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HelpTest ID: CBRP Coxiella burnetii (Q fever), Molecular Detection, PCR, Varies
Reporting Name
Coxiella burnetii (Q fever) PCRUseful For
Aiding in the diagnosis of Coxiella burnetii infection (eg, Q fever) using tissue specimens
Clinical Information
Coxiella burnetii, the causative agent of Q fever, is a small obligate intracellular bacterium, which is associated with animals. It is acquired through aerosol exposure and generally causes mild respiratory disease. A small number of acute cases advance to a chronic infection, which typically manifests as endocarditis. Left untreated, Q fever endocarditis may be fatal. Serologic and histopathologic studies may be nonspecific and subjective, respectively, limiting usefulness for patient diagnosis.
Evaluation of infected tissue, blood, or serum using PCR may be a useful tool for diagnosing some cases of C burnetii infection. Mayo Clinic Laboratories has developed a real-time PCR test that rapidly detects C burnetii DNA in clinical specimens by targeting a sequence of the shikimate dehydrogenase gene (aroE) unique to C burnetii.
Interpretation
A positive result indicates the presence of Coxiella burnetii DNA.
A negative result indicates the absence of detectable C burnetii DNA, but does not negate the presence of the organism and may occur due to inhibition of PCR, sequence variability underlying primers or probes, or the presence of C burnetii DNA in quantities less than the limit of detection of the assay.
Testing Algorithm
See Infective Endocarditis: Diagnostic Testing for Identification of Microbiological Etiology in Special Instructions.
Report Available
2 to 7 daysDay(s) Performed
Monday, Wednesday, Friday
Clinical Reference
1. Frangoulidis D, Meyer H, Kahlhofer C, Splettstoesser WD: 'Real-time' PCR-based detection of Coxiella burnetii using conventional techniques. FEMS Immunol Med Microbiol 2012;64:134-136
2. Marrie TJ, Raoult D: Coxiella burnetii (Q fever). In Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Edited by GL Mandell, JE Bennett, R Dolin. Seventh edition. Philadelphia, Churchill Livingstone/Elsevier, 2010, pp 2511-2519
3. Maurin M, Raoult D: Q fever. Clin Microbiol Rev 1999;12:518-533
4. Fenollar F, Fournier PE, Raoult D: Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection. J Clin Microbiol 2004;42:4919-4924
5. Fournier PE, Raoult D: Comparison of PCR and serology assays for early diagnosis of acute Q fever. J Clin Microbiol 2003;41:5094-5098
6. Tande A, Cunningham S, Raoult D, et al: Coxiella burnetii prosthetic joint infection-case report and assay for detection. J Clin Microbiol 2013;51:66-69
7. CDC Releases First National Guidelines on Managing Q Fever. JAMA 2013;309(18):1887
8. Anderson A, Bijlmer H, Fournier PE, et al: Diagnosis and management of Q fever-United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR Recomm Rep 2013;62(RR-03):1-30
Method Name
Specimen Type
VariesNecessary Information
Specimen source is required.
Specimen Required
The high sensitivity of amplification by PCR requires the specimen to be processed in an environment in which contamination of the specimen by Coxiella burnetii DNA is unlikely.
Submit only 1 of the following specimens:
Specimen Type: Fresh tissue or biopsy
Sources: Lung, bone, liver, heart valve, aorta, or endocardium
Container/Tube: Sterile container
Specimen Volume: Entire collection or 5 mm(3) - approximately the size of a pencil eraser
Collection Instructions:
1. Collect fresh tissue specimen.
2. Submit tissue only, do not add fluid to tissue
3. Refrigerate or freeze specimen.
Specimen Stability Information: Refrigerated (preferred) <7 days/ Frozen <7 days
Preferred Paraffin-embedded tissue block:
Supplies: Tissue Block Container (T553)
Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)
Sources: Lung, bone, liver, heart valve, aorta, or endocardium
Container/Tube: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block to be cut and returned.
Specimen Stability Information: Ambient (preferred)/Refrigerated
Acceptable Paraffin-embedded tissue block:
Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)
Sources: Lung, bone, liver, heart valve, aorta, or endocardium
Container/Tube: Sterile container for each individual cut section (scroll).
Collection Instructions: Perform microtomy and prepare five separate 10-micron sections. Each section (scroll) must be placed in a separate sterile container for submission.
Specimen Stability Information: Ambient (preferred)/Refrigerated
Specimen Minimum Volume
Fresh tissue or biopsy: 5 mm(3)
Paraffin-embedded tissue block: two 10-micron sections
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Varies | ||
Special Instructions
Reference Values
Not applicable
Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87798
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CBRP | Coxiella burnetii (Q fever) PCR | 90442-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SRCQF | Specimen Source | 31208-2 |
| 62193 | Coxiella burnetii PCR | 90442-5 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
mml-CNS-Infections