PCR-electrospray ionization mass spectrometry for direct detection of pathogens and antimicrobial resistance from heart valves in patients with infective endocarditis

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

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Microbiological diagnosis is pivotal to the appropriate management and treatment of infective endocarditis. We evaluated PCRelectrospray ionization mass spectrometry (PCR/ESI-MS) for bacterial and candidal detection using 83 formalin-fixed paraffinembedded 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.

Original languageEnglish (US)
Pages (from-to)2040-2046
Number of pages7
JournalJournal of clinical microbiology
Volume51
Issue number7
DOIs
StatePublished - Jul 2013

ASJC Scopus subject areas

  • Microbiology (medical)

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