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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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IMPACT FACTOR 2017: 3.556

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1437-4331
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Volume 56, Issue 1

Issues

α-Defensin point-of-care test for diagnosis of prosthetic joint infections: neglected role of laboratory and clinical pathologists

Lorenzo Drago
  • Corresponding author
  • Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
  • Laboratory of Clinical-Chemistry and Microbiology, IRCCS Galeazzi Institute, University of Milan, Milan, Italy, Phone: +390266214839, Fax: +3902662144774
  • Email
  • Other articles by this author:
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/ Marco Toscano
  • Laboratory of Clinical Microbiology, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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/ Lorenza Tacchini
  • Board Member of the Italian Commission for Biomedical Lab Technician, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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/ Giuseppe Banfi
  • Scientific Direction, IRCCS Galeazzi Institute, University of Milan, and Vita e Salute San Raffaele University, Milan, Italy
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Published Online: 2017-07-14 | DOI: https://doi.org/10.1515/cclm-2017-0041

Abstract

Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection. Currently, a point-of-care testing (POCT) assay able to detect the presence of human α-defensins 1–3 in synovial fluid of patients is aimed directly at orthopedic surgeons. However, many orthopedic surgeons lack experience and training in quality laboratory practices, often failing to appreciate the significance of quality control and proper documentation when using POCT assays. To guarantee the highest quality diagnostic services, the α-defensin test should be used together with other biochemical and microbiological criteria commonly used for PJI diagnosis. Additionally, the close cooperation and communication between laboratory, pathologists and physicians is of fundamental importance in the correct diagnosis of PJI.

Keywords: α-defensin; clinical outcome; periprosthetic joint infection; point-of-care testing

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About the article

Received: 2017-01-17

Accepted: 2017-05-03

Published Online: 2017-07-14

Published in Print: 2017-11-27


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 56, Issue 1, Pages 19–24, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2017-0041.

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