Detection and Identification of Ehrlichia species in Blood Using PCR and Electro

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J Clin Microbiol. 2009 Dec 2; [Epub ahead of print]

 

Detection and Identification of Ehrlichia species in Blood Using PCR and

Electrospray Ionization Mass Spectrometry.

 

Eshoo MW, Crowder CD, Li H, Matthews HE, Meng S, Sefers SE, Sampath R,

Stratton

CW, Blyn LB, Ecker DJ, Tang YW.

 

Ibis Biosciences, a subsidiary of Abbott Molecular, Inc., Carlsbad, CA

92008;

Departments of Pathology, and Medicine, Vanderbilt University School of

Medicine, Nashville, TN 37232.

 

Rapid detection and identification of Ehrlichia species improves clinical

outcome in patients suspected of ehrlichiosis. We describe an assay that

employs

multi-locus PCR and electrospray mass spectrometry (PCR/ESI-MS) to detect

and

identify Ehrlichia species directly from blood specimens. The results were

compared to a colorimetric microtiter PCR (PCR-EIA) being used as a

diagnostic

assay. Among 213 whole blood samples collected from patients who were

clinically

suspected of ehrlichiosis from May 1 to August 1, 2008 at Vanderbilt

University

Hospital, 40 were positive for an Ehrlichia species by the PCR/ESI-MS,

giving a

positive rate of 18.8%. In comparison to the PCR-EIA, the PCR/ESI-MS

possessed

sensitivity, specificity and positive and negative predictive values of

95.0%,

98.8%, 95.0%, and 98.8%, respectively. The 38 specimens that were positive

for

Ehrlichia by both PCR/ESI-MS and PCR-EIA were further characterized to the

species level with 100% agreement between the two assays. In addition,

Rickettsia rickettsii was detected by PCR/ESI-MS from four specimens which

were

confirmed retrospectively by serology and PCR-EIA. In three specimens, the

PCR/ESI-MS assay identified Pseudomonas aeruginosa, Neisseria

meningitidis, and

Staphylococcus aureus; these were confirmed by culture and/or clinical

diagnosis

as being clinically relevant. From specimen processing to result

reporting, the

PCR/ESI-MS assay can be completed within six hours, providing another

laboratory

tool for the diagnosis of ehrlichiosis. Moreover, this system may provide

rapid

detection and identification of additional pathogens directly from blood

specimens.

 

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PMID: 19955274 [PubMed - as supplied by publisher]