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Published on: January 7, 2019

Prosthetic valve endocarditis and bloodstream infection due to Mycobacterium chimaera

Yvonne Achermann1, Matthias Rössle, Matthias Hoffmann

  • 1Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital Zurich, Zurich, Switzerland.

Journal of Clinical Microbiology
|March 29, 2013
PubMed

Insights

Prosthetic valve endocarditis (PVE) from slowly growing nontuberculous mycobacteria (NTM) is rare. This study reports two cases of Mycobacterium chimaera infection, one PVE and one bloodstream infection, suggesting a potential link between these rare NTM infections.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Prosthetic valve endocarditis (PVE) is a serious complication of cardiac surgery.
  • Nontuberculous mycobacteria (NTM) are increasingly recognized as opportunistic pathogens.
  • While fast-growing NTM PVE is documented, PVE caused by slowly growing NTM is not well-reported.

Observation:

  • This report details two cases of infection caused by Mycobacterium chimaera, a slowly growing NTM.
  • One patient developed PVE, while the other experienced a bloodstream infection.
  • Genetic analysis using randomly amplified polymorphic DNA (RAPD)-PCR suggested a clonal relationship between the two M. chimaera isolates.

Findings:

  • The study highlights the potential for slowly growing NTM, specifically Mycobacterium chimaera, to cause PVE.
  • The genetic relatedness of the isolates from two patients, who underwent heart surgery years apart, suggests a possible common source or transmission pathway.
  • No nosocomial transmission was identified, indicating the need for further investigation into the source of infection.

Implications:

  • This case series expands the understanding of NTM involvement in PVE, particularly with slowly growing species.
  • It underscores the importance of considering atypical mycobacteria in the differential diagnosis of PVE, even in the absence of typical risk factors.
  • Further research is needed to elucidate transmission routes and develop effective diagnostic and therapeutic strategies for M. chimaera infections in cardiac patients.

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