PCR and electrospray ionization mass spectrometry for detection of persistent enterococcus faecalis in cerebrospinal fluid following treatment of postoperative ventriculitis
| Autor: | Rangarajan Sampath, Derek L. Martinez, Lisa Flier, Clifford Chen, Andrew J. Tsung, Robert A. Bonomo, Sarah B. Beam, John J. Farrell, Kristin Sannes Lowery |
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| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Ependymoma Male Pathology medicine.medical_specialty Spectrometry Mass Electrospray Ionization medicine.drug_class Antibiotics Case Reports Polymerase Chain Reaction Ventriculoperitoneal Shunt Enterococcus faecalis Cerebral Ventriculitis Cerebrospinal fluid Fatal Outcome Postoperative Complications medicine Ventriculitis Humans Gram-Positive Bacterial Infections Aged Cerebrospinal Fluid biology business.industry biology.organism_classification medicine.disease Antimicrobial Anti-Bacterial Agents Drug Monitoring business Meningitis |
| Zdroj: | Journal of clinical microbiology. 51(10) |
| ISSN: | 1098-660X |
| Popis: | We describe the use of PCR and electrospray ionization followed by mass spectrometry (PCR/ESI-MS) to evaluate “culture-negative” cerebrospinal fluid (CSF) from a 67-year-old man who developed postoperative bacterial ventriculitis following a suboccipital craniotomy for resection of an ependymoma in the 4th ventricle. CSF samples were obtained on seven occasions, beginning in the operating room at the time of insertion of a right ventriculoperitoneal shunt (VPS) and continuing until his death, 6 weeks later. During the course of the illness, two initial CSF specimens taken before the initiation of antimicrobial treatment were notable for growth of Enterococcus faecalis . Once antimicrobial treatment was initiated, all CSF cultures were negative. PCR/ESI-MS detected genetic evidence of E. faecalis in all CSF samples, but the level of detection (LOD) decreased once antimicrobial treatment was initiated. When our patient returned with symptoms of meningitis 3 days after the completion of antibiotic treatment, CSF cultures remained negative, but PCR/ESI-MS again found genetic evidence for E. faecalis at levels comparable to the pretreatment levels seen initially. This unique case and these findings suggest that determination of CSF LOD by PCR/ESI-MS may be a very sensitive indicator of persistent infection in patients on antibiotic therapy for complex CNS infections and may have relevance for treatment duration and assessment of persistent or recurrent infection at the completion of therapy. |
| Databáze: | OpenAIRE |
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