Why the study?
Does PCR-electrospray ionization mass spectrometry (PCR/ESI-MS) improve the detection of pathogens and antimicrobial resistance in heart valves from patients with infective endocarditis?
Does PCR-electrospray ionization mass spectrometry (PCR/ESI-MS) improve the detection of pathogens and antimicrobial resistance in heart valves from patients with infective endocarditis?
PCR/ESI-MS can detect pathogens and antimicrobial resistance directly from formalin-fixed heart valves in infective endocarditis, though it failed to detect organisms in 34% of culture-positive cases.
PCR/ESI-MS may aid direct detection from fixed valves but misses 34% of culture-positive cases; leaves open its diagnostic role in endocarditis.
Microbiological diagnosis is pivotal to the appropriate management and treatment of infective endocarditis. We evaluated PCR-electrospray ionization mass spectrometry (PCR/ESI-MS) for bacterial and candidal detection using 83 formalin-fixed paraffin-embedded heart valves from subjects with endocarditis who had positive valve and/or blood cultures, 63 of whom had positive valvular Gram stains. PCR/ESI-MS yielded 55% positivity with concordant microbiology at the genus/species or organism group level (e.g., viridans group streptococci), 11% positivity with discordant microbiology, and 34% with no detection. PCR/ESI-MS detected all antimicrobial resistance encoded by mecA or vanA/B and identified a case of Tropheryma whipplei endocarditis not previously recognized.
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Brinkman et al. (2013) studied this question.
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