Buijs Sheila B, Weehuizen Jesper M, Jensen Tim K, Boye Mette, Hermans Mirjam Ha, Nooijen Peet Tga, Hoepelman Andy Im, Bleeker-Rovers Chantal P, Oosterheert Jan Jelrik, Wever Peter C
Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Clin Microbiol Infect. 2022 Nov;28(11):1502.e1-1502.e5. doi: 10.1016/j.cmi.2022.06.015. Epub 2022 Jun 17.
Detection of the intracellular bacterium Coxiella burnetii, causative agent of chronic Q fever, is notoriously difficult. Diagnosis of and duration of antibiotic treatment for chronic Q fever is partly determined by detection of the bacterium with polymerase chain reaction (PCR). Fluorescence in situ hybridization (FISH) might be a promising technique for detecting C. burnetii in tissue samples from chronic Q fever patients, but its value in comparison with PCR is uncertain. We aim to assess the value of FISH for detecting C. burnetii in tissue of chronic Q fever patients.
FISH and PCR were performed on tissue samples from Dutch chronic Q fever patients collected during surgery or autopsy. Sensitivity, specificity, and overall diagnostic accuracy were calculated. Additionally, data on patient and disease characteristics were collected from electronic medical records.
In total, 49 tissue samples from mainly vascular walls, heart valves, or placentas, obtained from 39 chronic Q fever patients, were examined by FISH and PCR. The sensitivity and specificity of FISH compared to PCR for detecting C. burnetii in tissue samples from chronic Q fever patients was 45.2% (95% confidence interval (CI), 27.3% - 64.0%) and 84.6% (95% CI, 54.6% - 98.1%), respectively. The overall diagnostic accuracy was 56.8% (95% CI, 42.2% - 72.3%). Two C. burnetii PCR negative placentas were FISH positive. Four FISH results (8.2%) were deemed inconclusive because of autofluorescence.
With an overall diagnostic accuracy of 57.8%, we conclude that FISH has limited value in the routine diagnostics of chronic Q fever.
检测细胞内细菌伯纳特立克次体（慢性Q热的病原体）极为困难。慢性Q热的诊断及抗生素治疗时长部分取决于通过聚合酶链反应（PCR）检测该细菌。荧光原位杂交（FISH）可能是检测慢性Q热患者组织样本中伯纳特立克次体的一种有前景的技术，但其与PCR相比的价值尚不确定。我们旨在评估FISH在检测慢性Q热患者组织中伯纳特立克次体的价值。
对荷兰慢性Q热患者手术或尸检时采集的组织样本进行FISH和PCR检测。计算敏感性、特异性和总体诊断准确性。此外，从电子病历中收集患者和疾病特征数据。
总共对39例慢性Q热患者的49份主要来自血管壁、心脏瓣膜或胎盘的组织样本进行了FISH和PCR检测。与PCR相比，FISH检测慢性Q热患者组织样本中伯纳特立克次体的敏感性和特异性分别为45.2%（95%置信区间（CI），27.3% - 64.0%）和84.6%（95%CI，54.6% - 98.1%）。总体诊断准确性为56.8%（95%CI，42.2% - 72.3%）。两份伯纳特立克次体PCR阴性的胎盘FISH检测呈阳性。由于自发荧光，4份FISH结果（8.
