Mycobacterium chelonae valve endocarditis resulting from contaminated biological prostheses - 07/08/11
, Jussara Bianchi Castelli a, L.M.M.F. Demarchi a, Sylvia Cardoso Leão b, Cristina Viana-Niero b, Kozue Miyashiro c, Roney Orismar Sampaio a, Max Grinberg a, David Everson Uip a
Corresponding author. Tel.: +55 1138011724.Summary |
Objectives |
A rapid-growing mycobacteria biological prosthetic valve (BPV) endocarditis related to prosthetic manufacturing process is described in Brazil.
Methods |
From 1999 to 2008, thirty-nine patients underwent BPV replacement due to culture-negative suspected endocarditis. All these cases had histological sections stained by Ziehl-Neelsen method. Clinical and microbiological data were reviewed in all acid-fast bacilli (AFB) positive cases. The 16S-23S internal transcribed sequence (ITS) was amplified using DNA extracted from paraffin-embedded samples, digested with restrictions enzymes and/or sequenced.
Results |
Eighteen AFB positive BPV (18/39)(46%) were implanted in 13 patients and were from the same manufacturer. Four of them were implanted in other hospitals. Thirteen BPV were histologically proven endocarditis and five showed a colonization pattern. The examination of six non-implanted “sterile” BPV from this manufacturer resulted in 5 AFB positive. Mycobacterium chelonae was the AFB identified by ITS restriction analysis and sequencing.
Conclusions |
Rapid-growing mycobacteria infections must be suspected and Ziehl-Neelsen stain always performed on histology of either early or late BPV endocarditis, particularly when blood cultures are negative.
Le texte complet de cet article est disponible en PDF.Keywords : Endocarditis, Mycobacterium chelonae, Prostheses, Cardiac valve
Plan
Vol 60 - N° 6
P. 467-473 - juin 2010 Retour au numéro
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