Gautam V K, Saini Rishabh, Sharma Siddharth
1 Department of Orthopedics Lok Nayak Hospital, New Delhi, India.
2 Lok Nayak Hospital, New Delhi, India.
J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499016685019. doi: 10.1177/2309499016685019.
We hypothesized that leucocyte esterase strip test can aid in diagnosing septic arthritis in native synovial fluid because leucocyte esterase concentrations would be elevated at the infection site because of secretion by recruited neutrophils.
The cohort included 27 patients (suspected septic arthritis and normal subjects). A standard chemical test strip (graded as negative, trace, +, ++ or +++) was used to detect the presence of leucocyte esterase. Fluid leucocyte count, Gram staining, culture, erythrocyte sedimentation rate and C-reactive protein were also assessed.
The leucocyte esterase test with a threshold of ++/+++ had a sensitivity of 79.2% (95% CI [confidence interval], 65.9% to 89.2%), specificity of 80.8% (95% CI, 73.3% to 87.1%), positive predictive value (PPV) of 61.8% (95% CI, 49.2% to 73.3%) and negative predictive value (NPV) of 90.1% (95% CI, 84.3% to 95.4%).
The leucocyte esterase strip test yielded a high specificity, PPV, NPV, high sensitivity and high diagnostic accuracy. Leucocyte esterase is an accurate, quick and bedside test for septic arthritis and can be used effectively for diagnosing periprosthetic joint infections along with other battery of tests according to the Musculoskeletal Infection Society criteria.
我们推测白细胞酯酶试纸条检测有助于诊断天然滑液中的化脓性关节炎，因为由于募集的中性粒细胞分泌，感染部位的白细胞酯酶浓度会升高。
该队列包括27名患者（疑似化脓性关节炎患者和正常受试者）。使用标准化学试纸条（分级为阴性、微量、+、++或+++）检测白细胞酯酶的存在。还评估了滑液白细胞计数、革兰氏染色、培养、红细胞沉降率和C反应蛋白。
白细胞酯酶检测阈值为++/+++时，灵敏度为79.2%（95%置信区间[CI]，65.9%至89.2%），特异性为80.8%（95%CI，73.3%至87.1%），阳性预测值（PPV）为61.8%（95%CI，49.2%至73.3%），阴性预测值（NPV）为90.1%（95%CI，84.3%至95.4%）。
白细胞酯酶试纸条检测具有高特异性、PPV、NPV、高灵敏度和高诊断准确性。白细胞酯酶是一种用于化脓性关节炎的准确、快速的床旁检测方法，根据肌肉骨骼感染学会标准，可与其他一系列检测一起有效地用于诊断人工关节周围感染。
