Members of the writing committee stressed the impor- tance of consultation with the microbiology laboratory in all cases of CNE to optimize the chance of identification of the causative microorganism. Molecular techniques to identify 16S ribosomal RNA or DNA from tissue or PCR to detect DNA in blood specimens have identified agents of CNE on ; however, molecular methods to diagnose CNE remain suboptimal when applied to detection in blood.89 Commercial nucleic acid amplification tests (NAATs) do not currently target HACEK group organisms, Mycoplasma spe- cies, or zoonotic pathogens.90 Serological methods are often used to diagnose Bartonella species, T whipplei, C burnetii, Table 4. Duke Clinical Criteria for Diagnosis of IE Definite IE Pathological criteria Microorganisms: demonstrated by culture or histology in a vegetation, a vegetation that has embolized, or an intracardiac abscess or Pathological lesions: vegetation or intracardiac abscess present, confirmed by histology showing active endocarditis Clinical criteria as defined in Table 2 2 Major criteria or 1 Major criterion and 3 minor criteria or 5 Minor criteria Possible IE Findings consistent with IE that fall short of definite but not rejected Rejected Firm alternative diagnosis for manifestations of endocarditis or Resolution of manifestations of endocarditis with antibiotic therapy for 4 d or No pathological evidence of IE at surgery or autopsy, after antibiotic therapy for 4 d IE indicates infective endocarditis. Modified from Durack et al74 (copyright 1994, Elsevier) and Li et al75 (copyright 2000, Oxford University Press) with permission from the publishers. Brucella species, and Mycoplasma species.89 Urinary antigen tests are available for L pneumophila serogroup 1. 