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Journal of Clinical Microbiology, January 2005, p. 163-167, Vol. 43, No. 1
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.1.163-167.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

PCR Detection of Bacteria on Cardiac Valves of Patients with Treated Bacterial Endocarditis

Clarisse Rovery,1 Gilbert Greub,1 Hubert Lepidi,1 Jean-Paul Casalta,1 Gilbert Habib,2 Frédéric Collart,3 and Didier Raoult1*

Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée,1 Service de Cardiologie,2 Service de Chirurgie Cardiaque, Hôpital de la Timone, Marseille, France3

Received 12 May 2004/ Returned for modification 30 August 2004/ Accepted 1 September 2004

We used broad-range PCR amplification and sequencing to detect and identify bacterial DNA in 156 valves of patients treated for infective endocarditis (IE). Bacterial DNA was found more frequently in patients who underwent valve replacement while on antibiotic treatment for IE (60%) than in patients who had completed antibiotic treatment for IE (37%; P = 0.02). We found specific bacterial DNA in valves removed from 11 of 30 patients who had completed antibiotic treatment for IE. Six had no histological evidence of IE. The presence of DNA was significantly correlated with the presence of histologic lesions (P = 0.001) and with the presence of bacteria detected by Gram staining (P < 0.001). Bartonella and streptococci were detected for much longer after antibiotic treatment by PCR than other species (P = 0.047 and 0.04, respectively), and coagulase-negative staphylococci were detected for much shorter periods (P = 0.02). The finding that bacterial DNA was more likely to be detected in valves of patients with active IE than in patients who had completed antibiotic treatment for IE shows that bacterial DNA is cleared slowly. There was no significant correlation between the duration of antibiotic therapy and the presence of bacterial DNA in valves. Since the persistence of bacterial DNA in valves does not necessarily indicate the persistence of viable bacteria, the detection of bacterial DNA in valves from IE patients should be interpreted with caution, in particular in those patients with a past history of treated IE.

* Corresponding author. Mailing address: Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, 27 Blvd. Jean Moulin, 13385 Marseille, France. Phone: (00) 33.491.32.43.75. Fax: (00) 33.491.83.03.90. E-mail: didier.raoult{at}medecine.univ-mrs.fr.

Journal of Clinical Microbiology, January 2005, p. 163-167, Vol. 43, No. 1
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.1.163-167.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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