AMC Cardiovascular - Detection of Cardiovascular Infections

Description

Detection of Cardiovascular Infections

AMC Cardiovascular is a revolutionary clinical analysis that uses NGS technology to detect all microorganisms present in blood samples, enabling direct identification of the pathogens responsible for cardiovascular infections. This metagenomic approach overcomes the limitations of traditional cultures by analyzing all the genetic material found in the sample.

Bacterial Pathogens

Detection of the main bacteria responsible for cardiovascular infections.

• Staphylococcus aureus - Acute endocarditis
• Streptococcus viridans - Subacute endocarditis
• Streptococcus bovis - Associated with neoplasms
• Enterococcus spp. - Prosthetic infections
• HACEK Group - Slow-growing endocarditis

Other Microorganisms

Identification of fungi and other cardiovascular pathogens.

• Candida spp. - Fungal endocarditis
• Aspergillus spp. - Invasive infections
• Bartonella spp. - Atypical endocarditis
• Coxiella burnetii - Q fever
• Tropheryma whipplei - Whipple’s disease

Cardiovascular Infections Detected

Infective Endocarditis

• Native valves
• Prosthetic valves
• Intracardiac devices
• Pacemakers/ICDs

Vascular Infections

• Mycotic aneurysms
• Vascular grafts
• Intravascular catheters
• Infectious arteritis

Cardiovascular Sepsis

• Septic shock
• Persistent bacteremia
• Septic embolism
• Infectious myocarditis

Advantages of Metagenomic Analysis

Superiority vs Cultures

• Detection of non-culturable pathogens
• Identification of fastidious microorganisms
• Results in 15 days vs weeks
• Does not require pathogen viability

Diagnostic Precision

• Analysis of all genetic material
• Quantification of microbial load
• Antimicrobial resistance profile
• Detection of coinfections

Technology

NGS Technology for Cardiovascular Infections

We use Nanopore NGS technology optimized for the detection of cardiovascular pathogens, providing fast and accurate identification of microorganisms in complex blood samples.

Next-Generation Sequencing

• Platform: Oxford Nanopore GridION
• Long reads: Up to 2 Mb per read
• Real time: Progressive results
• Sensitivity: 1-10 CFU/ml
• Specificity: >99.5%

Cardiovascular Pipeline

• Preparation: Optimized cell lysis
• Extraction: Total DNA/RNA without bias
• Enrichment: Human DNA depletion
• Sequencing: R10.4.1 flow cells
• Analysis: Real-time base calling

Cardiovascular Bioinformatic Analysis

Taxonomic Identification

• NCBI RefSeq database
• Kraken2 classification
• MetaPhlAn4 profiling
• BLAST confirmation

Resistance Analysis

• CARD database
• ResFinder detection
• Specific AMR genes
• Phenotypic prediction

Virulence Factors

• VFDB virulence factors
• Adhesins and invasins
• Toxins and hemolysins
• Pathogenicity factors

Rigorous Quality Control

Guarantee of accurate results through:

• Positive controls with known pathogens
• Negative controls in each run
• Cross-validation with molecular methods
• Participation in external quality programs
• ISO 15189 clinical laboratory certification
• Complete process traceability

Sample

Blood Sample Collection Protocol

The quality of the blood sample is essential for the accurate detection of cardiovascular infections. We follow strict protocols to maximize pathogen recovery and minimize contamination.

Blood Draw

• Volume: 5 ml of arterial blood
• Tubes: Sterile EDTA (purple cap)
• Amount: One 5 ml tube
• Technique: Aseptic venipuncture
• Timing: During febrile/septic episode

Storage and Transport

• Temperature: 2-8°C (refrigerated)
• Maximum time: 48 hours
• Transport: Cold chain
• Processing: <24 hours optimal
• Identification: Clear labeling

Optimal Draw Protocol

Timing of Draw

• Preferably during febrile peak
• Before starting antibiotic therapy
• If possible, multiple draws
• Spaced 30-60 minutes apart
• From different venous sites

Aseptic Technique

• Extensive site disinfection
• 2% chlorhexidine or povidone iodine
• Minimum contact time 30 sec
• Do not palpate after disinfection
• Change gloves if necessary

Critical Considerations

• Avoid contamination during the draw
• Do not use venous catheters for the sample
• Report current antibiotic treatment
• Coordinate with the cardiology/infectious disease team
• Draw before invasive procedures
• Maintain chain of custody

Collection Kit Includes

• 1 sterile 10 ml EDTA tube
• Detailed draw instructions
• Identification labels
• Cardiovascular clinical form
• Refrigerated packaging material
• Courier service with cold chain

Results

Cardiovascular Infections Report

Our report provides accurate identification of cardiovascular pathogens with antimicrobial resistance analysis and specific therapeutic recommendations to optimize treatment.

Pathogens Detected

• Complete taxonomic identification
• Quantification of microbial load
• Clinical significance
• Probability of pathogenicity

Resistance Profile

• Resistance genes detected
• Susceptibility prediction
• Resistance mechanisms
• Antibiotic recommendations

Virulence Factors

• Pathogenicity determinants
• Invasive capacity
• Biofilm formation potential
• Risk of complications

Interpretation by Cardiovascular Pathogen

Endocarditis Pathogens

S. aureus High risk

S. viridans Moderate

Enterococcus Variable

HACEK Group Specialized

Emerging Pathogens

Candida spp. Fungal

Bartonella Atypical

Coxiella Zoonosis

Tropheryma Rare

Therapeutic Recommendations

• First line: Antibiotics of choice
• Alternatives: Options for resistance
• Duration: Optimal treatment time
• Route of administration: Oral vs IV
• Monitoring: Serum levels

Clinical Follow-up

• Control blood cultures: 48-72h post-initiation
• Echocardiography: Valvular follow-up
• Inflammatory markers: CRP, PCT
• Renal function: Antibiotic monitoring
• Complications: Embolism, abscesses

Cardiovascular Clinical Interpretation

Each report includes:

• Assessment of infective endocarditis risk
• Correlation with modified Duke criteria
• Recommendations for targeted antibiotic treatment
• Indications for echocardiography and follow-up
• Coordination with cardiology and infectious diseases
• Therapeutic monitoring protocol

Clinical indications

Clinical Indications for AMC Cardiovascular

Infective Endocarditis

• Clinical suspicion of endocarditis
• Persistent negative blood cultures
• Prosthetic valve endocarditis
• Infected intracardiac devices
• Endocarditis in IV drug users
• Septic embolism of cardiac origin
• Fever after cardiac procedure

Bacteremia and Sepsis

• Bacteremia of unknown source
• Sepsis with cardiovascular involvement
• Septic shock of uncertain origin
• Persistent bacteremia >72h
• Negative blood cultures in sepsis
• Inflammatory response syndrome
• Septic multiorgan failure

Device Infections

• Pacemaker/ICD infection
• Infected prosthetic valves
• Intravascular catheters
• Vascular grafts
• Ventricular assist devices
• ECMO and oxygenators
• Infected coronary stents

Atypical Pathogens

• Suspicion of HACEK endocarditis
• Bartonella infections
• Fungal endocarditis
• Q fever (Coxiella burnetii)
• Cardiac Whipple’s disease
• Mycobacterial infections
• Fastidious pathogens

High-Risk Populations

Cardiac Risk Factors

• Congenital valvulopathies
• History of endocarditis
• Cyanotic heart disease
• Hypertrophic cardiomyopathy
• Severe mitral prolapse

Predisposing Conditions

• Immunosuppression
• Diabetes mellitus
• Chronic kidney failure
• Intravenous drug use
• Chronic alcoholism

Analysis Urgency

Urgent (24-48h)

• Septic shock
• Acute endocarditis
• Multiorgan failure

Priority (3-7 days)

• Negative blood cultures
• Persistent bacteremia
• Device infection

Routine (7-15 days)

• Therapeutic follow-up
• Pre-procedure screening
• Epidemiological investigation

Clinical Advantages of AMC Cardiovascular

For the Patient

• Fast and accurate diagnosis
• Targeted treatment from the start
• Reduction of empirical antibiotic therapy
• Better cardiovascular prognosis

For the Clinician

• Identification of fastidious pathogens
• Antimicrobial resistance information
• Guidance on treatment duration
• Reduction of diagnostic uncertainty