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J. Clin. Microbiol. · Jul 2013
PCR-electrospray ionization mass spectrometry for direct detection of pathogens and antimicrobial resistance from heart valves in patients with infective endocarditis.
- Cassandra L Brinkman, Paschalis Vergidis, James R Uhl, Bobbi S Pritt, Franklin R Cockerill, James M Steckelberg, Larry M Baddour, Joseph J Maleszewski, William D Edwards, Rangarajan Sampath, and Robin Patel.
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
- J. Clin. Microbiol. 2013 Jul 1; 51 (7): 2040-6.
AbstractMicrobiological 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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