ArticleMicrobiology spectrum2026
IS-Pro-based pathogen detection in explanted heart valves of suspected endocarditis patients.
Article in Microbiology spectrum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Accurate pathogen identification in infective endocarditis (IE) is limited, particularly in culture-negative cases. This study evaluated the performance of the Molecular Culture ID (MC-ID) assay in heart valve specimens from patients with suspected IE. Fifty-seven valve specimens from patients with suspected IE were analyzed using conventional culture, 16S/18S rDNA sequencing (SepsiTest, Molzym, Germany), the Biofire Joint Infection Panel (BJP; bioMérieux, Marcy l'Étoile, France), and MC-ID, with previously reported results as comparators. Twelve specimens (21.1%) were culture-positive, and 45 (78.9%) were culture-negative. MC-ID showed 83.3% positive agreement and 44.4% negative agreement with culture, achieving species-level concordance in 8/12 cases. Three culture-positive/MC-ID-negative results reflected organisms outside the assay's detection range or limited taxonomic resolution. MC-ID detected pathogens in 25/45 (55.5%) culture-negative specimens; 21 were corroborated by PCR and/or BJP. Discrepancies largely reflected polymicrobial infections or taxonomic resolution limits. MC-ID identified pathogens in four PCR-/BJP-negative specimens, of which three likely were of clinical significance. MC-ID was negative in two culture-negative, PCR-/BJP-positive specimens. MC-ID can improve pathogen detection in both culture-positive and culture-negative IE, complementing conventional and molecular diagnostics and providing a comprehensive microbiological assessment in suspected IE cases.IMPORTANCEInfective endocarditis (IE) remains difficult to diagnose, especially when blood and tissue cultures fail to identify a pathogen. Accurate organism detection is essential for guiding targeted therapy and reducing reliance on broad-spectrum antibiotics. This study shows that the Molecular Culture ID (MC-ID) assay markedly improves diagnostic yield in culture-negative valve specimens, frequently identifying pathogens missed by conventional and molecular tests. MC-ID also clarifies cases complicated by polymicrobial infection or limited taxonomic resolution, providing species-level or clinically actionable identification in many instances. By complementing existing diagnostic methods and expanding detection beyond their constraints, MC-ID offers a more comprehensive microbiological assessment of suspected endocarditis. Its integration into diagnostic workflows has the potential to enhance clinical decision-making and improve management of this high-risk condition.
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