TY  - JOUR
A1  - Maneg, Daniela
A1  - Sponsel, Janina
A1  - Müller, Iris
A1  - Lohr, Benedikt
A1  - Penders, John
A1  - Madlener, Katharina
A1  - Hunfeld, Klaus-Peter
T1  - 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
T2  - BioMed research international
N2  - 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.
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/53511
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-535119
SN  - 2314-6141
SN  - 2314-6133
N1  - Copyright © 2016 Daniela Maneg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
VL  - 2016
IS  - Article ID 7923874
PB  - Hindawi Publishing Corporation
CY  - New York [u.a.]
ER  -