Value of polymerase chain reaction in etiological diagnostic of infectiove endocarditis

Abstract Introduction Identification of a causative agent in patients with infective endocarditis (IE) is crucial for diagnostic and prescribing etiotropic therapy which defines positive outcome disease. High rate culture negative IE inaccurate results traditional microbiological methods raise concern. So the etiological diagnostics are need development, particularly introduction polymerase chain reaction (PCR) method might be helpful. Aim Modernisation algorithm by introducing PCR Materials The study included 85 cases [first episode (n=79), recurrence/relapse (n=6)] verified DUKE criteria 2009, 2015, hospitalized Moscow primary hospital from 2012 to 2017. All patient had venous blood investigated both broadrange specific PCR. Following microorganisms' DNA were assessed PCR: Staphylococcus spp. (MRCoNS, S. aureus others), Streptococcus (S. agalactiae, pyogenes Enterococcus (E. faecium, E. faecalis Enterobacteriaceae, Klebsiella (K. pneumoniae coli, Proteus spp., A. baumanii, P. aeruginosa, Fungi (C. albicans, C. glabrata, Aspergillus others). Results Median age was 55.48 years (95% confidence interval (CI) 51.16–59.8), males 67.9%. History cardiovascular diseases 54 (68.35%), diabetes mellitus 18 (22.78%), hepatitis B and/or C 31 (39.2%), intravenous drug dependency 27 (34.18%), chronic kidney disease 38 (48.1%), median Charlson comorbidity index 5.44 CI 4.52–6.37). Left-side 50 (63.29%), right-side – 23 (29.12%), left-right-side 6 (7.59%). Secondary 53 (62.3%). Embolic events diagnosed in-hospital mortality 22 (27.8%). Microbiological identified 55 (61.2%), featuring (n=23), CoNS (n=6), Escherichia coli (n=1), Acinetobacter (n=2), (n=8), Gemella haemolysans several agents (n=6). Additional testing etiology 14 33 (42.2%) (n=3), sp. (n=1) Pasteurella multocida + spp.+ baumanii (n=1). fals-positive microbilogical investigation [S. epidermidis G. haemolysans, faecalis, K. pneumoniae], that most probably due preanalytical sample contamination Conclusions into increased validity laboratory findings on 23.5%. True present 19 patients. Rate complications remains high. FUNDunding Acknowledgement Type funding sources: Public Institution(s). Main source(s): Peoples' Friendship University Russia (RUDN), Moscow,