lock Open Access lock Peer-Reviewed




Atypical mycobacteria on bioprostheses: potential cause for culture-negative endocarditis

Ivan S. J Casagrande; José Lucciola; Cláudio A Salles

DOI: 10.1590/S0102-76381986000100006


The growth of atypical mycobacteria was observed in experimental studies in vitro of porcine aortic valve (aortic wall coupon) after tanning in glutaraldehyde solution at 0.625%. One hundred aortic wall coupons from different valves were incubated in 4 different culture media in a total of 400 cultures, employing the Thioglycollate, Brain-Heart-Infusion, liquid Sabouraud-Dextrose and Micosel, which did not become positive for 72 hours. The growth of atypical mycobacteria was recognized in 23% of the samples from the Thioglycollate and Sabouraud media after the 5th day utilizing appropriate subculturing techniques and special culture media. The atypical mycobacteria were identifyed as the Mycobacterium chelonei, which was demonstrated to be resistant to glutaraldehyde and it was completely eliminated by the formaldehyde in association with the surfactant.


O crescimento de micobactérias atípicas foi observado em estudos experimentais in vitro de fragmentos de válvulas aórticas porcinas após tanning em solução de glutaraldeído a 0,625%. Foram incubados 100 fragmentos de valvas distintas em 4 meios de cultura diferentes, em um total de 400 culturas, utilizando-se os meios de Thioglycollate, Brain-Heart-Infusion, Sabouraud-Dextrose liqüido e Micosel, que permaneceram estéreis por 72 horas. Prolongando-se o tempo de incubação e utilizando-se técnicas especiais de repique e meios especiais para as subculturas, verificou-se o crescimento de micobactérias atípicas a partir do 5? dia, em 23% das amostras, a partir de culturas nos meios de Thioglycollate e Sabouraud, identificados laboratorialmente como Mycobacterium chelonei. Testes posteriores demonstraram resistência desta micobactéria à ação bactericida do glutaraldeído e sua eliminação completa ocorreu após a ação do formaldeído associado ao surfactante.
Full text available only in portuguese PDF format.


1. CENTER FOR DISEASE CONTROL - Isolation of Mycobacteria species from porcine heart prostheses. MMWR, 26: 42-43, 1977.

2. COLLINS, F. M. & MONTALBINE, V. - Mycobactericidal activity of glutaraldehyde solutions. J. Clin. Microbiol., 4: 408-412, 1976. [MedLine]

3. GERACI, J. E.; ANDERSON, M. W.; KARLSON, A. G. - Endocarditis due to a rapidly growing chromogenic mycobacterium. Mayo Clin. Proc., 43: 124-133, 1968. [MedLine]

4. HAND, W. L. & SANFORD, J. P. - Mycobacterium fortuitum: a human pathogen. Ann. Intern. Med., 73: 971-977, 1970. [MedLine]

5. KURITSKY, J. N.; BULLEN, M. G.; BROOME, C. V.; SILCOX, V. A.; GOOD, R. C.; WALLACE Jr., R. J. - Sternal wound infections and endocarditis due to organisms of the Mycobacterium fortuitum complex. Ann. Intern. Med, 98: 938-939, 1983. [MedLine]

6. LASKOWSKI, L. F.; MARR, J. J.; SPERNOGA, J. F.; FRANK, N. J.; BARNER, H. B.; KAISER, G.; TYRAS, D. H. - Fastidious mycobacteria grown from porcine prosthetic-heart-valve cultures. N. Engl. J. Med., 297:101-102, 1977. [MedLine]

7. LEVY, C.; CURTIN, J. A.; WATKINS, A.; MARSH, B.; GARCIA, J.; MISPIRETA, L. - Mycobacterium chelonei infection of porcine heart valves. N. Engl. J. Med., 297: 667-668, 1977. [MedLine]

8. NARASIMHAN, S. L. & AUSTIN, T. W. - Prosthetic valve endocarditis due to Mycobacterium fortuitum. Can. Med. Assoc. J., 119: 154-155, 1978. [MedLine]

9. REPATH, F.; SEABURY, J. H.; SANDERS, C. V.; DOMER, J. - Prosthetic valve endocarditis due to Mycobacterium chelonei. South. Med. J., 69: 1244-1246, 1976. [MedLine]

10. ROBICSEK, F.; DAUGHERTY, H. K.; COOK, J. W. SELLE, J. G.; MASTERS, T. N.; O'BAR, P. R.; FERNANDEZ, C. R.; MAUNEY, C. U.; CALHOUN, D. M. - Mycobacterium fortuitum epidemics after open-heart surgery. J. Thorac. Cardiovasc. Surg., 75: 91-96, 1978. [MedLine]

11. ROCHSTEIN, E. - Summary of the 25th Research Conference in Pulmonary Diseases of the Veterans Administration - Armed Forces. Am. Rev. Respir. Dis., 91: 612, 1966.

12. RUMISEK, J. D.; ALBUS, R. A.; CLARKE, J. S. - Late Mycobacterium chelonei bioprosthetic valve endocarditis: activation of implanted contaminant? Ann. Thorac. Surg., 39: 277-279, 1985. [MedLine]

13. SZABÓ, J. & SARKOZI, K. - Letter to the Editor. Am. Rev. Respir. Dis., 121: 607, 1980. [MedLine]

14. TARSHIS, M. S. - The problem of the so-called unclassified mycobacteria in human disease. Tuberculology, 22: 13, 1964.

15. TYRAS, D. H.; KAISER, G.C.; BARNER, H. B.; LASKOWSKI, L. F.; MARR, J. J. - Atypical mycobacteria and the xenograft valve. J. Thorac. Cardiovasc. Surg., 75: 331-337, 1978. [MedLine]

16. VAN SCOY, R. E. - Culture-negative endocarditits. Mayo Clin. Proc., 57: 149-154, 1982. [MedLine]

17. WAGLEY, P. F.; KRESS, M. B.; BEACHAM, E.G. - Some clinical observations on anonymous mycobacteria. Bull. Johns Hopkins Hosp., 117: 207-227, 1965.

CCBY All scientific articles published at are licensed under a Creative Commons license


All rights reserved 2017 / © 2024 Brazilian Society of Cardiovascular Surgery DEVELOPMENT BY