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Evaluation of 99mTc-UBI 29-41 scintigraphy for specific detection of experimental Staphylococcus aureus prosthetic joint infections

  • Laure Sarda-MantelEmail author
  • Azzam Saleh-Mghir
  • Mick M. Welling
  • Alain Meulemans
  • Jean-Marc Vrigneaud
  • Olivier Raguin
  • Florence Hervatin
  • Geneviève Martet
  • Françoise Chau
  • Rachida Lebtahi
  • Dominique Le Guludec
Original Article

Abstract

Purpose

99mTc-UBI 29-41 (UBI), an antimicrobial peptide, specifically targets bacteria. We tested the ability of UBI to discriminate between infected and uninfected prosthetic joints using a rabbit model previously validated.

Methods

Left knee arthroplasty was performed on 20 New Zealand rabbits, then 107 cfu of S. aureus (n = 12) or sterile saline (n = 8) was injected into the joint. On days 9 and 20 after surgery, planar UBI scintigraphy was performed in six infected and four uninfected rabbits, 1 h and 4 h p.i. (150 MBq), on a gamma camera. Operated-to-normal knee activity ratio (ONKR) was calculated on each scintigram. Then, after sacrifice, tissue samples of both knees were counted in a gamma counter.

Results

One rabbit injected with sterile saline had cutaneous infection at sacrifice and was excluded from analysis. ONKR was higher in infected than in uninfected animals 4 h p.i. 20 days after surgery: 1.75  ±  0.48 vs 1.13 ± 0.11, p = 0.04. From 1 h to 4 h p.i., ONKR increased in 9/12 infected and 0/7 uninfected animals. According to UBI uptake intensity and kinetics, scintigraphy was truly positive in all infected cases on day 9 and in four of six infected cases on day 20. It was truly negative in two of three sterile inflamed prosthetic knees on day 9, and in all cases on day 20. Biodistribution studies revealed increased UBI uptake in periprosthetic tissues in all animals 9 days after surgery, and only in infected animals on day 20.

Conclusion

In this experimental study, 99mTc-UBI 29-41 scintigraphy permitted the early detection of acute prosthetic joint infection, and exclusion of infection in chronic sterile prosthetic joint inflammation.

Keywords

Antimicrobial peptide Technetium Rabbits Prosthetic joint infection Scintigraphy 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Laure Sarda-Mantel
    • 1
    • 2
    • 3
    Email author
  • Azzam Saleh-Mghir
    • 7
  • Mick M. Welling
    • 5
  • Alain Meulemans
    • 1
    • 2
    • 3
  • Jean-Marc Vrigneaud
    • 1
    • 2
    • 3
  • Olivier Raguin
    • 1
    • 2
    • 3
  • Florence Hervatin
    • 1
    • 6
  • Geneviève Martet
    • 1
    • 3
  • Françoise Chau
    • 1
    • 4
  • Rachida Lebtahi
    • 1
    • 2
    • 3
  • Dominique Le Guludec
    • 1
    • 2
    • 3
  1. 1.Université Denis Diderot-Paris 7, UMR S773ParisFrance
  2. 2.AP-HP, Groupe Hospitalier Bichat-BeaujonService de Médecine NucléaireParisFrance
  3. 3.INSERM, U773ParisFrance
  4. 4.Université Denis Diderot Paris 7, EA 3964ParisFrance
  5. 5.Department of Radiology, Section of Nuclear MedicineLeiden University Medical Center (LUCM)LeidenThe Netherlands
  6. 6.CEA, DSV/DRM/SHFJOrsayFrance
  7. 7.Université Versailles-St-Quentin, EA 3647GarchesFrance

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