Comparative molecular and microbiological diagnosis of 19 infective endocarditis cases in which causative microbes were identified by PCR-based DNA sequencing from the excised heart valves
| Autor: | Akiko Miyazato, Kazuhiko Uwabe, Mimiko Tabata, Hiroshi Niinami, Kiyofumi Ohkusu, Yoshimi Tachi, Kotaro Mitsutake, Toru Kawamura, Takayuki Ezaki |
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| Rok vydání: | 2011 |
| Předmět: |
Microbiology (medical)
Adult DNA Bacterial Male medicine.medical_specialty medicine.drug_class Antibiotics Bacteremia Microbial Sensitivity Tests Biology Polymerase Chain Reaction Microbiology law.invention Medical microbiology law medicine Humans Pharmacology (medical) Blood culture Polymerase chain reaction Gram-Positive Bacterial Infections Aged Aged 80 and over medicine.diagnostic_test Endocarditis Bacterial Sequence Analysis DNA Middle Aged Antimicrobial medicine.disease 16S ribosomal RNA Heart Valves Gram-Positive Cocci Infectious Diseases Gram staining Infective endocarditis Female |
| Zdroj: | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 18(3) |
| ISSN: | 1437-7780 |
| Popis: | Infective endocarditis (IE) is traditionally diagnosed by microbiological analysis of blood cultures, following which therapeutic antibiotics are chosen based on antimicrobial sensitivity tests. However, such conventional techniques do not always lead to an accurate etiological diagnosis. Recently, PCR analysis of the 16S rRNA gene has been employed to identify organisms isolated from excised heart valves. In this study, we analyzed 19 valve samples from patients with confirmed IE, as identified by Duke’s criteria. Using broad-range PCR amplification, followed by direct gene sequencing, pathological agents were identified in all samples. Although blood cultures yielded negative results in 4 cases, PCR analysis of valve samples showed positive identification of causative organisms. In 3 cases, there was a difference between blood culture and PCR in identification of pathological agents, which are likely to be misidentified by the conventional method based on the phenotypic database. Postoperative antibiotics were chosen considering the severity of lesions and the results of PCR, Gram staining, and valve cultures. All patients were cured without relapse. The broad-range PCR method was therefore beneficial for the management of IE because it enabled us to identify pathogens directly from the site of infection, even organisms that were difficult to culture or likely to be misidentified by the conventional culture method. Identification of the agents provided precise knowledge of the microbiological spectrum involved in the cases of IE. |
| Databáze: | OpenAIRE |
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