Apport des techniques de biologie moléculaire dans le diagnostic des endocardites infectieuses

There is no doubt that molecular biological techniques have dramatically altered the diagnostic procedures for infectious diseases and in particular for blood culture-negative endocarditis (BCNE), the diagnosis of which remains difficult and is often established only with delay. These molecular techniques have been developed mainly for the detection and identification of pathogens that are difficult to culture or non cultivable under standard conditions, or non viable due to previous antibiotic treatment. With the exception of some specific tests that can be carried out with serum or blood, the molecular techniques for the diagnosis of BCNE are most often carried out using cardiac tissue samples. Because of their current limitations, the molecular techniques have to be considered as adjunct procedures and care has to be taken with respect to the interpretation of the results. Also, the more or less conventional (serological, histopathological, cell and cell-free culture-based) tests must not be neglected. Future efforts should aim at the improvement of the sensitivity of the molecular techniques and also of the early (serum-based) diagnosis of BCNE, using molecular techniques as well as antigenic microarrays.