TY - JOUR
T1 - Fluorescence in situ hybridization for detecting Coxiella burnetii in tissue samples from chronic Q fever patients
AU - Buijs, Sheila B.
AU - Weehuizen, Jesper M.
AU - Jensen, Tim K.
AU - Boye, Mette
AU - Hermans, Mirjam HA
AU - Nooijen, Peet TGA
AU - Hoepelman, Andy IM
AU - Bleeker-Rovers, Chantal P.
AU - Oosterheert, Jan Jelrik
AU - Wever, Peter C.
N1 - Funding Information:
We gratefully acknowledge Jan Damen from the Jeroen Bosch Hospital for his time and effort in collecting and preparing the samples, Anne Jansen, Konnie Hebeda and Jannette Rahamat-Langendoen from the Radboud UMC for their time and effort in collecting the samples and Susannah Primdahl and Godelind Wolf-Jäckel from the National Veterinary Institute in Denmark for their time, effort, and help during the FISH procedure. The results of this study were presented during the ECCMID 2022.
Publisher Copyright:
© 2022 The Authors
PY - 2022/11
Y1 - 2022/11
N2 - Objective: Detection of the intracellular bacterium Coxiella burnetii, causative agent of chronic Q fever, is notoriously difficult. Diagnosis of and duration of antibiotic treatment for chronic Q fever is partly determined by detection of the bacterium with polymerase chain reaction (PCR). Fluorescence in situ hybridization (FISH) might be a promising technique for detecting C. burnetii in tissue samples from chronic Q fever patients, but its value in comparison with PCR is uncertain. We aim to assess the value of FISH for detecting C. burnetii in tissue of chronic Q fever patients. Methods: FISH and PCR were performed on tissue samples from Dutch chronic Q fever patients collected during surgery or autopsy. Sensitivity, specificity, and overall diagnostic accuracy were calculated. Additionally, data on patient and disease characteristics were collected from electronic medical records. Results: In total, 49 tissue samples from mainly vascular walls, heart valves, or placentas, obtained from 39 chronic Q fever patients, were examined by FISH and PCR. The sensitivity and specificity of FISH compared to PCR for detecting C. burnetii in tissue samples from chronic Q fever patients was 45.2% (95% confidence interval (CI), 27.3% – 64.0%) and 84.6% (95% CI, 54.6% – 98.1%), respectively. The overall diagnostic accuracy was 56.8% (95% CI, 42.2% - 72.3%). Two C. burnetii PCR negative placentas were FISH positive. Four FISH results (8.2%) were deemed inconclusive because of autofluorescence. Conclusion: With an overall diagnostic accuracy of 57.8%, we conclude that FISH has limited value in the routine diagnostics of chronic Q fever.
AB - Objective: Detection of the intracellular bacterium Coxiella burnetii, causative agent of chronic Q fever, is notoriously difficult. Diagnosis of and duration of antibiotic treatment for chronic Q fever is partly determined by detection of the bacterium with polymerase chain reaction (PCR). Fluorescence in situ hybridization (FISH) might be a promising technique for detecting C. burnetii in tissue samples from chronic Q fever patients, but its value in comparison with PCR is uncertain. We aim to assess the value of FISH for detecting C. burnetii in tissue of chronic Q fever patients. Methods: FISH and PCR were performed on tissue samples from Dutch chronic Q fever patients collected during surgery or autopsy. Sensitivity, specificity, and overall diagnostic accuracy were calculated. Additionally, data on patient and disease characteristics were collected from electronic medical records. Results: In total, 49 tissue samples from mainly vascular walls, heart valves, or placentas, obtained from 39 chronic Q fever patients, were examined by FISH and PCR. The sensitivity and specificity of FISH compared to PCR for detecting C. burnetii in tissue samples from chronic Q fever patients was 45.2% (95% confidence interval (CI), 27.3% – 64.0%) and 84.6% (95% CI, 54.6% – 98.1%), respectively. The overall diagnostic accuracy was 56.8% (95% CI, 42.2% - 72.3%). Two C. burnetii PCR negative placentas were FISH positive. Four FISH results (8.2%) were deemed inconclusive because of autofluorescence. Conclusion: With an overall diagnostic accuracy of 57.8%, we conclude that FISH has limited value in the routine diagnostics of chronic Q fever.
KW - Chronic Q fever
KW - Coxiella burnetii
KW - diagnosis
KW - Fluorescence in situ hybridization
KW - Polymerase chain reaction
UR - http://www.scopus.com/inward/record.url?scp=85136091440&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2022.06.015
DO - 10.1016/j.cmi.2022.06.015
M3 - Article
C2 - 35724869
AN - SCOPUS:85136091440
SN - 1198-743X
VL - 28
SP - 1502.e1-1502.e5
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 11
ER -