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Per-anders Mårdh - One of the best experts on this subject based on the ideXlab platform.
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Non-invasive sampling for detection of genital infection with Chlamydia trachomatis in males utilising urinary Leukocyte Esterase tests and immunoassays.
Infection, 1994Co-Authors: Marius Domeika, Mike Bassiri, Per-anders MårdhAbstract:First-void urine specimens from 224 male recruits and 443 patients of venereal disease clinics without complaints of symptoms of urethritis were collected. Urinary Leukocyte Esterase test, two enzyme immunoassays (EIAs: Syva Micro Trak and Orion), a chemiluminometric assay (Magic Lite) and Syva's Micro Trak direct immunofluorescence test were used. The prevalence of chlamydial urethritis in the study population as determined by direct immunofluorescence test of first-void urine in the military recruits and venereal disease patients was 1.3% and 6.3%, respectively. The denominator used for calculation of sensitivities was the sum of patients with positive test results in at least two of the different test systems used. The sensitivities of first-void urine were 100% for Syva EIA, 96.7% for Orion EIA and 86.7% for the chemiluminometric assay. All assays proved highly specific (99.5–99.7%). Compared with direct immunofluorescence test of first-void urine, the urine Leukocyte Esterase test had a sensitivity of 93.6% and a specificity of 94.3%. The study showed that the urine Leukocyte Esterase test is an effective method to detect males infected byChlamydia trachomatis.
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Non-invasive sampling for detection of genital infection withChlamydia trachomatis in males utilising urinary Leukocyte Esterase tests and immunoassays
Infection, 1994Co-Authors: Marius Domeika, Mike Bassiri, Per-anders MårdhAbstract:First-void urine specimens from 224 male recruits and 443 patients of venereal disease clinics without complaints of symptoms of urethritis were collected. Urinary Leukocyte Esterase test, two enzyme immunoassays (EIAs: Syva Micro Trak and Orion), a chemiluminometric assay (Magic Lite) and Syva's Micro Trak direct immunofluorescence test were used. The prevalence of chlamydial urethritis in the study population as determined by direct immunofluorescence test of first-void urine in the military recruits and venereal disease patients was 1.3% and 6.3%, respectively. The denominator used for calculation of sensitivities was the sum of patients with positive test results in at least two of the different test systems used. The sensitivities of first-void urine were 100% for Syva EIA, 96.7% for Orion EIA and 86.7% for the chemiluminometric assay. All assays proved highly specific (99.5–99.7%). Compared with direct immunofluorescence test of first-void urine, the urine Leukocyte Esterase test had a sensitivity of 93.6% and a specificity of 94.3%. The study showed that the urine Leukocyte Esterase test is an effective method to detect males infected by Chlamydia trachomatis . Von 224 männlichen Rekruten und 443 Patienten einer venerologischen Klinik ohne Beschwerden oder Zeichen einer Urethritis wurde Morgenurin gewonnen. Die Proben wurden mit einem Urin-LeukozytenEsterase-Test, zwei Immunassays (Syva MicroTrak und Orion) sowie einem direkten chemiluminometrischen Assay (Magic Lite) und dem direkten MicroTrak Immunfluoreszenztest von Syva getestet. Die Prävalenz der Chlamydien-Urethritis in den untersuchten Gruppen lag nach Ergebnissen des direkten Immunfluoreszenztests bei Rekruten bei 1,3% und bei den Patienten bei 6,3%. Für die Berechnung der Sensitivität wurde die Summe der Patienten mit positiven Testergebnissen bei mindestens zwei der verschiedenen Testsysteme verwendet. Für den Syva EIA betrug die Sensitivität in Morgenurin 100%, für den Orion EIA 96,7% und für den chemiluminometrischen Assay 86,7%. Alle Assays erwiesen sich als hochspezifisch (99,5–99,7%). Der LeukozytenEsterasetest hatte gemessen an den Ergebnissen des direkten Immunfluoreszenztests bei Testung von Morgenurin eine Sensitivität von 93,6% und eine Spezifität von 94,3%. Die Studie zeigte, daß der UrinleukozytenEsterasetest eine effektive Methode ist, männliche Patienten mit einer Chlamydia trachomatis -Infektion zu entdecken.
Marius Domeika - One of the best experts on this subject based on the ideXlab platform.
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Non-invasive sampling for detection of genital infection with Chlamydia trachomatis in males utilising urinary Leukocyte Esterase tests and immunoassays.
Infection, 1994Co-Authors: Marius Domeika, Mike Bassiri, Per-anders MårdhAbstract:First-void urine specimens from 224 male recruits and 443 patients of venereal disease clinics without complaints of symptoms of urethritis were collected. Urinary Leukocyte Esterase test, two enzyme immunoassays (EIAs: Syva Micro Trak and Orion), a chemiluminometric assay (Magic Lite) and Syva's Micro Trak direct immunofluorescence test were used. The prevalence of chlamydial urethritis in the study population as determined by direct immunofluorescence test of first-void urine in the military recruits and venereal disease patients was 1.3% and 6.3%, respectively. The denominator used for calculation of sensitivities was the sum of patients with positive test results in at least two of the different test systems used. The sensitivities of first-void urine were 100% for Syva EIA, 96.7% for Orion EIA and 86.7% for the chemiluminometric assay. All assays proved highly specific (99.5–99.7%). Compared with direct immunofluorescence test of first-void urine, the urine Leukocyte Esterase test had a sensitivity of 93.6% and a specificity of 94.3%. The study showed that the urine Leukocyte Esterase test is an effective method to detect males infected byChlamydia trachomatis.
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Non-invasive sampling for detection of genital infection withChlamydia trachomatis in males utilising urinary Leukocyte Esterase tests and immunoassays
Infection, 1994Co-Authors: Marius Domeika, Mike Bassiri, Per-anders MårdhAbstract:First-void urine specimens from 224 male recruits and 443 patients of venereal disease clinics without complaints of symptoms of urethritis were collected. Urinary Leukocyte Esterase test, two enzyme immunoassays (EIAs: Syva Micro Trak and Orion), a chemiluminometric assay (Magic Lite) and Syva's Micro Trak direct immunofluorescence test were used. The prevalence of chlamydial urethritis in the study population as determined by direct immunofluorescence test of first-void urine in the military recruits and venereal disease patients was 1.3% and 6.3%, respectively. The denominator used for calculation of sensitivities was the sum of patients with positive test results in at least two of the different test systems used. The sensitivities of first-void urine were 100% for Syva EIA, 96.7% for Orion EIA and 86.7% for the chemiluminometric assay. All assays proved highly specific (99.5–99.7%). Compared with direct immunofluorescence test of first-void urine, the urine Leukocyte Esterase test had a sensitivity of 93.6% and a specificity of 94.3%. The study showed that the urine Leukocyte Esterase test is an effective method to detect males infected by Chlamydia trachomatis . Von 224 männlichen Rekruten und 443 Patienten einer venerologischen Klinik ohne Beschwerden oder Zeichen einer Urethritis wurde Morgenurin gewonnen. Die Proben wurden mit einem Urin-LeukozytenEsterase-Test, zwei Immunassays (Syva MicroTrak und Orion) sowie einem direkten chemiluminometrischen Assay (Magic Lite) und dem direkten MicroTrak Immunfluoreszenztest von Syva getestet. Die Prävalenz der Chlamydien-Urethritis in den untersuchten Gruppen lag nach Ergebnissen des direkten Immunfluoreszenztests bei Rekruten bei 1,3% und bei den Patienten bei 6,3%. Für die Berechnung der Sensitivität wurde die Summe der Patienten mit positiven Testergebnissen bei mindestens zwei der verschiedenen Testsysteme verwendet. Für den Syva EIA betrug die Sensitivität in Morgenurin 100%, für den Orion EIA 96,7% und für den chemiluminometrischen Assay 86,7%. Alle Assays erwiesen sich als hochspezifisch (99,5–99,7%). Der LeukozytenEsterasetest hatte gemessen an den Ergebnissen des direkten Immunfluoreszenztests bei Testung von Morgenurin eine Sensitivität von 93,6% und eine Spezifität von 94,3%. Die Studie zeigte, daß der UrinleukozytenEsterasetest eine effektive Methode ist, männliche Patienten mit einer Chlamydia trachomatis -Infektion zu entdecken.
Deirdre L. Church - One of the best experts on this subject based on the ideXlab platform.
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a preliminary evaluation of the interaction between urine specific gravity and Leukocyte Esterase results using bayer multistix and the clinitek 500
Clinical Biochemistry, 2003Co-Authors: Martha E. Lyon, Cindy L Ball, E Walpole, Andrew W. Lyon, Deirdre L. ChurchAbstract:Abstract Objectives To determine the sensitivity of the Leukocyte Esterase (LE) pad to predict microscopically quantified white blood cells in urine sediment and to assess the interaction of urine specific gravity (SG) on Leukocyte Esterase sensitivity. Methods Microscopic quantification of white blood cells in urine sediment was performed manually and automated chemical urinalysis was performed using the Bayer Clinitek® 500 and Multistix® 8 SG strips on 422 random urine specimens. Results The sensitivity of the Leukocyte Esterase pad to predict white blood cells in centrifuged urine was 58% (61/106). There was a weak but statistically significant negative correlation between SG and LE pad performance, r = −0.12, p Conclusions The 58% sensitivity of the Multistix® Leukocyte Esterase detection of white blood cells in urine sediment was consistent with previous reports. The negative correlation of specific gravity and Leukocyte Esterase provides partial explanation for the lack of sensitivity of the Leukocyte Esterase test.
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evaluation of the Leukocyte Esterase and nitrite urine dipstick screening tests for detection of bacteriuria in women with suspected uncomplicated urinary tract infections
Journal of Clinical Microbiology, 1999Co-Authors: Heathe Semeniuk, Deirdre L. ChurchAbstract:A positive dipstick urinalysis (i.e., Leukocyte Esterase test and/or nitrite test) did not reliably detect significant bacteriuria in 479 ambulatory women with suspected uncomplicated urinary tract infection; 18.9% of the urine samples that demonstrated significant bacteriuria would have been rejected by the laboratory based on a negative urinalysis screen.
Mike Bassiri - One of the best experts on this subject based on the ideXlab platform.
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Non-invasive sampling for detection of genital infection with Chlamydia trachomatis in males utilising urinary Leukocyte Esterase tests and immunoassays.
Infection, 1994Co-Authors: Marius Domeika, Mike Bassiri, Per-anders MårdhAbstract:First-void urine specimens from 224 male recruits and 443 patients of venereal disease clinics without complaints of symptoms of urethritis were collected. Urinary Leukocyte Esterase test, two enzyme immunoassays (EIAs: Syva Micro Trak and Orion), a chemiluminometric assay (Magic Lite) and Syva's Micro Trak direct immunofluorescence test were used. The prevalence of chlamydial urethritis in the study population as determined by direct immunofluorescence test of first-void urine in the military recruits and venereal disease patients was 1.3% and 6.3%, respectively. The denominator used for calculation of sensitivities was the sum of patients with positive test results in at least two of the different test systems used. The sensitivities of first-void urine were 100% for Syva EIA, 96.7% for Orion EIA and 86.7% for the chemiluminometric assay. All assays proved highly specific (99.5–99.7%). Compared with direct immunofluorescence test of first-void urine, the urine Leukocyte Esterase test had a sensitivity of 93.6% and a specificity of 94.3%. The study showed that the urine Leukocyte Esterase test is an effective method to detect males infected byChlamydia trachomatis.
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Non-invasive sampling for detection of genital infection withChlamydia trachomatis in males utilising urinary Leukocyte Esterase tests and immunoassays
Infection, 1994Co-Authors: Marius Domeika, Mike Bassiri, Per-anders MårdhAbstract:First-void urine specimens from 224 male recruits and 443 patients of venereal disease clinics without complaints of symptoms of urethritis were collected. Urinary Leukocyte Esterase test, two enzyme immunoassays (EIAs: Syva Micro Trak and Orion), a chemiluminometric assay (Magic Lite) and Syva's Micro Trak direct immunofluorescence test were used. The prevalence of chlamydial urethritis in the study population as determined by direct immunofluorescence test of first-void urine in the military recruits and venereal disease patients was 1.3% and 6.3%, respectively. The denominator used for calculation of sensitivities was the sum of patients with positive test results in at least two of the different test systems used. The sensitivities of first-void urine were 100% for Syva EIA, 96.7% for Orion EIA and 86.7% for the chemiluminometric assay. All assays proved highly specific (99.5–99.7%). Compared with direct immunofluorescence test of first-void urine, the urine Leukocyte Esterase test had a sensitivity of 93.6% and a specificity of 94.3%. The study showed that the urine Leukocyte Esterase test is an effective method to detect males infected by Chlamydia trachomatis . Von 224 männlichen Rekruten und 443 Patienten einer venerologischen Klinik ohne Beschwerden oder Zeichen einer Urethritis wurde Morgenurin gewonnen. Die Proben wurden mit einem Urin-LeukozytenEsterase-Test, zwei Immunassays (Syva MicroTrak und Orion) sowie einem direkten chemiluminometrischen Assay (Magic Lite) und dem direkten MicroTrak Immunfluoreszenztest von Syva getestet. Die Prävalenz der Chlamydien-Urethritis in den untersuchten Gruppen lag nach Ergebnissen des direkten Immunfluoreszenztests bei Rekruten bei 1,3% und bei den Patienten bei 6,3%. Für die Berechnung der Sensitivität wurde die Summe der Patienten mit positiven Testergebnissen bei mindestens zwei der verschiedenen Testsysteme verwendet. Für den Syva EIA betrug die Sensitivität in Morgenurin 100%, für den Orion EIA 96,7% und für den chemiluminometrischen Assay 86,7%. Alle Assays erwiesen sich als hochspezifisch (99,5–99,7%). Der LeukozytenEsterasetest hatte gemessen an den Ergebnissen des direkten Immunfluoreszenztests bei Testung von Morgenurin eine Sensitivität von 93,6% und eine Spezifität von 94,3%. Die Studie zeigte, daß der UrinleukozytenEsterasetest eine effektive Methode ist, männliche Patienten mit einer Chlamydia trachomatis -Infektion zu entdecken.
Javad Parvizi - One of the best experts on this subject based on the ideXlab platform.
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The Leukocyte Esterase Test for Periprosthetic Joint Infection Is Not Affected by Prior Antibiotic Administration.
Journal of Bone and Joint Surgery American Volume, 2019Co-Authors: Alisina Shahi, Abtin Alvand, Camilo Restrepo, Elie Ghanem, Javad ParviziAbstract:BACKGROUND: It has been demonstrated that administration of antibiotics prior to performing diagnostic testing for periprosthetic joint infection can interfere with the accuracy of the standard diagnostic tests. Therefore, the purpose of this study was to evaluate the effects of antibiotic administration prior to performing the synovial Leukocyte Esterase strip test for periprosthetic joint infection. METHODS: We identified 121 patients who underwent revision hip or knee arthroplasty for a Musculoskeletal Infection Society (MSIS)-confirmed periprosthetic joint infection. All patients also had a Leukocyte Esterase strip test performed. Patients in one group (32%) took antibiotics prior to the diagnostic workup, whereas patients in another group (68%) did not receive antibiotics within 2 weeks of the diagnostic workup. The Leukocyte Esterase strip test, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), synovial white blood-cell (WBC) count, and polymorphonuclear neutrophil (PMN) percentage were collected and were compared between the 2 groups. RESULTS: The median serum ESR (85 compared with 67 mm/hr for patients who did not and did receive antibiotics; p = 0.009), CRP (16.5 compared with 12.9 mg/L; p = 0.032), synovial WBC count (45,675 compared with 9,650 cells/µL; p < 0.0001), and PMN percentage (93% compared with 88%; p = 0.004) were all significantly lower for patients receiving antibiotics. Furthermore, the administration of antibiotics resulted in a significant decrease in the sensitivity of all tests, except Leukocyte Esterase: ESR (79.5% in the antibiotics cohort compared with 92.7% in the no-antibiotics cohort [relative risk (RR) for false-negative results, 2.8; p = 0.04]), CRP (64.2% compared with 81.8% [RR, 1.9; p = 0.03]), WBC count (69.3% compared with 93.4% [RR, 5.0; p = 0.001]), PMN percentage (74.4% compared with 91.5% [RR, 3.0; p = 0.01]), and Leukocyte Esterase (78% compared with 83% [RR, 1.6; p = 0.17]). The rate of negative cultures was higher in the antibiotics group at 30.7% compared with the no-antibiotics group at 12.1% (p = 0.015). CONCLUSIONS: This current study and previous studies have demonstrated that the administration of premature antibiotics can compromise the results of standard diagnostic tests for periprosthetic joint infection, causing significant increases in false-negative results. However, in this study, the Leukocyte Esterase strip test maintained its performance even in the setting of antibiotic administration. Antibiotic administration prior to diagnostic workups for periprosthetic joint infection stands to interfere with diagnosis. The Leukocyte Esterase strip test can be used as a reliable diagnostic marker for diagnosing periprosthetic joint infection even when prior antibiotics are administered. LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Leukocyte Esterase: Metal-on-Metal Failure and Periprosthetic Joint Infection
Journal of Arthroplasty, 2016Co-Authors: Eric H. Tischler, Darren R. Plummer, Antonia F Chen, Craig J. J. Della Valle, Javad ParviziAbstract:Abstract Background Adverse local tissue reactions (ALTRs) and periprosthetic joint infection can occur after metal-on-metal total hip arthroplasty (THA), both potentially generating purulent synovial fluid (SF) and elevated white cell count. This makes it difficult to distinguish between diagnoses; therefore, we evaluated Leukocyte Esterase (LE) strip test's reliability in ruling out periprosthetic joint infection in ALTR revision THA. Methods Sixty-one patients with ALTRs and an LE strip test were evaluated, excluding 15 cases with SF metallic debris. LE strip tests were classified −/trace, + (mildly positive), and ++ (strongly positive). Results LE strip tests were ++, +, −/trace in 8 patients (13.1%), 14 (23.0%), and 39 (63.9%), respectively. Means and ranges of SF white cell count and polymorphonuclear percentage were 1291.4 (0-10,886 cells/μL), and 46.1% (0%-94%), respectively. Conclusion ++ LE strip test, in conjunction with preoperative work-ups, reliably rules out infection in 92.9% of patients undergoing THA revision secondary to ALTR.
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Leukocyte Esterase strip test matched for musculoskeletal infection society criteria
Journal of Bone and Joint Surgery American Volume, 2014Co-Authors: Eric H. Tischler, Priscilla K Cavanaugh, Javad ParviziAbstract:Background: The presence of Leukocyte Esterase in the synovial fluid has recently been proposed as a marker for periprosthetic joint infection. However, the sensitivity and specificity of Leukocyte Esterase has not been determined when matched for the current, most inclusive Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection. Methods: The presence of Leukocyte Esterase was prospectively evaluated in synovial joint aspirates from hips and knees from May 2009 to May 2013. The cohort consisted of 189 hip and knee aspirations (fifty-two positive and 137 negative for infection). If the aspirate was bloody, a centrifuge was used to precipitate red blood cells and obtain clear synovial fluid. A standard chemical test strip (graded as negative, trace, +, or ++) was used to detect the presence of Leukocyte Esterase. The sensitivity, specificity, positive predictive value, and negative predictive value of the Leukocyte Esterase strip test were calculated using ++ and ++/+ as two positive strip result scenarios. Results: Synovial fluid was obtained from 221 joints that underwent revision total hip or total knee arthroplasty for either mechanical failure or periprosthetic infection. Due to the lack of adequate criteria for MSIS criteria classification, thirty-two joints were excluded. The Leukocyte Esterase test with a threshold of +/++ had a sensitivity, specificity, positive predictive value, and negative predictive value of 79.2% (95% confidence interval [CI], 65.9% to 89.2%), 80.8% (95% CI, 73.3% to 87.1%), 61.8% (95% CI, 49.2% to 73.3%), and 90.1% (95% CI, 84.3% to 95.4%), respectively. Using the ++ as a positive Leukocyte Esterase result, the sensitivity, specificity, positive predictive value, and negative predictive value were 66.0% (95% CI, 51.7% to 78.5%), 97.1% (95% CI, 92.6% to 99.2%), 89.7% (95% CI, 75.8% to 97.1%), and 88.0% (95% CI, 81.7% to 92.7%), respectively. Conclusions: When matched to the current MSIS criteria, the Leukocyte Esterase strip test yielded a high specificity, positive predictive value, negative predictive value, and moderate sensitivity. These results demonstrate that Leukocyte Esterase is an accurate, effective marker of periprosthetic joint infection as defined by the MSIS criteria. The Leukocyte Esterase strip test is a valuable tool that can be used in conjunction with the current battery of diagnostic tests available. Level of Evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Leukocyte Esterase from synovial fluid aspirate a technical note
Journal of Arthroplasty, 2013Co-Authors: Vinay K Aggarwal, Eric H. Tischler, Elie Ghanem, Javad ParviziAbstract:Accurate and efficient diagnosis of periprosthetic joint infection remains one of the most challenging tasks for orthopedic surgeons. Currently, no widely used diagnostic test allows for quick and efficient performance, low cost, and high sensitivity and specificity. Aspiration of synovial fluid from a patient's joint can be done in the clinic both quickly and easily; oftentimes, the aspirate obtained is bloody, thus rendering the use of colorimetric strip testing impractical. We describe a simple, inexpensive, and effective protocol using centrifugation to allow for Leukocyte Esterase (LE) testing after bloody joint aspirations. In all cases, both septic and aseptic, there was a 100% concordance in LE enzyme test results. Although further validation may be necessary, these initial results demonstrate that accuracy of LE testing is not affected by centrifugation.