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The diagnosis of IE was based on the modified Duke's criteria [36] that include clinical data, blood cultures, immunohistochemical analyses of cardiac valves and molecular detection of organisms in blood and cardiac valves.
Diagnostic techniques for Bartonella-related infections include culture of the pathogen (4, 5 ), detection of organisms in lymph nodes by immunofluorescence (6 ), molecular techniques including PCR amplification of Bartonella spp. genes (7, 8 ), and serologic analysis (9, 10 ).
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The detection of organism in an URT sample may occur due to extension of infection to the upper airways in severe disease or by organisms that are propelled to the upper airway during coughing [ 16].
The EIP may play a unique role in helping to decipher true infections from mere detection of organisms and in describing true polymicrobial infections because laboratory results can be matched with epidemiologic and clinical data.
The sensitivity of PCR often precludes the need for isolation and culture, thus making it ideal for the rapid detection of organisms involved in acute infections.
These genes could be used for the detection and identification of organisms in each cluster.
There is much evidence from many workers that C. pneumoniae is present in atheromatous material including studies using electronmicroscopy, antigen detection and even culture.[ 13] However sensitive techniques such as PCR should be the gold standard for detection of organisms at low levels in atheromatous material.
In a study in Malawi, shaking of containers led to a 3-fold increase in detection of indicator organisms in unimproved buckets, suggesting that bacteria that had settled to the bottom of the storage container were still viable on resuspension (Roberts et al. 2001).
The chromogenic Rainbow™ agar O157 medium designed for the rapid identification of E. coli O157 H7 was used for the detection of these organisms in various river-water samples in the Vaal Barrage Reservoir drainage basin of South Africa.
It also assists in an early detection of organisms with acquired drug resistance [ 9, 10].
The high prevalence in asymptomatic kittens highlights the possibility that the detection of these organisms in kittens with gastrointestinal disease may be an incidental finding.
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