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08:47
Culturing Mouse Cardiac Valves in the Miniature Tissue Culture System
Published on: October 19, 2015
Heart valves should not be routinely cultured
Patricia Muñoz1, Emilio Bouza, Mercedes Marín
1Department of Clinical Microbiology-Infectious Diseases, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo 46, 28007 Madrid, Spain. pmunoz@micro.hggm.es
Journal of Clinical Microbiology
|July 18, 2008
Summary
Heart valve cultures have low sensitivity and positive predictive value for diagnosing infectious endocarditis (IE). Routine valve cultures are not recommended for patients without suspected IE, and results for confirmed IE cases require cautious interpretation.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Microbiology
Background:
- Heart valve (HV) culture is a Duke criterion for infectious endocarditis (IE) diagnosis.
- Previous studies indicate low sensitivity (7.8-17.6%) and potential contamination of HV cultures.
- The diagnostic value of routine HV cultures in patients with and without IE needs clarification.
Purpose of the Study:
- To evaluate the utility of routine heart valve cultures in diagnosing infectious endocarditis.
- To determine the sensitivity, specificity, and predictive values of heart valve cultures for IE.
- To assess the impact of prior antimicrobial therapy on heart valve culture results.
Main Methods:
- Systematic culturing of 1,101 resected heart valves from 2004-2006.
- IE diagnosis based on Duke criteria and broad-range PCR on valve specimens for blood culture-negative cases.
- Analysis of culture results stratified by IE and non-IE patient groups.
Main Results:
- Overall, 29.2% of cultures were positive (39.4% in IE, 28.4% in non-IE).
- Sensitivity for IE diagnosis was 25.4%, specificity 71.6%, PPV 5.8%, and NPV 93.3%.
- All IE patients with negative cultures had received prior antimicrobial therapy.
Conclusions:
- Heart valve cultures exhibit poor sensitivity and positive predictive value for IE diagnosis.
- Routine HV cultures are not recommended for patients without clinical suspicion of IE.
- For confirmed IE cases, heart valve culture results should be interpreted cautiously, especially if antimicrobial therapy was administered.
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