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Molecular diagnosis is valid for culture negative infective endocarditis

Patients with suspected infective endocarditis can expect a more reliable diagnosis after a clinical validation study has confirmed that molecular methods are suitable for identifying the causal organisms in culture negative endocarditis.

A universal bacterial or fungal PCR test was positive in samples of heart valves from 14 of 15 patients with culture negative endocarditis who had undergone surgery; 11 patients had a positive bacterial and three a positive fungal test. Bacteria were identified in eight patients as species of Staphylococcus, Streptococcus, Enterobacter and—unusually—Tropheryma whipelii and Borrelia burgdorferi (sensu lato). Background contamination made the others unidentifiable. Fungi were identified as Aspergillus and Candida spp. Samples from 13 controls were PCR negative. These results correlated with clinical criteria except in two patients; their condition was asymptomatic and evident only at operation.

The retrospective case-control study included 15 culture negative patients with infective endocarditis according to Duke criteria—clinical measures . . . [Full text of this article]