ORIGINAL ARTICLE

Imaging bacterial infection with ^99mTc-ciprofloxacin (Infecton)

K E Britton¹, D W Wareham¹, S S Das¹, K K Solanki¹, H Amaral², A Bhatnagar³, A H S Katamihardja⁴, J Malamitsi⁵, H M Moustafa⁶, V E Soroa⁷, F X Sundram⁸ and A K Padhy⁹

¹ St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, UK
² Clinica Alemana, Santiago CP6681920, Chile
³ Institute of Nuclear Medicine and Allied Sciences, Delhi 11058, India
⁴ University of Padjadjaran, Bandung 40161, Indonesia
⁵ Hippokration General Hospital, Athens 11527, Greece
⁶ Nemrock Centre, Cairo University, 1111 Cairo, Egypt
⁷ Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
⁸ Singapore General Hospital, Singapore 169608
⁹ International Atomic Energy Agency, IAEA, A-1400 Vienna, Austria

Correspondence to:
Correspondence to:
Dr S S Das, Department of Medical Microbiology, St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, UK;
S.S.Das{at}qmul.ac.uk

Aims: The diagnosis of deep seated bacterial infections, such as intra-abdominal abscesses, endocarditis, and osteomyelitis, can be difficult and delayed, thereby compromising effective treatment. This study assessed the efficacy of a new radioimaging agent, Tc-99m ciprofloxacin (Infecton), in accurately detecting sites of bacterial infection.

Methods: Eight hundred and seventy nine patients with suspected bacterial infection underwent Infecton imaging and microbiological evaluation. The sensitivity and specificity of Infecton in detecting sites of bacterial infection were determined with respect to Centres of Disease Control, World Health Organisation, and Dukes’s criteria.

Results: Five hundred and seventy four positive and 295 negative images were produced. These included 528 true positives, 46 false positives, 205 true negatives and 90 false negatives, giving an overall sensitivity of 85.4% and a specificity of 81.7% for detecting infective foci. Sensitivity was higher (87.6%) in microbiologically confirmed infections.

Conclusions: Infecton is a sensitive technique, which aids in the earlier detection and treatment of a wide variety of deep seated bacterial infections. The ability to localise infective foci accurately is also important for surgical intervention, such as drainage of abscesses. In addition, serial imaging with Infecton might be useful in monitoring clinical response and optimising the duration of antimicrobial treatment.

Keywords: Infecton; bacterial infection; ciprofloxacin; radioimaging

Abbreviations: CDC, Centres for Disease Control; WHO, World Health Organisation

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