Next Article in Journal
Volatile Compounds in Honey: A Review on Their Involvement in Aroma, Botanical Origin Determination and Potential Biomedical Activities
Previous Article in Journal
Modeling Natural Anti-Inflammatory Compounds by Molecular Topology

Q Fever Endocarditis in Romania: The First Cases Confirmed by Direct Sequencing

National Institute for Research in Microbiology and Immunology, Cantacuzino, Spl. Independentei 103, 050096, Bucharest, Romania
Institute for Emergency Cardiovascular Diseases Prof. C.C. Iliescu, Sos. Fundeni 258, 022328, Bucharest, Romania
Institute for Cardiovascular Diseases and Transplant Targu Mures, Str. Gheorghe Marinescu 50, 540136, Targu Mures, Mures, Romania
University of Medicine and Pharmacy Targu Mures, Str. Gheorghe Marinescu 38, 540139, Targu Mures, Mures, Romania
Institute for Cardiovascular Diseases Timisoara, Str. Gheorghe Adam, 13A, 300310, Timişoara, Timis, Romania
Clinical Hospital for Infectious Diseases Cluj-Napoca, Str. Iuliu Moldovan 23, 400348, Cluj-Napoca, Cluj, Romania
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2011, 12(12), 9504-9513;
Received: 18 November 2011 / Revised: 9 December 2011 / Accepted: 12 December 2011 / Published: 20 December 2011
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
Infective endocarditis (IE) is a serious, life-threatening disease with highly variable clinical signs, making its diagnostic a real challenge. A diagnosis is readily made if blood cultures are positive, but in 2.5 to 31% of all infective endocarditis cases, routine blood cultures are negative. In such situations, alternative diagnostic approaches are necessary. Coxiella burnetii and Bartonella spp. are the etiological agents of blood culture-negative endocarditis (BCNE) most frequently identified by serology. The purpose of this study is to investigate the usefulness of molecular assays, as complementary methods to the conventional serologic methods for the rapid confirmatory diagnostic of Q fever endocarditis in patients with BCNE. Currently, detection of C. burnetii by culture or an antiphase I IgG antibody titers >800 represents a major Duke criterion for defining IE, while a titers of >800 for IgG antibodies to either B. henselae or B. quintana is used for the diagnosis of endocarditis due to Bartonella spp. We used indirect immunofluorescence assays for the detection of IgG titers for C. burnetii, B. henselae and B. quintana in 57 serum samples from patients with clinical suspicion of IE. Thirty three samples originated from BCNE patients, whereas 24 were tested before obtaining the blood cultures results, which finally were positive. The results of serologic testing showed that nine out of 33 BCNE cases exhibited antiphase I C. burnetii IgG antibody titer >800, whereas none has IgG for B. henselae or B. quintana. Subsequently, we used nested-PCR assay for the amplification of C. burnetii DNA in the nine positive serum samples, and we obtained positive PCR results for all analyzed cases. Afterwards we used the DNA sequencing of amplicons for the repetitive element associated to htpAB gene to confirm the results of nested-PCR. The results of sequencing allowed us to confirm that C. burnetii is the causative microorganism responsible for BCNE. In conclusion, the nested PCR amplification followed by direct sequencing is a reliable and accurate method when applied to serum samples, and it may be used as an additional test to the serological methods for the confirmatory diagnosis of BCNE cases determined by C. burnetii. View Full-Text
Keywords: chronic Q fever; blood culture-negative endocarditis; molecular diagnosis chronic Q fever; blood culture-negative endocarditis; molecular diagnosis
Show Figures

MDPI and ACS Style

Cotar, A.I.; Badescu, D.; Oprea, M.; Dinu, S.; Banu, O.; Dobreanu, D.; Dobreanu, M.; Ionac, A.; Flonta, M.; Straut, M. Q Fever Endocarditis in Romania: The First Cases Confirmed by Direct Sequencing. Int. J. Mol. Sci. 2011, 12, 9504-9513.

AMA Style

Cotar AI, Badescu D, Oprea M, Dinu S, Banu O, Dobreanu D, Dobreanu M, Ionac A, Flonta M, Straut M. Q Fever Endocarditis in Romania: The First Cases Confirmed by Direct Sequencing. International Journal of Molecular Sciences. 2011; 12(12):9504-9513.

Chicago/Turabian Style

Cotar, Ani Ioana, Daniela Badescu, Mihaela Oprea, Sorin Dinu, Otilia Banu, Dan Dobreanu, Minodora Dobreanu, Adina Ionac, Mirela Flonta, and Monica Straut. 2011. "Q Fever Endocarditis in Romania: The First Cases Confirmed by Direct Sequencing" International Journal of Molecular Sciences 12, no. 12: 9504-9513.

Find Other Styles

Article Access Map by Country/Region

Only visits after 24 November 2015 are recorded.
Back to TopTop