Abstract
Infective endocarditis (IE) is a serious infection of the endocardium and heart valves that necessitate early diagnosis. The conventional blood culture has lots of false-negative results besides being time consuming. Polymerase chain reaction (PCR) is a rapid diagnostic tool that helps in saving the patients’ life. This study aimed to investigate the feasibility of multiplex PCR in early diagnosis of IE compared to the conventional blood culture, and to evaluate its impact on IE diagnosis in cases of negative blood cultures. The current study was conducted on 30 patients admitted to the Cardiology Department, Faculty of Medicine, Ain Shams Hospitals, Cairo, Egypt, which were diagnosed clinically as infective endocarditis according to the modified Duke’s criteria. After processing of the patient's blood samples, the blood cultures recorded positivity in 5 cases (16.7 %). The most common recovered bacteria were, Staphylococcus aureus 2(6.7 %), Staphylococcus epidermedis 1(3.3 %), Enterococcus faecalis 1(3.3 %), and Escherichia coli 1(3.3 %); however, no other pathogens were isolated. On the other hand, results of multiplex PCR showed positivity in 13 cases (43.3 %), mainly; Staphylococcus aureus 5(16.7 %), E. faecalis 3(10 %), Staphylococcus epidermidis 2(6.7 %), Pseudomonas aeruginosa 2(6.7 %), and E. coli 1(3.3 %). No other bacterial of fungal pathogens were detected by multiplex PCR. Finally, the multiplex PCR assay exhibited remarkable sensitivity and feasibility in IE diagnosis over blood culture, besides being a rapid and accurate diagnostic assay that enhances proper treatment.
Highlights
Infective endocarditis (IE) is a microbial infection of the endothelial lining of the heart, it continues to be a non-widespread condition; it showed elevated levels of associated morbidity and mortalityNovel Research in Microbiology Journal, 2021Eltantawy et al, 2021(Rajani and Klein, 2020)
Blood culture was positive in 5 patients that represented 16.7 % of total patients
The first was Staph. aureus that was demonstrated in 2 cases (6.7 %), and represented the highest detectable microorganism in the blood culture
Summary
Infective endocarditis (IE) is a microbial infection of the endothelial lining of the heart, it continues to be a non-widespread condition; it showed elevated levels of associated morbidity and mortalityNovel Research in Microbiology Journal, 2021Eltantawy et al, 2021(Rajani and Klein, 2020). Infective endocarditis (IE) is a microbial infection of the endothelial lining of the heart, it continues to be a non-widespread condition; it showed elevated levels of associated morbidity and mortality. Infective endocarditis (IE) encompasses native, prosthetic valves or any intracardiac devices within the heart. A study conducted by Iung and Duval, (2019) highlighted that in spite of the advances in diagnostic methods; the advent of antibiotic therapy and the performance of valvular surgery during acute infection; the prognosis for IE remain poor, this supports the attempts to improve early diagnosis, therapeutic management and prevention of microbial infection. The incidence of IE averages 1.7-6.2 cases in every 100 000 individuals per year. Rizk et al, (2019) revealed that neither the incidence nor the mortality of IE have declined in the previous 20 year
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