182. Clinical experience with Coxiella burnetii PCR
Session: Poster Abstract Session: Diagnostics: Bacteriology, Sequencing, and Resistance
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Coxiella PCR IDweek2016.pdf (323.3 kB)
  • Background:

    C. burnetii PCR, though not widely available, can be used in the diagnosis of Q fever. We have offered C. burnetii PCR to Mayo Clinic and Mayo Medical Laboratories patients since July 2013.

    Methods:

    We reviewed the clinical and laboratory data of those patients whose clinical specimens tested positive for C. burnetii PCR from July 2013 to May 2016.

    Results:

    A total of 1,065 C. burnetii PCR tests were performed. Among these, 625 (59%) were performed on serum, 293 (27%) on whole blood and 147 (14%) on other specimen sources. The test resulted positive in 10 (0.9%) samples from 8 patients. Most patients with positive results were men (7/8), and were older than 40 years (7/8). Q fever antibody titers were positive in all seven patients from whom they were available. Fever was the most frequently reported symptom. The clinical syndromes included endocarditis (5), vertebral osteomyelitis/epidural and psoas abscess (1), aortic endovascular graft infection/psoas abscess (1), and fever of unknown origin (1). All but two patients had exposures to cattle/farms.

    Conclusion:

    In our experience, C. burnetii PCR is rarely positive, but, when positive, it is associated with clinically significant infection and positive serologic results.

    Clinical and laboratory data of patients who tested positive by C. burnetii PCR

    No.

    Age

    Sex

    Comorbidities

    Clinical syndromes

    Specimens positive by C. burnetii PCR

    Phase 1 

    IgG                   

    Phase 1 IgM

    Phase 2

    IgG

    Phase 2

    IgM

    1.

    57

    M

    None

    Vertebral osteomyelitis,

    epidural abscess, right psoas abscess

    Lumbar vertebrae

     1:2048

    1:32

    1:1024

    Unknown

    2.

    62

    M

    Rheumatoid arthritis

    Chronic Q fever

    (fever, lethargy)

    Blood

    1:32768

    1:2048

    1:32768

    1:2048

    3.

    71

    M

    Aortic aneurysm repair

     

    Psoas abscess

    Infected aortic endovascular graft

    Psoas abscess

    Aortic endovascular graft #1 and #2

    <1:16

    1:256

      1:8192

     <1:16

    4.

    21

    M

    Tetralogy of Fallot

    Probable

     Q fever endocarditis (thickened pulmonic valve)

    Serum

    >1:32768

     

    <1:16  

    >1:32768

     <1:16  

    5.

    43

    M

    Bicuspid aortic valve

    Aortic valve endocarditis

    Aortic valve

    1:16384    

    1:1024

      1:4096

     

    <1:16

    6.

    63

    M

    Aortic valve replacement

    Prosthetic aortic valve endocarditis

    Heart/perivalvular tissue

    >1:800

    >1:800

    >1:800

    >1:20,000

    7.

    57

    M

    Glomerulonephritis,    aortic valve replacement

    Prosthetic aortic valve endocarditis.

    Aortic tissue

    +

    8.

    44

    F

    Unknown

    Mitral valve

    Unknown

    Poornima Ramanan, MD, Senait Gebrehiwot, MLS(ASCP), Stefanea Rucinski, MT(ASCP), Matthew Murphy, MLS(ASCP), Micah Bhatti, MD, PhD, Phillip Heaton, PhD, Neil Anderson, MD, Scott Cunningham, MT(ASCP), MS and Robin Patel, MD, FIDSA, D(ABMM), Division of Clinical Microbiology, Dept. of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN

    Disclosures:

    P. Ramanan, None

    S. Gebrehiwot, None

    S. Rucinski, None

    M. Murphy, None

    M. Bhatti, None

    P. Heaton, None

    N. Anderson, None

    S. Cunningham, TIBMolBio: PCR Oligonucleotide Manufacturer , Licensing agreement or royalty

    R. Patel, BioFire: Grant Investigator , Grant recipient
    Check-Points: Grant Investigator , Grant recipient
    Merck: Grant Investigator , Grant recipient
    Curetis: Grant Investigator , Grant recipient
    Accelerate Diagnostics: Grant Investigator , Grant recipient
    Allergen: Grant Investigator , Grant recipient
    Qvella: Grant Investigator , Grant recipient

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.