Evaluation of commercial universal rRNA gene PCR plus sequencing tests for identification of bacteria and fungi associated with infectious endocarditis

J Clin Microbiol. 2011 Aug;49(8):2919-23. doi: 10.1128/JCM.00830-11. Epub 2011 Jun 29.

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.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / classification
  • Bacteria / genetics
  • Bacteria / isolation & purification*
  • Blood / microbiology
  • Endocarditis / diagnosis*
  • Endocarditis / microbiology
  • Female
  • Fungi / classification
  • Fungi / genetics
  • Fungi / isolation & purification*
  • Genes, rRNA*
  • Germany
  • Heart Valves / microbiology
  • Humans
  • Male
  • Microbiological Techniques / methods*
  • Middle Aged
  • Polymerase Chain Reaction / methods*
  • Sensitivity and Specificity
  • Sequence Analysis, DNA / methods*