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Case Reports
. 2021 Dec 29;23(1):381.
doi: 10.3390/ijms23010381.

Mycobacterium chelonae Infection Identified by Metagenomic Next-Generation Sequencing as the Probable Cause of Acute Contained Rupture of a Biological Composite Graft-A Case Report

Andrea C Büchler  1 , Vladimir Lazarevic  2 , Nadia Gaïa  2 , Myriam Girard  2 , Friedrich Eckstein  3 , Adrian Egli  4   5 , Sarah Tschudin Sutter  1 , Jacques Schrenzel  2   6
Affiliations
Case Reports

Mycobacterium chelonae Infection Identified by Metagenomic Next-Generation Sequencing as the Probable Cause of Acute Contained Rupture of a Biological Composite Graft-A Case Report

Andrea C Büchler et al. Int J Mol Sci. .

Abstract

We present the case of a 72-year-old female patient with acute contained rupture of a biological composite graft, 21 months after replacement of the aortic valve and the ascending aorta due to an aortic dissection. Auramine-rhodamine staining of intraoperative biopsies showed acid-fast bacilli, but classical culture and molecular methods failed to identify any organism. Metagenomic analysis indicated infection with Mycobacterium chelonae, which was confirmed by target-specific qPCR. The complexity of the sample required a customized bioinformatics pipeline, including cleaning steps to remove sequences of human, bovine ad pig origin. Our study underlines the importance of multiple testing to increase the likelihood of pathogen identification in highly complex samples.

Keywords: Mycobacteroides; aortic surgery; clinical metagenomics; culture-negative infection; mycobacteria; shotgun sequencing.

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Conflict of interest statement

The authors declare no conflict of interest.

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