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, 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

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Kumar, R., Basu, S., Torigian, D., Anand, V., Zhuang, H., Alavi, A. (2008). Role of Modern Imaging Techniques for Diagnosis of Infection in the Era of 18F-Fluorodeoxyglucose Positron Emission Tomography. Clin. Microbiol. Rev. 21: 209-224 [Abstract] [Full Text]  
• Biswal, S., Resnick, D. L., Hoffman, J. M., Gambhir, S. S. (2007). Molecular Imaging: Integration of Molecular Imaging into the Musculoskeletal Imaging Practice. Radiology 244: 651-671 [Abstract] [Full Text]  
• Dumarey, N., Egrise, D., Blocklet, D., Stallenberg, B., Remmelink, M., del Marmol, V., Van Simaeys, G., Jacobs, F., Goldman, S. (2006). Imaging Infection with 18F-FDG-Labeled Leukocyte PET/CT: Initial Experience in 21 Patients. JNM 47: 625-632 [Abstract] [Full Text]  
• van Eerd, J. E.M., Broekema, M., Harris, T. D., Edwards, D. S., Oyen, W. J.G., Corstens, F. H.M., Boerman, O. C. (2005). Imaging of Infection and Inflammation with an Improved 99mTc-Labeled LTB4 Antagonist. JNM 46: 1546-1551 [Abstract] [Full Text]  
• Siaens, R. H., Rennen, H. J., Boerman, O. C., Dierckx, R., Slegers, G. (2004). Synthesis and Comparison of 99mTc-Enrofloxacin and 99mTc-Ciprofloxacin. JNM 45: 2088-2094 [Abstract] [Full Text]  
• Brunner, M., Langer, O., Dobrozemsky, G., Muller, U., Zeitlinger, M., Mitterhauser, M., Wadsak, W., Dudczak, R., Kletter, K., Muller, M. (2004). [18F]Ciprofloxacin, a New Positron Emission Tomography Tracer for Noninvasive Assessment of the Tissue Distribution and Pharmacokinetics of Ciprofloxacin in Humans. Antimicrob. Agents Chemother. 48: 3850-3857 [Abstract] [Full Text]  
• Britton, K. E., Das, S. S., Solanki, K. K., Sarda-Mantel, L., Meulemans, A., Le Guludec, D. (2004). Ability of 99mTc-Ciprofloxacin Scintigraphy to Discriminate Between Septic and Sterile Osteoarticular Diseases. JNM 45: 922-923 [Full Text]