Diagnostic Yield and Incremental Value of 16S rRNA Gene PCR and Sequencing on Excised Heart-Valve Tissue in Infective Endocarditis: A Systematic Review and Meta-Analysis.

@article{buzdug2026diagnostic,
  title = {{Diagnostic Yield and Incremental Value of 16S rRNA Gene PCR and Sequencing on Excised Heart-Valve Tissue in Infective Endocarditis: A Systematic Review and Meta-Analysis.}},
  author = {Florina Olivia Buzdug and Mirela Indrieș and Victor Alexandru and Claudia Elena Stanis and Felicia Manole and Sabina Florina Călugăr-Solea and Corina-Maria Mocan and Dumitru Adrian Buzdug and Alexandra Manuela Buzle and Andrei Nicolae Csep and Ioana Manuela Caraman and Felicia Liana Andronie-Cioara and Georgeta Pasca and Andrei Dăescu and Gheorghe Adrian Osiceanu and Alina Stanca Osiceanu and Marius Rus},
  journal = {Diagnostics (Basel, Switzerland)},
  year = {2026},
  month = sep,
  doi = {10.3390/diagnostics16193125},
  url = {https://europepmc.org/article/MED/42882280},
  note = {CC BY},
}

TY  - JOUR
TI  - Diagnostic Yield and Incremental Value of 16S rRNA Gene PCR and Sequencing on Excised Heart-Valve Tissue in Infective Endocarditis: A Systematic Review and Meta-Analysis.
AU  - Florina Olivia Buzdug
AU  - Mirela Indrieș
AU  - Victor Alexandru
AU  - Claudia Elena Stanis
AU  - Felicia Manole
AU  - Sabina Florina Călugăr-Solea
AU  - Corina-Maria Mocan
AU  - Dumitru Adrian Buzdug
AU  - Alexandra Manuela Buzle
AU  - Andrei Nicolae Csep
AU  - Ioana Manuela Caraman
AU  - Felicia Liana Andronie-Cioara
AU  - Georgeta Pasca
AU  - Andrei Dăescu
AU  - Gheorghe Adrian Osiceanu
AU  - Alina Stanca Osiceanu
AU  - Marius Rus
PY  - 2026
DA  - 2026/09/25
JO  - Diagnostics (Basel, Switzerland)
DO  - 10.3390/diagnostics16193125
UR  - https://europepmc.org/article/MED/42882280
AB  - Background/Objectives: Broad-range bacterial 16S rRNA gene PCR followed by sequencing may improve the etiological diagnosis of infective endocarditis (IE), particularly when conventional cultures are negative. This systematic review and meta-analysis evaluated the overall molecular detection yield and incremental value of valve-tissue 16S molecular testing in surgically managed IE. Methods: PubMed/MEDLINE, Scopus, Web of Science Core Collection, and Europe PMC were searched for Open Access studies published from 2016 to 2026. Eligible studies evaluated broad-range bacterial 16S PCR with sequence-based identification on excised native or prosthetic heart-valve tissue. Random-effects generalized linear mixed models were used to pool overall diagnostic yield, strict blood-culture-negative IE (BCNE) yield, and strict incremental etiologic yield beyond conventional microbiology. Diagnostic accuracy was summarized descriptively when complete 2 × 2 data were available. Results: Eight studies comprising 925 patients, surgical cases, or IE episodes contributed to the primary analysis, with 704 study-reported molecular-positive results. The pooled diagnostic yield was 75.9% (95% CI, 68.7-82.0%), with substantial heterogeneity (I² = 81.8%) and a 95% prediction interval of 49.2-91.2%. In strict BCNE, the pooled yield was 53.7% (95% CI, 41.2-65.8%). The strict incremental etiologic yield was 8.8% (95% CI, 6.1-12.5%). Sensitivity analyses yielded similar estimates. Conclusions: Valve-tissue 16S PCR/sequencing can provide valuable etiological information, particularly in BCNE. However, the substantial between-study heterogeneity and wide prediction interval indicate that its expected molecular detection yield varies considerably across clinical settings and is influenced by patient selection, local diagnostic algorithms, laboratory methods, and reference standards.
SN  - 2075-4418
ER  -