author_facet Eichinger, Simone
Kikhney, Judith
Moter, Annette
Wießner, Alexandra
Eichinger, Walter B
Eichinger, Simone
Kikhney, Judith
Moter, Annette
Wießner, Alexandra
Eichinger, Walter B
author Eichinger, Simone
Kikhney, Judith
Moter, Annette
Wießner, Alexandra
Eichinger, Walter B
spellingShingle Eichinger, Simone
Kikhney, Judith
Moter, Annette
Wießner, Alexandra
Eichinger, Walter B
Interactive CardioVascular and Thoracic Surgery
Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine
Surgery
author_sort eichinger, simone
spelling Eichinger, Simone Kikhney, Judith Moter, Annette Wießner, Alexandra Eichinger, Walter B 1569-9285 Oxford University Press (OUP) Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Surgery http://dx.doi.org/10.1093/icvts/ivz159 <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>In infective endocarditis (IE), identification of the causative organism and consecutive treatment are crucial for patient survival. Although the macroscopic aspect resembles infected tissue, standard diagnostic tests often fail to allow one to identify bacteria. Fluorescence in situ hybridization (FISH) is a molecular, culture-independent technique that allows one to identify and visualize microorganisms within tissue and to recognize their morphology, number and activity. We analysed the diagnostic benefit of FISH/polymerase chain reaction (PCR) by comparing its results to those of standard diagnostic tests.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>From September 2015 to April 2018, 128 patients underwent first-time or redo valve surgery to treat IE. Patients were designated according to the modified Duke criteria as definite (n = 61), possible (n = 34) or rejected (n = 33) IE. Tissue specimens obtained intraoperatively were analysed using FISH/PCR in addition to undergoing standard diagnostic testing and PCR alone.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>We used blood cultures to detect microorganisms in 67/128 patients; valve cultures, in 34/128; PCR, in 67/128; histopathological diagnosis showed IE in 72/128 cases. We were able to detect microorganisms in 103/128 cases using FISH/PCR, with 55/61 in definite IE. Furthermore, we were able to identify 26 cases of bacterial biofilm using FISH/PCR, despite antibiotic treatment of 61 in the definite, 13 in the possible and 1 in the rejected group, including 8/33 patients in the rejected group with active bacteria. In all cases, the patient’s therapy was altered.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>FISH/PCR was used to identify microorganisms in cases in which standard diagnostic tests failed to provide sufficient results for various reasons. Furthermore, FISH/PCR enabled us to identify bacterial biofilms and to differentiate between active versus degraded bacteria, thus indicating the impact of treatment. Therefore, we suggest FISH/PCR as an additional diagnostic tool in IE alongside standard diagnostic tests.</jats:p> </jats:sec> Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis Interactive CardioVascular and Thoracic Surgery
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title Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_unstemmed Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_full Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_fullStr Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_full_unstemmed Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_short Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_sort fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
topic Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine
Surgery
url http://dx.doi.org/10.1093/icvts/ivz159
publishDate 2019
physical 678-684
description <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>In infective endocarditis (IE), identification of the causative organism and consecutive treatment are crucial for patient survival. Although the macroscopic aspect resembles infected tissue, standard diagnostic tests often fail to allow one to identify bacteria. Fluorescence in situ hybridization (FISH) is a molecular, culture-independent technique that allows one to identify and visualize microorganisms within tissue and to recognize their morphology, number and activity. We analysed the diagnostic benefit of FISH/polymerase chain reaction (PCR) by comparing its results to those of standard diagnostic tests.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>From September 2015 to April 2018, 128 patients underwent first-time or redo valve surgery to treat IE. Patients were designated according to the modified Duke criteria as definite (n = 61), possible (n = 34) or rejected (n = 33) IE. Tissue specimens obtained intraoperatively were analysed using FISH/PCR in addition to undergoing standard diagnostic testing and PCR alone.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>We used blood cultures to detect microorganisms in 67/128 patients; valve cultures, in 34/128; PCR, in 67/128; histopathological diagnosis showed IE in 72/128 cases. We were able to detect microorganisms in 103/128 cases using FISH/PCR, with 55/61 in definite IE. Furthermore, we were able to identify 26 cases of bacterial biofilm using FISH/PCR, despite antibiotic treatment of 61 in the definite, 13 in the possible and 1 in the rejected group, including 8/33 patients in the rejected group with active bacteria. In all cases, the patient’s therapy was altered.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>FISH/PCR was used to identify microorganisms in cases in which standard diagnostic tests failed to provide sufficient results for various reasons. Furthermore, FISH/PCR enabled us to identify bacterial biofilms and to differentiate between active versus degraded bacteria, thus indicating the impact of treatment. Therefore, we suggest FISH/PCR as an additional diagnostic tool in IE alongside standard diagnostic tests.</jats:p> </jats:sec>
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author Eichinger, Simone, Kikhney, Judith, Moter, Annette, Wießner, Alexandra, Eichinger, Walter B
author_facet Eichinger, Simone, Kikhney, Judith, Moter, Annette, Wießner, Alexandra, Eichinger, Walter B, Eichinger, Simone, Kikhney, Judith, Moter, Annette, Wießner, Alexandra, Eichinger, Walter B
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container_issue 5
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container_title Interactive CardioVascular and Thoracic Surgery
container_volume 29
description <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>In infective endocarditis (IE), identification of the causative organism and consecutive treatment are crucial for patient survival. Although the macroscopic aspect resembles infected tissue, standard diagnostic tests often fail to allow one to identify bacteria. Fluorescence in situ hybridization (FISH) is a molecular, culture-independent technique that allows one to identify and visualize microorganisms within tissue and to recognize their morphology, number and activity. We analysed the diagnostic benefit of FISH/polymerase chain reaction (PCR) by comparing its results to those of standard diagnostic tests.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>From September 2015 to April 2018, 128 patients underwent first-time or redo valve surgery to treat IE. Patients were designated according to the modified Duke criteria as definite (n = 61), possible (n = 34) or rejected (n = 33) IE. Tissue specimens obtained intraoperatively were analysed using FISH/PCR in addition to undergoing standard diagnostic testing and PCR alone.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>We used blood cultures to detect microorganisms in 67/128 patients; valve cultures, in 34/128; PCR, in 67/128; histopathological diagnosis showed IE in 72/128 cases. We were able to detect microorganisms in 103/128 cases using FISH/PCR, with 55/61 in definite IE. Furthermore, we were able to identify 26 cases of bacterial biofilm using FISH/PCR, despite antibiotic treatment of 61 in the definite, 13 in the possible and 1 in the rejected group, including 8/33 patients in the rejected group with active bacteria. In all cases, the patient’s therapy was altered.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>FISH/PCR was used to identify microorganisms in cases in which standard diagnostic tests failed to provide sufficient results for various reasons. Furthermore, FISH/PCR enabled us to identify bacterial biofilms and to differentiate between active versus degraded bacteria, thus indicating the impact of treatment. Therefore, we suggest FISH/PCR as an additional diagnostic tool in IE alongside standard diagnostic tests.</jats:p> </jats:sec>
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spelling Eichinger, Simone Kikhney, Judith Moter, Annette Wießner, Alexandra Eichinger, Walter B 1569-9285 Oxford University Press (OUP) Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Surgery http://dx.doi.org/10.1093/icvts/ivz159 <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>In infective endocarditis (IE), identification of the causative organism and consecutive treatment are crucial for patient survival. Although the macroscopic aspect resembles infected tissue, standard diagnostic tests often fail to allow one to identify bacteria. Fluorescence in situ hybridization (FISH) is a molecular, culture-independent technique that allows one to identify and visualize microorganisms within tissue and to recognize their morphology, number and activity. We analysed the diagnostic benefit of FISH/polymerase chain reaction (PCR) by comparing its results to those of standard diagnostic tests.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>From September 2015 to April 2018, 128 patients underwent first-time or redo valve surgery to treat IE. Patients were designated according to the modified Duke criteria as definite (n = 61), possible (n = 34) or rejected (n = 33) IE. Tissue specimens obtained intraoperatively were analysed using FISH/PCR in addition to undergoing standard diagnostic testing and PCR alone.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>We used blood cultures to detect microorganisms in 67/128 patients; valve cultures, in 34/128; PCR, in 67/128; histopathological diagnosis showed IE in 72/128 cases. We were able to detect microorganisms in 103/128 cases using FISH/PCR, with 55/61 in definite IE. Furthermore, we were able to identify 26 cases of bacterial biofilm using FISH/PCR, despite antibiotic treatment of 61 in the definite, 13 in the possible and 1 in the rejected group, including 8/33 patients in the rejected group with active bacteria. In all cases, the patient’s therapy was altered.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>FISH/PCR was used to identify microorganisms in cases in which standard diagnostic tests failed to provide sufficient results for various reasons. Furthermore, FISH/PCR enabled us to identify bacterial biofilms and to differentiate between active versus degraded bacteria, thus indicating the impact of treatment. Therefore, we suggest FISH/PCR as an additional diagnostic tool in IE alongside standard diagnostic tests.</jats:p> </jats:sec> Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis Interactive CardioVascular and Thoracic Surgery
spellingShingle Eichinger, Simone, Kikhney, Judith, Moter, Annette, Wießner, Alexandra, Eichinger, Walter B, Interactive CardioVascular and Thoracic Surgery, Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Surgery
title Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_full Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_fullStr Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_full_unstemmed Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_short Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_sort fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
title_unstemmed Fluorescence in situ hybridization for identification and visualization of microorganisms in infected heart valve tissue as addition to standard diagnostic tests improves diagnosis of endocarditis
topic Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Surgery
url http://dx.doi.org/10.1093/icvts/ivz159