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Journal of Clinical Microbiology, November 2004, p. 4919-4924, Vol. 42, No. 11
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.11.4919-4924.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Molecular Detection of Coxiella burnetii in the Sera of Patients with Q Fever Endocarditis or Vascular Infection

F. Fenollar, P. E. Fournier, and D. Raoult*

Unité des rickettsies, IFR 48 CNRS UMR 6020, Faculté de médecine, Université de la Méditerranée, Marseille, France

Received 30 January 2004/ Returned for modification 28 June 2004/ Accepted 9 August 2004

In the absence of a specific diagnosis based on serology, chronic Q fever is inevitably fatal. However, diagnosis is often delayed because the test is not widely available. To shorten the diagnostic delay, we adapted a nested-PCR assay with serum as a template and the LightCycler as a thermal cycler, termed LCN-PCR. We retrospectively and prospectively applied this method to samples from 48 patients diagnosed with Q fever endocarditis or vascular infection and to samples from 100 controls with endocarditis caused by other microorganisms. We also prospectively applied this technique to samples from 30 patients treated for a Q fever endocarditis and to samples from 13 patients with a convalescent acute Q fever with ambiguous immunoglobulin G (IgG) phase I titer. LCN-PCR had a specificity of 100%. It was positive only in samples from patients with evolutive Q fever, as none of the samples from patients with a treated chronic Q fever or with a convalescent acute Q fever presented positive results. When performed prospectively on recently stored sera, the sensitivity of LCN-PCR is 64% (7 of 11 samples; P = 0.004), but the efficiency of LCN-PCR was dramatically altered by the storage of specimens at –20°C. High IgG phase I titers decreased the sensitivity of LCN-PCR. A significant difference was observed among LCN-PCR results for sera with IgG phase I titers of ≥1:25,600 compared to sera with IgG phase I titers of <1:25,600 (0 of 15 samples versus 13 of 33 samples; P = 0.004). In patient samples with titers below 1:25,600 tested prospectively, sensitivity was 100% (7 of 7). The LCN-PCR assay may be helpful in establishing an early diagnosis of chronic Q fever.

* Corresponding author. Mailing address: Unité des rickettsies, IFR 48 CNRS UMR 6020, Faculté de médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille cedex 5, France. Phone: (33) 491 38 55 17. Fax: (33) 491 83 03 90. E-mail: Didier.Raoult{at}medecine.univ-mrs.fr.

Journal of Clinical Microbiology, November 2004, p. 4919-4924, Vol. 42, No. 11
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.11.4919-4924.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Karakousis, P. C., Trucksis, M., Dumler, J. S. (2006). Chronic q Fever in the United States.. J. Clin. Microbiol. 44: 2283-2287 [Abstract] [Full Text]  
  • Rolain, J.-M., Raoult, D., Marmion, B.P., Harris, R.J., Storm, P., Ayres, J.G. (2005). Molecular detection of Coxiella burnetii in blood and sera during Q fever. QJM 98: 615-620 [Full Text]  


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