Proof of Concept Evaluation of a New Diagnostic POCT Device for Culture- Independent Microbiological Diagnosis of Infective Endocarditis
/nƚƌŽĚƵÄƟŽn: Accurate and fast microbiological diagnosis of ÅnĨĞcÆŸvÄž ÄžnĚŽcÄ‚rÄšÅÆŸÆ (IE) is of vital importance for ƉĂƟĞnÆš outcome. Material & Methods: Forty cƵůƚƵrĞͲnÄžÅÄ‚ÆŸvÄž heart valves were evaluated with a new POCT mƵůƟƉůĞxͲWCZ cartridge (Unyvero™, CƵrÄžÆŸÆ AG, Holzgerlingen, Germany), Ä‚ÄšvÄžrÆŸÆĞĚ to detect several Gram ƉŽÆÅÆŸvĞͬnÄžÅÄ‚ÆŸvÄž bacteria and fungi, together with several Ä‚nÆŸbÅŽƟc resistance genes. Those POCT results were compared to cŽnvÄžnƟŽnĂů 16S rDNA PCR/sequencing results. Results: POCT mƵůƟƉůĞxͲWCZ was ƉŽÆÅÆŸvÄž in 13 cases. [Staphylococcus aureus (n=5), Enterococcus spp. / E. faecalis (n=5), ConS (n=1), Granulicatella adjacens (n=1), Abiotrophia adjacens (n=1)]. nÆŸbÅŽƟc resistances were found in 44 specimens, from which 2 specimens were without any pathogen ÅĚĞnÆŸÄ®cĂƟŽn͘ 16S rDNA PCR was ƉŽÆÅÆŸvÄž in 20 cases. CŽnÆÄžcƵƟvÄž sequencing ÅĚĞnƟĮĞĚ those as Staphylococcus spp. (n=6), Enterococcus faecalis (n=4), Streptococcus spp. (n=4), Leifsonia shinshuensis (n=1), Granulicatella elegans / G. adjacens (n=2), Abiotrophia adjacens (n=1). One case was ƉŽÆÅÆŸvÄž in 16S PCR without any reliable signal in sequencing. When comparing both methods, ÅĚĞnÆŸÄ®cĂƟŽn was consistent in 9 cases and divergent in other 9 cases. Discussion: This POCT cartridge is easy to integrate into the daily microbiology laboratory work ŇŽwÍ• and is less laborious than 16S sequencing PCR. For the ĂƉƉůÅcĂƟŽn in rŽƵƟnÄž IE diagnosis, the system needs to be ŽƉƟmÅnjĞĚ to include targets for viridans streptococci and HACEK group. In ĂĚĚÅƟŽnÍ• problems with invalid resistance and pathogen target ĚĞƚĞcƟŽn need to be Ä®xĞĚ by the producer. Conclusion: The analyzed POCT system might be a future ÄšÅÄ‚ÅnŽÆÆŸc tool for IE ĚĞƚĞcƟŽn following assay ŽƉƟmÅnjĂƟŽn͘