PCR-Electrospray Ionization Mass Spectrometry for Direct Detection of Pathogens and Antimicrobial Resistance from Heart Valves in Patients with Infective Endocarditis |
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| Authors: | 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 Robin Patel |
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| Affiliation: | Division of Clinical Microbiology, Department of Laboratory Medicine and Pathologya;Division of Infectious Diseases, Department of Internal Medicineb;Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology,c Mayo Clinic, Rochester, Minnesota, USA;Ibis Biosciences, Abbott, Carlsbad, California, USAd |
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| Abstract: | ![]()
Microbiological 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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