ABSTRACT
The use of radiopharmaceuticals for the diagnosis of infection is increasing due to their ability to distinguish between septic and aseptic inflammation. The aim of this study was to analyze the intracellular accumulation of technetium-99m-ciprofloxacin in strains of Staphylococcus aureus and Pseudomonas aeruginosa harboring an overexpression of NorA and MexAB-OprM, respectively.
Subject(s)
Ciprofloxacin/analogs & derivatives , Organotechnetium Compounds/pharmacokinetics , Pseudomonas aeruginosa/metabolism , Radiopharmaceuticals/pharmacokinetics , Staphylococcus aureus/metabolism , Bacterial Outer Membrane Proteins/genetics , Bacterial Outer Membrane Proteins/metabolism , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Ciprofloxacin/pharmacokinetics , Gene Expression , Genes, Bacterial , Humans , Membrane Transport Proteins/genetics , Membrane Transport Proteins/metabolism , Multidrug Resistance-Associated Proteins/genetics , Multidrug Resistance-Associated Proteins/metabolism , Pseudomonas Infections/diagnostic imaging , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/genetics , Radionuclide Imaging , Staphylococcal Infections/diagnostic imaging , Staphylococcal Infections/microbiology , Staphylococcus aureus/geneticsABSTRACT
AIM: To evaluate the usefulness of 111In-oxine-labelled platelet scan in the therapeutic management of prolonged febrile syndrome in dialysis patients with a non-functional renal allograft. MATERIAL AND METHODS: One hundred and fifty-eight patients (94 men, 64 women; mean age 44 +/- 9 years) were studied. Duration of fever was 42 days (range 7-112). A total of 68 % of the patients (107/158) were on low doses of corticosteroids (<10 mg/day). Platelet scans were performed 48 hours after reinjection of 111In-ixone-labelled platelets. A platelet uptake index (PUI) was calculated by dividing the cpm/pixel in the allograft by the cpm/pixel in a mirror background. A PUI > or = 1.5 was considered as threshold for immunological fever. The final diagnosis of immunological fever was established when it disappeared after transplantectomy, embolization or high doses of corticosteroid therapy. Fever of non-immunological origin was established when it disappeared after antibiotic therapy. RESULTS: In 102/158 patients the fever was considered of immunological origin. In 56/158 patients the fever was considered of non immunological origin. Sensitivity and the specificity of the platelet scan was 80 % and 100 %, respectively. All those patients considered as having fever of immunological origin who had PUI <1.5 had been using corticosteroids during platelet scan. CONCLUSION: 111In-labelled platelet scintigraphy is a useful technique in the therapeutic management of prolonged febrile syndrome in dialysis patients with non-functional renal allograft. The use of corticosteroids can reduce the sensitivity of 111In- labelled platelet scan.