Value of PCR in surgically treated patients with staphylococcal infective endocarditis: a 4-year retrospective study
Jazyk angličtina Země Německo Médium print-electronic
Typ dokumentu hodnotící studie, časopisecké články, práce podpořená grantem
- MeSH
- bakteriologické techniky metody MeSH
- diagnostické techniky molekulární metody MeSH
- endokarditida diagnóza mikrobiologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- polymerázová řetězová reakce metody MeSH
- retrospektivní studie MeSH
- senzitivita a specificita MeSH
- stafylokokové infekce diagnóza mikrobiologie chirurgie MeSH
- Staphylococcus klasifikace genetika izolace a purifikace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
The aim of the study was to establish a diagnostic value for broad-range polymerase chain reaction (br-PCR) and staphylococci-specific multiplex PCR (ssm-PCR) performed on surgical material from patients with staphylococcal infective endocarditis (IE). Data were analysed retrospectively from 60 patients with suspected staphylococcal IE and 59 controls who were surgically treated at three cardiosurgery centres over 4 years. Both PCR tests showed high agreement and could be aggregated. In patients with definite and rejected IE, the clinical sensitivity and specificity of PCR reached 89 and 95%, respectively. Tissue culture (TC) and PCR agreed with blood culture (BC) in 29% and 67% of IE cases. TC helped to determine aetiology in five BC negative cases while PCR aided in nine cases. Out of 52 patients with conclusive staphylococcal IE, 40 were diagnosed with S. aureus and 12 with coagulase-negative staphylococci. PCR was shown to be highly superior to TC in confirming preoperative diagnosis of IE. In addition to aid in culture negative patients, PCR helped to establish or refine aetiology in inconclusive cases. We suggest that simultaneous br-PCR and ssm-PCR performed on surgical material together with histopathology could significantly increase the performance of current Duke criteria.
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