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J Clin Pathol 2002;55:817-823 doi:10.1136/jcp.55.11.817
  • Original article

Imaging bacterial infection with 99mTc-ciprofloxacin (Infecton)

  1. K E Britton1,
  2. D W Wareham1,
  3. S S Das1,
  4. K K Solanki1,
  5. H Amaral2,
  6. A Bhatnagar3,
  7. A H S Katamihardja4,
  8. J Malamitsi5,
  9. H M Moustafa6,
  10. V E Soroa7,
  11. F X Sundram8,
  12. A K Padhy9
  1. 1St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, UK
  2. 2Clinica Alemana, Santiago CP6681920, Chile
  3. 3Institute of Nuclear Medicine and Allied Sciences, Delhi 11058, India
  4. 4University of Padjadjaran, Bandung 40161, Indonesia
  5. 5Hippokration General Hospital, Athens 11527, Greece
  6. 6Nemrock Centre, Cairo University, 1111 Cairo, Egypt
  7. 7Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  8. 8Singapore General Hospital, Singapore 169608
  9. 9International Atomic Energy Agency, IAEA, A-1400 Vienna, Austria
  1. 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
  • Accepted 5 June 2002

Abstract

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.

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