Objectives: 

To compare a large panel of plasma protein inflammatory biomarkers and mid-infrared (MIR) spectral patterns in patients with confirmed fracture-related infections (FRIs) with those in controls without infection.

Design: 

Prospective case–control study.

Setting: 

Academic, Level 1 trauma center.

Patients: 

Thirteen patients meeting confirmatory FRI criteria were matched to 13 controls based on age, time after surgery, and fracture region.

Intervention: 

Plasma levels of 49 proteins were measured using enzyme-linked immunosorbent assay techniques. Fourier transform infrared spectroscopy of dried films was used to obtain MIR spectra of plasma samples.

Main Outcome Measurements: 

The main outcome measurements included plasma protein levels and MIR spectra of samples.

Results: 

Multivariate analysis-based predictive model developed using enzyme-linked immunosorbent assay–based biomarkers had sensitivity, specificity, and accuracy of 69.2% ± 0.0%, 99.9% ± 1.0%, and 84.5% ± 0.6%, respectively, with platelet-derived growth factor-AB/BB, C-reactive protein, and MIG selected as the minimum number of variables explaining group differences (P < 0.05). Sensitivity, specificity, and accuracy of the predictive model based on MIR spectra were 69.9% ± 6.2%, 71.9% ± 5.9%, and 70.9% ± 4.8%, respectively, with 6 wavenumbers as explanatory variables (P < 0.05).

Conclusions: 

This pilot study demonstrates the feasibility of using a select panel of plasma proteins and Fourier transform infrared spectroscopy to diagnose FRIs. Preliminary data suggest that the measurement of these select proteins and MIR spectra may be potential clinical tools to detect FRIs. Further investigation of these biomarkers in a larger cohort of patients is warranted.

Level of Evidence: 

Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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血浆蛋白生物标志物和中红外光谱在诊断骨折相关感染中的应用：初步研究

目标： 

比较确诊骨折相关感染 (FRI) 患者与未感染对照组患者的大量血浆蛋白炎症生物标志物和中红外 (MIR) 光谱模式。

设计： 

前瞻性病例对照研究。

环境： 

学术，一级创伤中心。

患者： 

根据年龄、手术后时间和骨折区域，将 13 名符合确认性 FRI 标准的患者与 13 名对照相匹配。

干涉： 

使用酶联免疫吸附测定技术测量了 49 种蛋白质的血浆水平。干膜的傅里叶变换红外光谱用于获得血浆样品的中红外光谱。

主要结果测量： 

主要结果测量包括血浆蛋白水平和样品的 MIR 光谱。

结果： 

使用基于酶联免疫吸附测定的生物标志物开发的基于多变量分析的预测模型对血小板衍生生长的敏感性、特异性和准确性分别为 69.2% ± 0.0%、99.9% ± 1.0% 和 84.5% ± 0.6%选择因子-AB/BB、C-反应蛋白和 MIG 作为解释组差异的最小变量数 ( P < 0.05)。基于 MIR 光谱的预测模型的灵敏度、特异性和准确性分别为 69.9% ± 6.2%、71.9% ± 5.9% 和 70.9% ± 4.8%，以 6 个波数作为解释变量（P < 0.05）。

结论： 

该试点研究证明了使用一组选定的血浆蛋白和傅里叶变换红外光谱来诊断 FRI 的可行性。初步数据表明，这些选定蛋白质和 MIR 光谱的测量可能是检测 FRI 的潜在临床工具。有必要在更大的患者队列中进一步研究这些生物标志物。

证据等级： 

诊断级别IV。有关证据等级的完整描述，请参阅作者须知。