Department of Clinical Microbiology, Karolinska University Hospital and Department of Clinical Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
J Infect. 2011 Jun;62(6):472-8. doi: 10.1016/j.jinf.2011.04.010. Epub 2011 May 1.
The aim was to evaluate 16S rDNA sequencing in heart valves in patients with infective endocarditis undergoing surgery.
Fifty-seven patients with infective endocarditis were examined in this prospective study by analysing heart valves with 16S rDNA sequencing and culturing methods and comparing the results to blood cultures. As controls, heart valves from 61 patients without any signs of endocarditis were examined.
All together 77% of the endocarditis patients were positive for 16S rDNA, 84% had positive blood cultures and 23% had positive cultures from heart valves, whereas only 16% of the cultures from heart valves were concordant with results from blood cultures or 16S rDNA. Concordant results between 16S rDNA sequencing and blood cultures were found in 75% patients. All controls were negative for 16S rDNA. In 4 out of 9 patients with negative blood cultures, the aetiology was established by 16S rDNA alone, i.e. viridans group streptococci.
In this Swedish study, 16S rDNA sequencing of valve material was shown to be a valuable addition in blood culture-negative cases. The value of heart valve culture was low. Molecular diagnosis using 16S rDNA sequencing should be recommended in patients undergoing valve replacement for infective endocarditis.
评估在接受手术的感染性心内膜炎患者的心脏瓣膜中进行 16S rDNA 测序的效果。
在这项前瞻性研究中，通过分析心脏瓣膜的 16S rDNA 测序和培养方法，对 57 例感染性心内膜炎患者进行了检查，并将结果与血培养进行了比较。作为对照，检查了 61 例无任何心内膜炎迹象的患者的心脏瓣膜。
所有心内膜炎患者中有 77% 的 16S rDNA 阳性，84% 的血培养阳性，23% 的心脏瓣膜培养阳性，而只有 16%的心脏瓣膜培养与血培养或 16S rDNA 结果一致。16S rDNA 测序和血培养在 75%的患者中有一致的结果。所有对照均为 16S rDNA 阴性。在 9 例血培养阴性的患者中，有 4 例通过 16S rDNA 单独确定了病因，即草绿色链球菌。
在这项瑞典研究中，瓣膜材料的 16S rDNA 测序被证明是血培养阴性病例的一个有价值的补充。心脏瓣膜培养的价值较低。对于因感染性心内膜炎而接受瓣膜置换的患者，建议使用 16S rDNA 测序进行分子诊断。
