Abstract
AIMS: To determine the sensitivity and specificity of 99mTc-Infecton (Infecton), a novel ciprofloxacin based imaging agent, in detecting sites of infection. METHODS: Ninety patients thought to be suffering from a variety of infections were administered 300-400 MBq of Infecton intravenously. Whole body images were taken one and four hours later. Appropriate specimens were taken for microbiological investigations. Statistical analysis was performed using a computer statistical package. RESULTS: Ninety eight Infecton images were produced. Forty one of these were positive, including three false positives, where the patients had non-infective conditions. Fifty seven negative images were obtained, of which 41 were true negatives and 16 were false negatives, having definite evidence of infection. Thus, Infecton imaging has a sensitivity of 70.3% and a specificity of 93.1% for detecting infective foci. The positive and negative predictive values were 92.6% and 71.9%, respectively. CONCLUSION: Infecton imaging is a new diagnostic tool that is specific for detecting sites of bacterial infection in the body. The high positive predictive value displayed by the technique is clinically important because a positive image strongly supports a diagnosis of bacterial infection. A negative result does not rule out an infection, and may be a result of previous or current antibiotic treatment and/or infection with organisms that do not take up Infecton. Infecton imaging has major advantages over well established imaging techniques, including radiolabelled leucocytes, and may prove to be a superior method for localising bacterial infections.
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- Datz F. L. Indium-111-labeled leukocytes for the detection of infection: current status. Semin Nucl Med. 1994 Apr;24(2):92–109. [PubMed] [Google Scholar]
- Easmon C. S., Crane J. P., Blowers A. Effect of ciprofloxacin on intracellular organisms: in-vitro and in-vivo studies. J Antimicrob Chemother. 1986 Nov;18 (Suppl 500):43–48. doi: 10.1093/jac/18.supplement_d.43. [DOI] [PubMed] [Google Scholar]
- Fischman A. J., Rubin R. H., White J. A., Locke E., Wilkinson R. A., Nedelman M., Callahan R. J., Khaw B. A., Strauss H. W. Localization of Fc and Fab fragments of nonspecific polyclonal IgG at focal sites of inflammation. J Nucl Med. 1990 Jul;31(7):1199–1205. [PubMed] [Google Scholar]
- Garner J. S., Jarvis W. R., Emori T. G., Horan T. C., Hughes J. M. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988 Jun;16(3):128–140. doi: 10.1016/0196-6553(88)90053-3. [DOI] [PubMed] [Google Scholar]
- Morgan J. R., Williams L. A., Howard C. B. Technetium-labelled liposome imaging for deep-seated infection. Br J Radiol. 1985 Jan;58(685):35–39. doi: 10.1259/0007-1285-58-685-35. [DOI] [PubMed] [Google Scholar]
- Streule K., de Schrijver M., Fridrich R. 99Tcm-labelled HSA-nanocolloid versus 111In oxine-labelled granulocytes in detecting skeletal septic process. Nucl Med Commun. 1988 Jan;9(1):59–67. [PubMed] [Google Scholar]
- Vinjamuri S., Hall A. V., Solanki K. K., Bomanji J., Siraj Q., O'Shaughnessy E., Das S. S., Britton K. E. Comparison of 99mTc infecton imaging with radiolabelled white-cell imaging in the evaluation of bacterial infection. Lancet. 1996 Jan 27;347(8996):233–235. doi: 10.1016/s0140-6736(96)90407-9. [DOI] [PubMed] [Google Scholar]