Molecular Analysis With 16S rRNA PCR/Sanger Sequencing and Molecular Antibiogram Performed on DNA Extracted From Valve Improve Diagnosis and Targeted Therapy of Infective Endocarditis: A Prospective Study

Mularoni, Alessandra; Mikulska, Małgorzata; Barbera, Floriana; Graziano, Elena; Medaglia, Alice Annalisa; Carlo, Daniele Di; Monaco, Francesco; Bellavia, Diego; Raffa, Giuseppe Maria; Sciacca, Sergio; Luca, Angelo; Pilato, Michele; Conaldi, Pier Giulio

doi:10.1093/cid/ciac452

Cited by 11 publications

(7 citation statements)

References 40 publications

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“…The molecular anti-biogram was based on genes encoding for multi-drug resistant mechanisms. It showed 100% concordance with anti-microbial susceptibility testing [58].…”

Section: Molecular Techniquesmentioning

confidence: 69%

Novel Diagnostic Methods for Infective Endocarditis

Burban,

Słupik,

Reda

et al. 2024

IJMS

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Infective endocarditis (IE) remains a dangerous disease and continues to have a high mortality rate. Unfortunately, despite continuous improvements in diagnostic methods, in many cases, blood cultures remain negative, and the pathogen causing endocarditis is unknown. This makes targeted therapy and the selection of appropriate antibiotics impossible. Therefore, we present what methods can be used to identify the pathogen in infective endocarditis. These are mainly molecular methods, including PCR and MGS, as well as imaging methods using radiotracers, which offer more possibilities for diagnosing IE. However, they are still not widely used in the diagnosis of IE. The article summarizes in which cases we should choose them and what we are most hopeful about in further research into the diagnosis of IE. In addition, registered clinical trials that are currently underway for the diagnosis of IE are also presented.

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“…The molecular anti-biogram was based on genes encoding for multi-drug resistant mechanisms. It showed 100% concordance with anti-microbial susceptibility testing [58].…”

Section: Molecular Techniquesmentioning

confidence: 69%

Novel Diagnostic Methods for Infective Endocarditis

Burban,

Słupik,

Reda

et al. 2024

IJMS

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“…In order to assess the diagnostic accuracy of the FISHseq method, we calculated the positive and negative percentage agreement and their 95% confidence intervals (CIs), as previously described [ 24 , 32 ] and in accordance with Food and Drug Administration (FDA) recommendations [ 33 ]. All statistical analyses were performed with R 4.2.0 (R Foundation for Statistical Computing, Vienna, Austria).…”

Section: Methodsmentioning

confidence: 99%

New Perspectives for Prosthetic Valve Endocarditis: Impact of Molecular Imaging by FISHseq Diagnostics

Hajduczenia

Klefisch

Hopf

et al. 2022

Clinical Infectious Diseases

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Background The causative microbial etiology of prosthetic valve infective endocarditis (PVE) can be difficult to identify. Our aim was to investigate the benefit of the molecular imaging technique fluorescence in situ hybridization (FISH) combined with 16S rRNA-gene PCR and sequencing (FISHseq) for the analysis of infected prosthetic heart valves. Methods We retrospectively evaluated the diagnostic outcome of 113 prosthetic valves from 105 patients with suspected PVE, treated in the years 2003-2013 in the Department of Cardiac Surgery, Charité University Medicine Berlin. Each prosthetic valve underwent cultural diagnostics and was routinely examined by FISH combined with 16S rRNA-gene PCR and sequencing. We compared classical microbiological culture outcomes (blood and valve cultures) with FISHseq results and evaluated the diagnostic impact of the molecular imaging technique. Results Conventional microbiological diagnostic alone turned out to be insufficient, as 67% of preoperative blood cultures were non-informative (negative, inconclusive or not obtained) and 67% valve cultures remained negative. FISHseq improved the conventional cultural diagnostic methods in PVE in 30% of the cases and increased diagnostic accuracy. Out of the valve culture-negative PVE cases, FISHseq succeeded to identify the causative pathogen in 35%. Conclusions FISHseq improves PVE diagnostics, complementing the conventional cultural methods. In addition to species identification, FISH provides information about the severity of PVE and state of the pathogens, e.g. stage of biofilm formation, activity and localization on and within the prosthetic material. As a molecular imaging technique, FISHseq enables the unambiguous discrimination of skin flora as contaminant or infectious agent.

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“…A persistent diagnostic challenge is the prevalence of culture negative endocarditis. In many studies, > 30% of patients will have negative blood cultures, complicating their care [21,22]. This is often because patients receive antibiotics before cultures are obtained or due to infection with difficult to culture organisms.…”

Section: Diagnosismentioning

confidence: 99%

Endocarditis: A Review of Recent Literature

Dale,

Tayyem,

Maceyko

2024

Curr Emerg Hosp Med Rep

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Purpose of Review Endocarditis remains a challenging diagnosis, with significant implications for early identification and initiation of therapy. In this review, we examine the evolution in the epidemiology and presentation of infectious endocarditis (IE), the role of new diagnostic tools, and the approach to therapy. Recent Findings Staphylococcus and Streptococcus species remain the most common causative organisms, but the prevalence of IE caused by enterococcus and non-HACEK organisms is increasing. While newer antibiotics such as dalbavancin have shown promise, treatment must still be tailored on an individual basis. Evidence suggests that antibiotic prophylaxis to prevent IE be limited to high-risk patients undergoing invasive procedures. Summary The Duke Criteria, first established in 1994, provide a guideline by which clinicians can identify affected patients. Now, 23 years after their last update in 2000, the Modified Duke Criteria have been revised to account for changes in our understanding of the disease. When combined with evolving treatment guidelines, clinicians have updated tools to help combat this disease.

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Molecular Analysis With 16S rRNA PCR/Sanger Sequencing and Molecular Antibiogram Performed on DNA Extracted From Valve Improve Diagnosis and Targeted Therapy of Infective Endocarditis: A Prospective Study

Cited by 11 publications

References 40 publications

Novel Diagnostic Methods for Infective Endocarditis

Novel Diagnostic Methods for Infective Endocarditis

New Perspectives for Prosthetic Valve Endocarditis: Impact of Molecular Imaging by FISHseq Diagnostics

Endocarditis: A Review of Recent Literature

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