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Sonication of heart valves detects more bacteria in infective endocarditis

Anna Gomes1, Marleen van Oosten2, Kasper L B Bijker2

  • 1Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. a.gomes@umcg.nl.

Scientific Reports
|August 30, 2018
PubMed

Insights

Sonication of explanted heart valves significantly improves pathogen identification for infective endocarditis (IE). This method doubles culture positives, aiding antimicrobial susceptibility testing and enhancing diagnosis beyond molecular methods.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Accurate pathogen identification and antimicrobial susceptibility are crucial for treating infective endocarditis (IE).
  • Sonication has shown promise in recovering pathogens from prosthetic devices in other infections.
  • The diagnostic yield of standard methods for IE can be limited.

Purpose of the Study:

  • To prospectively evaluate the added diagnostic value of sonication of explanted heart valves in patients with active definite IE.
  • To compare two sonication protocols (broth enrichment vs. centrifugation) for pathogen recovery and contamination rates.

Main Methods:

  • Twenty-six explanted heart valves from IE patients were processed using standard microbiology plus sonication/centrifugation.
  • Two sonication protocols were tested on 35 negative control valves to assess contamination.
  • Molecular testing was also incorporated into the analysis.

Main Results:

  • Sonication/centrifugation significantly increased the diagnostic yield from 6/26 to 17/26 valves (p=0.003) compared to direct culture alone.
  • Culture positives nearly doubled (from 6 to 10), providing essential antimicrobial susceptibility data.
  • Sonication/centrifugation provided additional diagnostic information in 31% of cases (8/26; p=0.013), even when molecular testing was used.

Conclusions:

  • Sonication followed by centrifugation is a valuable adjunctive method for diagnosing infective endocarditis from explanted heart valves.
  • This technique enhances pathogen detection and provides crucial antimicrobial susceptibility information.
  • The method offers acceptable contamination rates, making it a relevant addition to the diagnostic workup.

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