2021;103-B(12):1745–1753.

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High-Performance Liquid Chromatography as a Novel Method for the Determination of α-Defensins in Synovial Fluid for Diagnosis of Orthopedic Infections

Cited by 12 publications

References 25 publications

Alpha-defensins determination in different types of synovial fluid and parallel collected serum samples by ELISA

Alpha-defensins determination in different types of synovial fluid and parallel collected serum samples by ELISA

Acute peri-prosthetic joint infection: improving diagnosis through the novel alpha-defensins test

What are the best diagnostic tests for diagnosing bacterial arthritis of a native joint?

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