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Mycobacterium chelonae valve endocarditis resulting from contaminated biological prostheses

Authors
  • STRABELLI, T. M. V.
  • SICILIANO, Rinaldo Focaccia
  • CASTELLI, Jussara Bianchi
  • DEMARCHI, L. M. M. F.
  • LEAO, Sylvia Cardoso
  • VIANA-NIERO, Cristina
  • MIYASHIRO, Kozue
  • SAMPAIO, Roney Orismar
  • GRINBERG, Max
  • UIP, David Everson
Publication Date
Jan 01, 2010
Source
Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP)
Keywords
Language
English
License
Unknown
External links

Abstract

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. (C) 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

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