scholarly journals Advantages and Limitations of Direct PCR Amplification of Bacterial 16S-rDNA from Resected Heart Tissue or Swabs Followed by Direct Sequencing for Diagnosing Infective Endocarditis: A Retrospective Analysis in the Routine Clinical Setting

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Daniela Maneg ◽  
Janina Sponsel ◽  
Iris Müller ◽  
Benedikt Lohr ◽  
John Penders ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Treatment ◽  
Clinical Setting ◽  
Direct Sequencing ◽  
Heart Tissue ◽  
High Morbidity ◽  
Direct Pcr ◽  
Predictive Values ◽  
Routine Clinical Setting ◽  
Culture Negative

Infective endocarditis (IE) is a life-threatening disease that is associated with high morbidity and mortality. Its long-term prognosis strongly depends on a timely and optimized antibiotic treatment. Therefore, identification of the causative pathogen is crucial and currently based on blood cultures followed by characterization and susceptibility testing of the isolate. However, antibiotic treatment starting prior to blood sampling or IE caused by fastidious or intracellular microorganisms may cause negative culture results. Here we investigate the additional diagnostic value of broad-range PCR in combination with direct sequencing on resected heart tissue or swabs in patients with tissue or swab culture-negative IE in a routine clinical setting. Sensitivity, specificity, and positive and negative predictive values of broad-range PCR from diagnostic material in our patients were 33.3%, 76.9%, 90.9%, and 14.3%, respectively. We identified a total of 20 patients (21.5%) with tissue or culture-negative IE who profited by the additional application of broad-range PCR. We conclude that broad-range PCR on resected heart tissue or swabs is an important complementary diagnostic approach. It should be seen as an indispensable new tool for both the therapeutic and diagnostic management of culture-negative IE and we thus propose its possible inclusion in Duke’s diagnostic classification scheme.

scholarly journals Evaluation of 16S rDNA Heart Tissue PCR as a Complement to Blood Cultures for the Routine Etiological Diagnosis of Infective Endocarditis

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1372
Author(s):  
Raquel Rodríguez-García ◽  
María Ángeles Rodríguez-Esteban ◽  
Jonathan Fernández-Suárez ◽  
Ana Morilla ◽  
Enrique García-Carús ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
16S Rdna ◽  
Heart Valve ◽  
Heart Tissue ◽  
Blood Cultures ◽  
Causative Pathogen ◽  
Complementary Information ◽  
Skin Microbiota ◽  
16S Rdna Pcr ◽  
Culture Negative

Identification of the causative pathogen is required to optimize the effective therapy in infective endocarditis (IE). The aim of this study was to assess a 16S rDNA PCR to identify bacteria from heart valve tissues and to evaluate its usefulness as a complement to blood and removed valves cultures. A total of 266 patients diagnosed with IE from January 2015 to December 2019 were evaluated. Results between 16S rDNA PCR from heart valve tissues were compared with microbiological cultures. Blood cultures were positive in 83.5% of patients diagnosed with IE, while 39.6% and 71.8% of the evaluated heart valve samples were positive by culture and 16S rDNA PCR, respectively. For 32 (12%) patients, 16S rDNA tissue PCR provided valuable information supporting the results of blood cultures in the case of bacteria characteristic from the skin microbiota. Additionally, a microorganism was identified by using 16S rDNA PCR in 36% of blood culture-negative cases. The present study reveals that molecular diagnosis using 16S rDNA tissue PCR provides complementary information for the diagnosis of IE, and it should be recommended in surgical endocarditis, especially when blood cultures are negative.

scholarly journals Ineffectiveness of Tigecycline against Persistent Borrelia burgdorferi

2009 ◽  
Vol 54 (2) ◽  
pp. 643-651 ◽  
Author(s):  
Stephen W. Barthold ◽  
Emir Hodzic ◽  
Denise M. Imai ◽  
Sunlian Feng ◽  
Xiaohua Yang ◽  
...  
Keyword(s):  
Borrelia Burgdorferi ◽  
Antibiotic Treatment ◽  
Early Stage ◽  
Heart Tissue ◽  
Scid Mice ◽  
Subcutaneous Transplantation ◽  
C3h Mice ◽  
Negative Effect ◽  
Positive Effect ◽  
Culture Negative

ABSTRACT The effectiveness of a new first-in-class antibiotic, tigecycline (glycylcycline), was evaluated during the early dissemination (1 week), early immune (3 weeks), or late persistent (4 months) phases of Borrelia burgdorferi infection in C3H mice. Mice were treated with high or low doses of tigecycline, saline (negative-effect controls), or a previously published regimen of ceftriaxone (positive-effect controls). Infection status was assessed at 3 months after treatment by culture, quantitative ospA real-time PCR, and subcutaneous transplantation of joint and heart tissue into SCID mice. Tissues from all saline-treated mice were culture and ospA PCR positive, tissues from all antibiotic-treated mice were culture negative, and some of the tissues from most of the mice treated with antibiotics were ospA PCR positive, although the DNA marker load was markedly decreased compared to that in saline-treated mice. Antibiotic treatment during the early stage of infection appeared to be more effective than treatment that began during later stages of infection. The viability of noncultivable spirochetes in antibiotic-treated mice (demonstrable by PCR) was confirmed by transplantation of tissue allografts from treated mice into SCID mice, with dissemination of spirochetal DNA to multiple recipient tissues, and by xenodiagnosis, including acquisition by ticks, transmission by ticks to SCID mice, and survival through molting into nymphs and then into adults. Furthermore, PCR-positive heart base tissue from antibiotic-treated mice revealed RNA transcription of several B. burgdorferi genes. These results extended previous studies with ceftriaxone, indicating that antibiotic treatment is unable to clear persisting spirochetes, which remain viable and infectious, but are nondividing or slowly dividing.

scholarly journals 18F-FDGPET/CT improves diagnostic certainty over the modified Duke Criteria in blood culture negative infective endocarditis

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
C Primus ◽  
I Bvekerwa ◽  
TA Clay ◽  
M Mccue ◽  
K Wong ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Blood Culture ◽  
Transoesophageal Echocardiography ◽  
Predictive Values ◽  
Surgical Specimen ◽  
Funding Sources ◽  
Duke Criteria ◽  
Diagnostic Certainty ◽  
Sensitivity Specificity ◽  
Culture Negative

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Diagnosis of blood culture negative infective endocarditis (BCNIE) is challenging, with positive microbiology key in the modified Duke Criteria (mDC). ESC IE Guidelines (2015) recommend the use of 18F-FDG PET/CT (PET) in cases where transoesophageal echocardiography (TOE) is equivocal and where cardiac implantable device-related IE (CIDRE) is suspected. We explored the role of PET to improve diagnostic certainty in the challenging cohort of BCNIE. Methods Retrospective review of all suspected BCNIE patients undergoing PET (10/2015 to 01/2021). Myocardial suppression technique was used in all cases, and studies were assessed for valve/device avidity. Patients were classified as definite/possible/rejected IE by mDC pre- and post-PET, with incremental benefit assessed by net reclassification index (NRI) versus actual diagnosis. Actual diagnosis was defined by Endocarditis Team consensus or surgical specimen (where available) at a minimum of 2-months following index admission. Results PET was performed in 110/807 (13.6%) cases overall. BCNIE prevalence was 18% across the total cohort, with 25/110 (22.7%) PET studies in BCNIE patients (male = 17, mean age 65). (p = 0.16 for PET in BCNIE compared to overall). PET was undertaken in 8 CIDRE, 9 native IE (NVE) and 10 prosthetic IE (PVE); 2-patients had suspected CIDRE + PVE. TOE was performed in all cases, and surgery was required in 8/25 patients. IE was confirmed in 44% of cases. PET sensitivity, specificity, positive and negative predictive values were 73%, 93%, 89% and 81%, respectively. Addition of PET to the mDC improved re-classification to definite or rejected IE, with NRI 0.633 (positive NRI 0.3; negative 0.333), and added weight to the original mDC classification in 14/25 (56%) of cases. Conclusion PET improves diagnostic certainty when combined with mDC in the evaluation of patients with BCNIE across NVE, PVE and CIDRE.

Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective Spanish cohort study

2021 ◽  
pp. 1-9
Author(s):  
Lorenzo Roberto Suardi ◽  
Arístides de Alarcón ◽  
María Victoria García ◽  
Antonio Plata Ciezar ◽  
Carmen Hidalgo Tenorio ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Culture Negative ◽  
Spanish Cohort

scholarly journals An investigation of general predictors for cognitive–behavioural therapy outcome for anxiety disorders in a routine clinical setting

BMJ Open ◽  
2016 ◽  
Vol 6 (3) ◽  
pp. e010898 ◽  
Author(s):  
Sara Kerstine Kaya Nielsen ◽  
Signe Vangkilde ◽  
Kate B Wolitzky-Taylor ◽  
Sarah Ingrid Franksdatter Daniel ◽  
Ida Hageman
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Clinical Setting ◽  
Behavioural Therapy ◽  
Therapy Outcome ◽  
Cognitive Behavioural ◽  
Routine Clinical Setting

Diagnostic implications of TERT promoter mutation status in diffuse gliomas in a routine clinical setting

2017 ◽  
Vol 471 (5) ◽  
pp. 641-649 ◽  
Author(s):  
Ekkehard Hewer ◽  
Nadine Prebil ◽  
Sabina Berezowska ◽  
Marielena Gutt-Will ◽  
Philippe Schucht ◽  
...  
Keyword(s):  
Clinical Setting ◽  
Tert Promoter Mutation ◽  
Promoter Mutation ◽  
Mutation Status ◽  
Tert Promoter ◽  
Routine Clinical Setting ◽  
Diffuse Gliomas

scholarly journals First field evaluation of the optimized CE marked Abbott protocol for HIV RNA testing on dried blood spot in a routine clinical setting in Vietnam

PLoS ONE ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. e0191920 ◽  
Author(s):  
Fabien Taieb ◽  
Tram Tran Hong ◽  
Hien Thi Ho ◽  
Binh Nguyen Thanh ◽  
Tram Pham Phuong ◽  
...  
Keyword(s):  
Clinical Setting ◽  
Field Evaluation ◽  
Dried Blood Spot ◽  
Hiv Rna ◽  
Routine Clinical Setting ◽  
Blood Spot
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