Association of Escherichia coli with Fever following Mitral Valve Replacement in Patients Suffering Rhumatic Mitral Valve Disease

Two patients (adult females) were admitted to Ahmed Gasim Medical Hospital, Khartoum North, Sudan, with history of severe combined mitral regurgitation and stenosis. The patients were referred to the thoracic surgery unit for mitral valvectomy and valve replacement. Both patients received early empirical prophylactic antibiotic therapy half an hour before as well as post operatively. However, they developed fever shortly after the operation. Blood samples were collected and submitted to the diagnostic laboratory for conventional and molecular microbiological examinations. Conventional bacteriological examination revealed that blood cultures were negative for any bacterial growth. However, the Polymerase Chain Reaction (PCR) detected a 486 bp PCR product specific for E. coli. The identity of the nucleic acid sequence was confirmed by nested amplification of a 186 bp PCR product from the primary PCR product. The scientific data presented in this study indicated that PCR provides a rapid method for detection of E. coli during bacteraemia, irrespective of their viability. However, conventional bacterial isolation methods failed to diagnose E. coli infection in patients receiving high doses of antibiotics.