Objective. To establish the diagnostic value of the test for the D-lactate determination in the surgically infected (SI) patients’ biological fluids.
Materials and methods. The main group (n=104) included 32 patients of the Neurosurgery Department of Vitebsk Regional Clinical Hospital with nosocomial meningoencephalitis (ME), 48 children of the Department of Surgery of Vitebsk Regional Children’s Clinical Center with acute destructive appendicitis (ADA) and 24 patients of the Department of Traumatology of Vitebsk Clinical Emergency Hospital with periprosthesic infections (PPI). The group of comparison of 105 patients without surgical infections was comparable to the main one by the age and the sex (p>0.05). The cerebrospinal fluid (CF), peritoneal exudate (PE) and synovial exudate (SE) bacteriological analyses were performed on an ATV Expression automatic microbiological analyzer (Bio Merieux, France). The D-lactate level was determined by a «D-Lactam» test system (Sivital Ltd., Belarus). The data was processed statistically using STATISTICA 10.0 (StatSoft Inc., USA) and MedCalc 10.2 software calculating ROC-analysis.
Results. Comparative analysis values of the D-lactate CF, PE and SE concentrations in the main group exceeded statistically reliably (Mann – Whitney U-test, p<0.0001) those of the persons lacking SI. The ROC-analysis determined the
D-lactate diagnostic levels to be in CF — 0.26 mmol/l, in PE — 0.33 mmol/l, in SE — 0.48 mmol/l indicating reliably the bacterial infection presence, sensitivity (p<0.001), specificity (p<0.001) and area under the AUC curve (p<0001) being high.
Conclusion. D-lactate determination in CF at ME (AUC=0.993%), in PE at ADA (AUC=0.938%), in SE at PPI (AUC=0.968%) is a highly informative method for the CI early diagnosis (p<0.0001).Ключевые слова:
Автор(ы): K. M. Kubrakov, V. M. Semenov, O. V. Marshalko, M. A. Litvyakov, D. V. Yeudakimau