title: Evaluation of commercial universal rRNA gene PCR plus sequencing tests for identification of bacteria and fungi associated with infectious endocarditis.
abstract: Two new commercially available universal rRNA gene PCR plus sequencing tests, SepsiTest and universal microbe detection (UMD; Molzym, Bremen, Germany), were evaluated using blood specimens and heart valves from 30 patients with suspected infectious endocarditis (IE). The sensitivity of PCR (85%) was nearly twice as high as that of culture (45%), which in 10/20 IE cases presumably stayed negative as a consequence of growth inhibition of the pathogens by antibiotics. Further, PCR provided the basis for reclassification of 5/10 non-IE cases into IE cases. Culture-negative infections were identified by PCR, including single infections due to streptococci and Gram-negative bacteria (Escherichia coli, Haemophilus parainfluenzae) and mixed infections involving two Gram-positive bacteria or Candida spp. with Gram-positive bacteria. The new commercial tests proved to be of value for the rapid diagnosis of IE, particularly in cases of culture-negative infections. Issues regarding the feasibility of these tests for routine use are discussed.
authors.affiliation: Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany. kuehn.christian@mh-hannover.de
authors.forename: Christian
authors.initials: C
authors.lastname: Kühn
authors.forename: Claudia
authors.initials: C
authors.lastname: Disqué
authors.forename: Helge
authors.initials: H
authors.lastname: Mühl
authors.forename: Peter
authors.initials: P
authors.lastname: Orszag
authors.forename: Meike
authors.initials: M
authors.lastname: Stiesch
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology; D004696:Endocarditis / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D020459:Genes, rRNA; D005858:Germany; D006351:Heart Valves / Q000382:microbiology; D006801:Humans; D008297:Male; D008828:Microbiological Techniques / Q000379:methods*; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA / Q000379:methods*