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Abstract：
Endocarditis and vascular infections are common manifestations of persistent localized infection due to Coxiella burnetii, and recently, fluorescence in situ hybridization (FISH) was proposed as an alternative tool for their diagnosis. In this study, we evaluated the efficiency of FISH in a series of valve and vascular samples infected by C. burnetii We tested 23 C. burnetii-positive valves and thrombus samples obtained from patients with Q fever endocarditis. Seven aneurysms and thrombus specimens were retrieved from patients with Q fever vascular infections. Samples were analyzed by culture, immunochemistry, and FISH with oligonucleotide and PNA probes targeting C. burnetii-specific 16S rRNA sequences. The immunohistochemical analysis was positive for five (17%) samples with significantly more copies of C. burnetii DNA than the negative ones (P = 0.02). FISH was positive for 13 (43%) samples and presented 43% and 40% sensitivity compared to that for quantitative PCR (qPCR) and culture, respectively. PNA FISH detected C. burnetii in 18 (60%) samples and presented 60% and 55% sensitivity compared to that for qPCR and culture, respectively. Immunohistochemistry had 38% and 28% sensitivity compared to that for FISH and PNA FISH, respectively. Samples found positive by both immunohistochemistry and PNA FISH contained significantly more copies of C. burnetii DNA than the negative ones (P = 0.03). Finally, PNA FISH was more sensitive than FISH (60% versus 43%, respectively) for the detection of C. burnetii We provide evidence that PNA FISH and FISH are important assays for the diagnosis of C. burnetii endocarditis and vascular infections.
摘要：
心内膜炎和血管感染是由于伯氏柯西氏菌引起的持续性局部感染的常见表现。最近,建议将荧光原位杂交（FISH）作为其诊断的替代工具。在这项研究中,我们评估了FISH在一系列被C.burnetii感染的瓣膜和血管样本中的效率。我们测试了从Q发热心内膜炎患者获得的23例C.burnetii阳性瓣膜和血栓样本。从Q发烧血管感染患者中检索到7个动脉瘤和血栓标本。通过培养分析样品，免疫化学，和FISH，寡核苷酸和PNA探针靶向布氏梭菌特异性16SrRNA序列。5个（17％）样品的免疫组织化学分析为阳性，与阴性的C.burnetiiDNA拷贝明显更多（P=0.02）。与定量PCR（qPCR）和培养相比，FISH对13（43％）样品呈阳性，灵敏度分别为43％和40％。分别。PNAFISH在18个（60％）样品中检测到C.burnetii，与qPCR和培养相比，灵敏度分别为60％和55％，分别。与FISH和PNAFISH相比，免疫组织化学的敏感性分别为38％和28％，分别。通过免疫组织化学和PNAFISH发现阳性的样品比阴性的样品含有明显更多的伯氏梭菌DNA拷贝(P=0.03)。最后,PNAFISH比FISH更敏感(60%对43%，分别）用于检测C.burnetii我们提供了证据，证明PNAFISH和FISH是诊断C.burnetii心内膜炎和血管感染的重要检测方法。
