Artículos de revistas
Mycobacterium chelonae valve endocarditis resulting from contaminated biological prostheses
Fecha
2010Registro en:
JOURNAL OF INFECTION, v.60, n.6, p.467-473, 2010
0163-4453
10.1016/j.jinf.2010.03.008
Autor
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
Institución
Resumen
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.