The aim was to evaluate 16S rDNA sequencing in heart valves in patients with infective endocarditis undergoing surgery.
Fifty-seven patients with infective endocarditis were examined in this prospective study by analysing heart valves with 16S rDNA sequencing and culturing methods and comparing the results to blood cultures. As controls, heart valves from 61 patients without any signs of endocarditis were examined.
All together 77% of the endocarditis patients were positive for 16S rDNA, 84% had positive blood cultures and 23% had positive cultures from heart valves, whereas only 16% of the cultures from heart valves were concordant with results from blood cultures or 16S rDNA. Concordant results between 16S rDNA sequencing and blood cultures were found in 75% patients. All controls were negative for 16S rDNA. In 4 out of 9 patients with negative blood cultures, the aetiology was established by 16S rDNA alone, i.e. viridans group streptococci.
In this Swedish study, 16S rDNA sequencing of valve material was shown to be a valuable addition in blood culture-negative cases. The value of heart valve culture was low. Molecular diagnosis using 16S rDNA sequencing should be recommended in patients undergoing valve replacement for infective endocarditis.
The purpose was to compare the prevalence of healthcare-associated infections (HAI) in the Swedish point prevalence survey with an assessment using the European Centre of Disease Prevention and Control (ECDC) definitions of HAI. A total of 1247 patients were included from three Swedish hospitals. The prevalence of HAI was higher in the Swedish survey as compared to when using the ECDC definitions. The correspondence between results according to Swedish and ECDC protocols was better in Region Västerbotten than at Karolinska University Hospital. In Västerbotten, but not at Karolinska University Hospital, quality control was performed on collected data in the Swedish point prevalence survey. The study highlights the importance of expert knowledge of HAI and quality control to obtain valid survey results.