Tyras D H, Kaiser G C, Barner H B, Laskowski L F, Marr J J
J Thorac Cardiovasc Surg. 1978 Mar;75(3):331-7.
During a 4 month interval, cultures taken at the time of porcine xenograft valve implantation grew a fastidious atypical mycobacterium, Mycobacterium chelonei (Runyon's groups IV), in eight of 20 patients. Initial growth occurred at 2 to 3 weeks in thioglycollate broth only; detailed biochemical and bacteriologic evaluation demonstrates altered catalase activity accounting for its initial slow growth. Only one patient has manifested clinical evidence of infection 5 months after mitral valve replacement. A large pericardial effusion required pericardiectomy. Pericardial tissue and fluid have grown M. chelonei with the same growth characteristics as the initial valve culture. It is recommended that manufacturers of xenograft valve bioprostheses maintain a quarantine of 6 weeks until cultures, smears of culture broth, and microscopic evaluation of aortic wall coupons are negative. Users of these prostheses should keep cultures for a minimum of 3 weeks. Should positive cultures result, antimicrobial therapy should be considered only with clinical evidence of infection.
在4个月的时间间隔内，20例患者中有8例在植入猪异种移植瓣膜时采集的培养物中培养出一种苛求的非典型分枝杆菌——龟分枝杆菌（Runyon分类IV组）。最初的生长仅在硫乙醇酸盐肉汤中于2至3周时出现；详细的生化和细菌学评估表明过氧化氢酶活性改变是其最初生长缓慢的原因。二尖瓣置换术后5个月只有1例患者出现感染的临床证据。大量心包积液需要进行心包切除术。心包组织和液体培养出的龟分枝杆菌具有与最初瓣膜培养物相同的生长特征。建议异种移植瓣膜生物假体制造商保持6周的隔离期，直到培养物、培养液涂片以及主动脉壁样本的显微镜评估均为阴性。这些假体的使用者应至少保留培养物3周。如果培养结果为阳性，只有在有感染临床证据时才应考虑抗菌治疗。
