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Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection
AIMS: This study aimed to explore the diagnostic value of synovial fluid neutrophil extracellular traps (SF-NETs) in periprosthetic joint infection (PJI) diagnosis, and compare it with that of microbial culture, serum ESR and CRP, synovial white blood cell (WBC) count, and polymorphonuclear neutroph...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9950667/ https://www.ncbi.nlm.nih.gov/pubmed/36718647 http://dx.doi.org/10.1302/2046-3758.122.BJR-2022-0391.R1 |
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author | Cai, Yuanqing Liang, Jialin Chen, Xiaoqing Zhang, Guangyang Jing, Zhaopu Zhang, Rupeng Lv, Leifeng Zhang, Wenming Dang, Xiaoqian |
author_facet | Cai, Yuanqing Liang, Jialin Chen, Xiaoqing Zhang, Guangyang Jing, Zhaopu Zhang, Rupeng Lv, Leifeng Zhang, Wenming Dang, Xiaoqian |
author_sort | Cai, Yuanqing |
collection | PubMed |
description | AIMS: This study aimed to explore the diagnostic value of synovial fluid neutrophil extracellular traps (SF-NETs) in periprosthetic joint infection (PJI) diagnosis, and compare it with that of microbial culture, serum ESR and CRP, synovial white blood cell (WBC) count, and polymorphonuclear neutrophil percentage (PMN%). METHODS: In a single health centre, patients with suspected PJI were enrolled from January 2013 to December 2021. The inclusion criteria were: 1) patients who were suspected to have PJI; 2) patients with complete medical records; and 3) patients from whom sufficient synovial fluid was obtained for microbial culture and NET test. Patients who received revision surgeries due to aseptic failure (AF) were selected as controls. Synovial fluid was collected for microbial culture and SF-WBC, SF-PNM%, and SF-NET detection. The receiver operating characteristic curve (ROC) of synovial NET, WBC, PMN%, and area under the curve (AUC) were obtained; the diagnostic efficacies of these diagnostic indexes were calculated and compared. RESULTS: The levels of SF-NETs in the PJI group were significantly higher than those of the AF group. The AUC of SF-NET was 0.971 (95% confidence interval (CI) 0.903 to 0.996), the sensitivity was 93.48% (95% CI 82.10% to 98.63%), the specificity was 96.43% (95% CI 81.65% to 99.91%), the accuracy was 94.60% (95% CI 86.73% to 98.50%), the positive predictive value was 97.73%, and the negative predictive value was 90%. Further analysis showed that SF-NET could improve the diagnosis of culture-negative PJI, patients with PJI who received antibiotic treatment preoperatively, and fungal PJI. CONCLUSION: SF-NET is a novel and ideal synovial fluid biomarker for PJI diagnosis, which could improve PJI diagnosis greatly. Cite this article: Bone Joint Res 2023;12(2):113–120. |
format | Online Article Text |
id | pubmed-9950667 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-99506672023-02-25 Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection Cai, Yuanqing Liang, Jialin Chen, Xiaoqing Zhang, Guangyang Jing, Zhaopu Zhang, Rupeng Lv, Leifeng Zhang, Wenming Dang, Xiaoqian Bone Joint Res Infection AIMS: This study aimed to explore the diagnostic value of synovial fluid neutrophil extracellular traps (SF-NETs) in periprosthetic joint infection (PJI) diagnosis, and compare it with that of microbial culture, serum ESR and CRP, synovial white blood cell (WBC) count, and polymorphonuclear neutrophil percentage (PMN%). METHODS: In a single health centre, patients with suspected PJI were enrolled from January 2013 to December 2021. The inclusion criteria were: 1) patients who were suspected to have PJI; 2) patients with complete medical records; and 3) patients from whom sufficient synovial fluid was obtained for microbial culture and NET test. Patients who received revision surgeries due to aseptic failure (AF) were selected as controls. Synovial fluid was collected for microbial culture and SF-WBC, SF-PNM%, and SF-NET detection. The receiver operating characteristic curve (ROC) of synovial NET, WBC, PMN%, and area under the curve (AUC) were obtained; the diagnostic efficacies of these diagnostic indexes were calculated and compared. RESULTS: The levels of SF-NETs in the PJI group were significantly higher than those of the AF group. The AUC of SF-NET was 0.971 (95% confidence interval (CI) 0.903 to 0.996), the sensitivity was 93.48% (95% CI 82.10% to 98.63%), the specificity was 96.43% (95% CI 81.65% to 99.91%), the accuracy was 94.60% (95% CI 86.73% to 98.50%), the positive predictive value was 97.73%, and the negative predictive value was 90%. Further analysis showed that SF-NET could improve the diagnosis of culture-negative PJI, patients with PJI who received antibiotic treatment preoperatively, and fungal PJI. CONCLUSION: SF-NET is a novel and ideal synovial fluid biomarker for PJI diagnosis, which could improve PJI diagnosis greatly. Cite this article: Bone Joint Res 2023;12(2):113–120. The British Editorial Society of Bone & Joint Surgery 2023-02-01 /pmc/articles/PMC9950667/ /pubmed/36718647 http://dx.doi.org/10.1302/2046-3758.122.BJR-2022-0391.R1 Text en © 2023 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Infection Cai, Yuanqing Liang, Jialin Chen, Xiaoqing Zhang, Guangyang Jing, Zhaopu Zhang, Rupeng Lv, Leifeng Zhang, Wenming Dang, Xiaoqian Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection |
title | Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection |
title_full | Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection |
title_fullStr | Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection |
title_full_unstemmed | Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection |
title_short | Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection |
title_sort | synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection |
topic | Infection |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9950667/ https://www.ncbi.nlm.nih.gov/pubmed/36718647 http://dx.doi.org/10.1302/2046-3758.122.BJR-2022-0391.R1 |
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