Britton K E, Wareham D W, Das S S, Solanki K K, Amaral H, Bhatnagar A, Katamihardja A H S, Malamitsi J, Moustafa H M, Soroa V E, Sundram F X, Padhy A K
St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
J Clin Pathol. 2002 Nov;55(11):817-23. doi: 10.1136/jcp.55.11.817.
The diagnosis of deep seated bacterial infections, such as intra-abdominal abscesses, endocarditis, and osteomyelitis, can be difficult and delayed, thereby compromising effective treatment. This study assessed the efficacy of a new radioimaging agent, Tc-99m ciprofloxacin (Infecton), in accurately detecting sites of bacterial infection.
Eight hundred and seventy nine patients with suspected bacterial infection underwent Infecton imaging and microbiological evaluation. The sensitivity and specificity of Infecton in detecting sites of bacterial infection were determined with respect to Centres of Disease Control, World Health Organisation, and Dukes's criteria.
Five hundred and seventy four positive and 295 negative images were produced. These included 528 true positives, 46 false positives, 205 true negatives and 90 false negatives, giving an overall sensitivity of 85.4% and a specificity of 81.7% for detecting infective foci. Sensitivity was higher (87.6%) in microbiologically confirmed infections.
Infecton is a sensitive technique, which aids in the earlier detection and treatment of a wide variety of deep seated bacterial infections. The ability to localise infective foci accurately is also important for surgical intervention, such as drainage of abscesses. In addition, serial imaging with Infecton might be useful in monitoring clinical response and optimising the duration of antimicrobial treatment.
深部细菌感染的诊断,如腹腔内脓肿、心内膜炎和骨髓炎,可能困难且延迟,从而影响有效治疗。本研究评估了一种新型放射性显像剂锝-99m环丙沙星(Infecton)在准确检测细菌感染部位方面的疗效。
879例疑似细菌感染患者接受了Infecton显像和微生物学评估。根据疾病控制中心、世界卫生组织和杜克标准确定Infecton在检测细菌感染部位方面的敏感性和特异性。
产生了574张阳性图像和295张阴性图像。其中包括528例假阳性、46例假阴性、205例真阴性和90例假阴性,检测感染灶的总体敏感性为85.4%,特异性为81.7%。在微生物学确诊的感染中,敏感性更高(87.6%)。
Infecton是一种敏感的技术,有助于早期检测和治疗多种深部细菌感染。准确确定感染灶的位置对于手术干预(如脓肿引流)也很重要。此外,使用Infecton进行系列显像可能有助于监测临床反应并优化抗菌治疗的持续时间。