Value of PCR in surgically treated patients with staphylococcal infective endocarditis: a 4-year retrospective study

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Authors

MALIŠOVÁ Barbora NĚMCOVÁ Eva POL Jiří ŠORM Z. WURMOVÁ Š. NOVOTNÁ K. VANĚRKOVÁ M. HOLÁ Veronika RŮŽIČKA Filip DUŠEK Ladislav NĚMEC Petr FREIBERGER Tomáš

Year of publication 2012
Type Article in Periodical
Magazine / Source European Journal of Clinical Microbiology & Infectious Diseases
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1007/s10096-011-1427-3
Field Cardiovascular diseases incl. cardiosurgery
Keywords polymerase chain reaction; staphylococcal infective endocarditis
Attached files
Description The aim of the study was to establish a diagnostic value for broad-range polymerase chain reaction (br-PCR) and staphylococci-specific multiplex PCR (ssm-PCR) performed on surgical material from patients with staphylococcal infective endocarditis (IE). Data were analysed retrospectively from 60 patients with suspected staphylococcal IE and 59 controls who were surgically treated at three cardiosurgery centres over 4 years. Both PCR tests showed high agreement and could be aggregated. In patients with definite and rejected IE, the clinical sensitivity and specificity of PCR reached 89 and 95%, respectively. Tissue culture (TC) and PCR agreed with blood culture (BC) in 29% and 67% of IE cases. TC helped to determine aetiology in five BC negative cases while PCR aided in nine cases. Out of 52 patients with conclusive staphylococcal IE, 40 were diagnosed with S. aureus and 12 with coagulasenegative staphylococci. PCR was shown to be highly superior to TC in confirming preoperative diagnosis of IE. In addition to aid in culture negative patients, PCR helped to establish or refine aetiology in inconclusive cases. We suggest that simultaneous br-PCR and ssm-PCR performed on surgical material together with histopathology could significantly increase the performance of current Duke criteria.
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