title: Comparative molecular and microbiologic diagnosis of bacterial endocarditis.
abstract: Sequencing of 16S rDNA, and of sodAint and rpoBint in some cases, was applied to DNA from heart valves of 46 patients (36 with definite and 10 with possible endocarditis). Sequence-based identifications were compared with those obtained with conventional methods. Among the 36 definite cases, 30 had positive blood cultures and 6 had negative cultures. Among the 30 positive cases, sequencing of 16S rDNA permitted identification of species (18), genus (8), or neither (4); sodAint and rpoBint sequencing was necessary for species identification in 8 cases. Species identifications were identical in only 61.5%, when conventional techniques and DNA sequencing were used. In five of the six blood culture-negative endocarditis cases, sequencing identified Bartonella quintana (3), B. henselae (1), and Streptococcus gallolyticus (1). Our results demonstrate a clear benefit of molecular identification, particularly in cases of blood culture-negative endocarditis and of possible endocarditis, to confirm or invalidate the diagnosis. Moreover, in 19.4% of the definite cases, the improvement in species identification by sequencing led to improved patient management.
authors.affiliation: Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Podglajen
authors.forename: Fabienne
authors.initials: F
authors.lastname: Bellery
authors.forename: Claire
authors.initials: C
authors.lastname: Poyart
authors.forename: Philippe
authors.initials: P
authors.lastname: Coudol
authors.forename: Annie
authors.initials: A
authors.lastname: Buu-Hoï
authors.forename: Patrick
authors.initials: P
authors.lastname: Bruneval
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Mainardi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D012321:DNA-Directed RNA Polymerases / Q000737:chemistry / Q000235:genetics; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D004926:Escherichia coli / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000737:chemistry / Q000235:genetics; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D013210:Staphylococcus / Q000235:genetics / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D013291:Streptococcus / Q000235:genetics / Q000302:isolation & purification; D013482:Superoxide Dismutase / Q000737:chemistry / Q000235:genetics
chemical_list: D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S; D013482:Superoxide Dismutase; D012321:DNA-Directed RNA Polymerases; C105078:RNA polymerase beta subunit