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Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection.
J Clin Microbiol. 2004 Nov; 42(11):4919-24.JC

Abstract

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 degrees 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 > or =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.

Authors+Show Affiliations

Unité des rickettsies, IFR 48 CNRS UMR 6020, Faculté de médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille cedex 5, France.No affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

15528674

Citation

Fenollar, F, et al. "Molecular Detection of Coxiella Burnetii in the Sera of Patients With Q Fever Endocarditis or Vascular Infection." Journal of Clinical Microbiology, vol. 42, no. 11, 2004, pp. 4919-24.
Fenollar F, Fournier PE, Raoult D. Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection. J Clin Microbiol. 2004;42(11):4919-24.
Fenollar, F., Fournier, P. E., & Raoult, D. (2004). Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection. Journal of Clinical Microbiology, 42(11), 4919-24.
Fenollar F, Fournier PE, Raoult D. Molecular Detection of Coxiella Burnetii in the Sera of Patients With Q Fever Endocarditis or Vascular Infection. J Clin Microbiol. 2004;42(11):4919-24. PubMed PMID: 15528674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection. AU - Fenollar,F, AU - Fournier,P E, AU - Raoult,D, PY - 2004/11/6/pubmed PY - 2005/1/28/medline PY - 2004/11/6/entrez SP - 4919 EP - 24 JF - Journal of clinical microbiology JO - J Clin Microbiol VL - 42 IS - 11 N2 - 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 degrees 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 > or =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. SN - 0095-1137 UR - https://www.unboundmedicine.com/medline/citation/15528674/Molecular_detection_of_Coxiella_burnetii_in_the_sera_of_patients_with_Q_fever_endocarditis_or_vascular_infection_ L2 - https://journals.asm.org/doi/10.1128/JCM.42.11.4919-4924.2004?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -