New diagnostic approaches in infective endocarditis

Millar, B. Cherie; Habib, Gilbert; Moore, John E.

doi:10.1136/heartjnl-2014-307021

Cited by 18 publications

(9 citation statements)

References 95 publications

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“…Interestingly, the culture and mNGS results of cases 5, 6, 7, 8, and 9 were all Streptococcus, but the specific populations were different, suggesting that antibiotics may have different efficacies in treating different populations of Streptococcus; (2) The bacteria detected in valve tissue by mNGS may be bacterial debris (5). Yet, we lacked the micro-transcription analysis of valve tissue; (3) The valve and sampling conditions may also affect the test results (31).…”

Section: Discussionmentioning

confidence: 99%

Application of Metagenomic Next-Generation Sequencing in the Etiological Diagnosis of Infective Endocarditis During the Perioperative Period of Cardiac Surgery: A Prospective Cohort Study

Zeng

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveThe present study aimed to prospectively evaluate the role of metagenomic next-generation sequencing (mNGS) in the etiological diagnosis of patients with perioperative infective endocarditis (IE).MethodsFrom May 1st, 2019 to December 31st, 2020, a total of 99 patients with IE were enrolled in the present study according to the modified Duke criteria, etiological, and pathological results. 11 non-IE patients undergoing heart valve surgery in the same period were selected as the control group. A blood culture test was performed immediately after admission, and the valves harvested operatively were examined by blood culture and mNGS.ResultsIn the IE group, there were 29 cases (29.3%) with positive blood culture, 16 cases (16.2%) with positive valve culture, and 85 cases (85.9%) with positive valve mNGS. Compared to culture-based detection, mNGS achieved better performance with a sensitivity, specificity, area under the curve (AUC) of 0.859, 0.727, and 0.793, respectively. The combined approach using culture and mNGS further improved the diagnostic accuracy (sensitivity 89.9%, specificity 72.7%, AUC 0.813). Preoperative white blood cell (P = 0.029) and neutrophils (P = 0.046) were identified as independent factors affecting the detection rate of mNGS. In the mNGS-positive group, 95 strains of pathogens were found and 10 cases were identified with mixed infection. There were 72 gram-positive bacteria and 14 gram-negative bacteria. mNGS positive group displayed higher species richness than mNGS negative group with enrichment of Streptococcus sanguis, Streptococcus buccalis, and Streptococcus griseus. Proteobacteria and Actinomycetes were enriched in mNGS negative group. Notably, six patients showed disconcordant results between culture and mNGS. Rothia aeria was identified in the blood culture, valve culture, and valve mNGS in one patient. Bartonella Quintana and Coxiella burnetii, which were fastidious intracellular bacteria, were found in two blood and valve culture-negative cases.ConclusionsmNGS outperformed the conventional culture method and displayed high accuracy in detecting pathogens in IE patients. This study provided support for the use of mNGS in the etiological diagnosis of IE.

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Section: Discussionmentioning

confidence: 99%

Application of Metagenomic Next-Generation Sequencing in the Etiological Diagnosis of Infective Endocarditis During the Perioperative Period of Cardiac Surgery: A Prospective Cohort Study

Zeng

et al. 2022

Front. Cardiovasc. Med.

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“…Positron emission tomography-computed tomography is a functional molecular imaging technique that depicts metabolic activity. Several studies [16,17,41] have shown its utility for diagnosing PVE. Recently, ESC IE guidelines [10] have included abnormal activity around a prosthetic valve as a major criterion and embolic phenomena as a minor criterion for diagnosing PVE.…”

Section: Discussionmentioning

confidence: 99%

“…Oral antibiotics have shown to be effective for shortening intravenous treatment in selected cases of uncomplicated left-sided IE [15]; however, there is a lack information regarding oral long-term antibiotic treatment (LTAT) in the context of SINUS-IE. Moreover, new imaging techniques [16], such as positron emission tomography-computed tomography (PET/CT) might play a role in monitoring responses and establishing an appropriate duration for LTAT [17,18] in SINUS-IE.…”

Section: Introductionmentioning

confidence: 99%

Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

et al. 2021

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“…Blood culture‐negative IE accounts for 2%−30% of patients with IE due to either prior antimicrobial therapy or the presence of intracellular and difficult‐to‐culture microorganisms . Molecular approaches, like 16S ribosomal DNA PCR, have proven advantageous in cases of culture‐negative IE., PCR analysis of valve tissue has a variable sensitivity (41.2%−96%) and high specificity (95.3%−100%), which has prompted many researchers to propose a PCR‐positive finding to be included as a major Duke criterion …”

Section: Discussionmentioning

confidence: 99%

Salvage heart transplantation for Mycoplasma hominis prosthetic valve endocarditis: A case report and review of the literature

Givone

Peghin

Vendramin

et al. 2020

Transplant Infectious Dis

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Heart transplantation (HT) has been rarely performed in patients with infective endocarditis (IE) and is considered a "last resort" procedure. Orthotropic HT with bicaval technique was performed in a man with culture-negative endocarditis. Mycoplasma hominis was later detected using 16S ribosomal DNA PCR from surgically removed valve tissue. Literature review and previous results are summarized. HT may be considered as salvage treatment in selected patients with intractable IE. In cases when there is no growth in culture, 16S ribosomal DNA PCR sequencing can be used to identify the pathogen in excised valvular tissue. Mycoplasma spp. is extremely uncommon and difficult to diagnose cause of infective endocarditis (IE). There are no proposed or defined criteria for heart transplantation (HT) in patients with refractory IE, and HT has been rarely performed in this setting. We report a case of M hominis prosthetic valve endocarditis diagnosed by 16S ribosomal DNA PCR in a patient who underwent a salvage HT. We reviewed in the literature other cases of IE caused by Mycoplasma spp. K E Y W O R D S infective endocarditis, Mycoplasma, salvage heart transplantation

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New diagnostic approaches in infective endocarditis

Abstract: International audienceno abstrac

Cited by 18 publications

References 95 publications

Application of Metagenomic Next-Generation Sequencing in the Etiological Diagnosis of Infective Endocarditis During the Perioperative Period of Cardiac Surgery: A Prospective Cohort Study

Application of Metagenomic Next-Generation Sequencing in the Etiological Diagnosis of Infective Endocarditis During the Perioperative Period of Cardiac Surgery: A Prospective Cohort Study

Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

Salvage heart transplantation for Mycoplasma hominis prosthetic valve endocarditis: A case report and review of the literature

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