Most cited article - PubMed ID 12591825
Molecular diagnosis of culture negative infective endocarditis: clinical validation in a group of surgically treated patients
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.
- MeSH
- Bacteriological Techniques methods MeSH
- Molecular Diagnostic Techniques methods MeSH
- Endocarditis diagnosis microbiology surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Polymerase Chain Reaction methods MeSH
- Retrospective Studies MeSH
- Sensitivity and Specificity MeSH
- Staphylococcal Infections diagnosis microbiology surgery MeSH
- Staphylococcus classification genetics isolation & purification MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Evaluation Study MeSH
- Research Support, Non-U.S. Gov't MeSH