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

Abstract

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.

Clinical Significance of a 16S-rDNA Analysis of Heart Valves in Patients with Infective Endocarditis: a Retrospective Study

“…In our study, a 16S-analysis had a diagnostic benefit in only 9.0% of all episodes of IE. In contrast to our findings, previous studies have presented data of a diagnostic benefit in 13 to 31% of the episodes ( 7 , 8 , 15 ). The differences between the results of Armstrong et al ( 8 ), Rodrígez-García et al ( 15 ), and our study could possibly be explained by different definitions of diagnostic benefits.…”

Oral bacteria in infective endocarditis requiring surgery: a retrospective analysis of 134 patients

“…Rodriguez-Garcia et al described the impact of 16SrDNA tissue PCR for diagnostic complementation in IE patients with negative blood cultures. Such modern molecular diagnostics are important to obtain better information for the diagnosis of IE and to create preventive therapeutic treatment tools, including dental treatments [ 24 ].…”

Endocarditis in the intensive care unit: an update

“…Microorganism detection and identification have dramatically improved over the last years, especially due to the improvements in 16S-ARN PCR and Next-Generation Sequencing (NGS). The impact of these techniques has been mostly described in cases of suspected IE with negative blood cultures, where NGS or 16S-RNA sequencing were performed postoperatively on valvular tissue [55][56][57][58][59], without specific application in the ICU setting.…”