Isolation of Coxiella burnetii from heart valves of patients treated for Q fever endocarditis

Mühlemann, Kathrin; Matter, L; Meyer, Beat J.; Schopfer, K

doi:10.1128/jcm.33.2.428-431.1995

Cited by 32 publications

(7 citation statements)

References 19 publications

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“…Tissue biopsy specimens are tested either fresh or following formalin fixation and paraffin embedding. Immunodetection may be performed by the immunoperoxidase technique (41), capture ELISA/ELIFA systems (358), or immunofluorescence with polyclonal or monoclonal antibodies (226,245,358). Only the last technique may be used with paraffin-embedded tissues (298).…”

Section: Pathological Findings and Immunohistologymentioning

confidence: 99%

Q Fever

1999

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SUMMARY Q fever is a zoonosis with a worldwide distribution with the exception of New Zealand. The disease is caused by Coxiella burnetii, a strictly intracellular, gram-negative bacterium. Many species of mammals, birds, and ticks are reservoirs of C. burnetii in nature. C. burnetii infection is most often latent in animals, with persistent shedding of bacteria into the environment. However, in females intermittent high-level shedding occurs at the time of parturition, with millions of bacteria being released per gram of placenta. Humans are usually infected by contaminated aerosols from domestic animals, particularly after contact with parturient females and their birth products. Although often asymptomatic, Q fever may manifest in humans as an acute disease (mainly as a self-limited febrile illness, pneumonia, or hepatitis) or as a chronic disease (mainly endocarditis), especially in patients with previous valvulopathy and to a lesser extent in immunocompromised hosts and in pregnant women. Specific diagnosis of Q fever remains based upon serology. Immunoglobulin M (IgM) and IgG antiphase II antibodies are detected 2 to 3 weeks after infection with C. burnetii, whereas the presence of IgG antiphase I C. burnetii antibodies at titers of ≥1:800 by microimmunofluorescence is indicative of chronic Q fever. The tetracyclines are still considered the mainstay of antibiotic therapy of acute Q fever, whereas antibiotic combinations administered over prolonged periods are necessary to prevent relapses in Q fever endocarditis patients. Although the protective role of Q fever vaccination with whole-cell extracts has been established, the population which should be primarily vaccinated remains to be clearly identified. Vaccination should probably be considered in the population at high risk for Q fever endocarditis.

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Section: Pathological Findings and Immunohistologymentioning

confidence: 99%

Q Fever

1999

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“…Several techniques are available, including immunoperoxidase staining (16) (Fig. 2B), a capture enzyme-linked immunosorbent assay system (ELISA) or enzyme-linked immunosorbent fluorescence assay system (176), or tests with monoclonal antibodies (114,119,176). The last technique can also be used for detection of antigen in paraffin-embedded tissues (148).…”

Section: Specific Laboratory Diagnosismentioning

confidence: 99%

“…In our laboratory, we systematically amplify shell vial supernatants by PCR. Although Mühlemann et al (119) could isolate C. burnetii from the heart valves of patients treated for Q fever endocarditis, better results are obtained if clinical specimens are collected prior to the initiation of antibiotic therapy (121). Fifteen percent of untreated patients with Q fever pneumonia have positive blood cultures by this method, as do 53% of patients with endocarditis (53,121).…”

Section: Specific Laboratory Diagnosismentioning

confidence: 99%

Diagnosis of Q Fever

1998

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“…Since the reason for this clinical diversity between acute cases of Q fever is not known, the causative roles of strain differences cannot be excluded. However, no firm conclusions can be drawn because of the small number of C. burnetii strains isolated from patients suffering from acute Q fever (18)(19)(20)36). Thus, isolation of C. burnetii strains from different geographic areas is needed.…”

mentioning

confidence: 99%

“…A number of C. burnetii strains originating from patients suffering from either chronic or acute Q fever have been isolated by a shell vial culture method. The method was successfully applied on valves, arterial prostheses, bone, skin biopsies, bone marrow, and blood (11,18,20,29,30).…”

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Q Fever in the Greek Island of Crete: Detection, Isolation, and Molecular Identification of Eight Strains of Coxiella burnetii from Clinical Samples

et al. 1998

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Over a period of 6 years (1989 to 1995), serum samples from 3,300 patients suspected to be infected by Coxiella burnetii were assayed for the presence of antibodies against antigen phase II of the microorganism by the indirect immunofluorescence antibody technique (IFAT). One hundred fifty-two cases were recorded, and blood samples from 17 patients were cultured for the isolation of the pathogen. By a centrifugation shell vial technique, eight strains were isolated from patients suffering from acute Q fever. The microorganism was detected in the cultures by IFAT, by Gimenez staining, and by the cytopathogenic effect on Vero and human embryonic lung (HEL) cells. PCR followed by restriction fragment length polymorphism analysis was used to confirm the diagnosis and identify the Coxiella burnetii strains within the cell cultures as well as to compare them with reference strains. In order to avoid time-consuming cultures, to achieve direct detection of Coxiella burnetii in clinical samples (blood, buffy coat, etc.), and to increase the specificity and sensitivity of the detection, nested PCR was performed. The first step of DNA extraction was performed with the QIAamp blood kit 250. For the second step of the PCR assays, the conditions of temperature and times of recycling were properly modified, and the microorganism was detected within 4 h. Our study demonstrates that Q fever is an endemic disease in Crete and that the diagnosis of Coxiella burnetii infection can be rapidly achieved by the detection of the microorganism in buffy coat samples by nested PCR. Although the presenting symptoms of the disease in this study differed from those in other studies, the Cretan strains do not differ genotypically from the reference strains (Nine Mile and Q212).

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Isolation of Coxiella burnetii from heart valves of patients treated for Q fever endocarditis

Cited by 32 publications

References 19 publications

Q Fever

Q Fever

Diagnosis of Q Fever

Q Fever in the Greek Island of Crete: Detection, Isolation, and Molecular Identification of Eight Strains of Coxiella burnetii from Clinical Samples

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