<i>Mycobacterium chimaera</i> in heater-cooler units used during cardiac surgery – growth and decontamination

Bengtsson, Daniel; Westerberg, Martin; Nielsen, Susanne; Ridell, Malin; Jönsson, Bodil

doi:10.1080/23744235.2018.1464204

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…2 When NT|M contaminates a body of water such as in HCUs, it creates a biofilm on surfaces that is resistant to disinfection and requires specialized techniques to decontaminate. 2,3,7 Similarly, a conduit endocarditis due to NTM requires full surgical excision and prolonged antibiotic treatment to eradicate. Since 2015 M chimaera has been traced to contaminated water in HCUs which is aerosolized into the operating theatre atmosphere.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic Conduit Endocarditis With Nontuberculous Mycobacteria in a Child: Associated With the Water Mattress and Heater Chiller Unit

Sargent

Crouch

Roberts

et al. 2019

World J Pediatr Congenit Heart Surg

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There is a growing body of literature on infection with nontuberculous mycobacteria (NTM) associated with heater chiller units in the cardiac surgery population. We report a pediatric case undergoing reoperation for early right ventricle-to-pulmonary artery conduit stenosis. A successful outcome was achieved following excision of the infected conduit and six-week antibiotic treatment. To our knowledge, there is only one other pediatric cardiac case reported in the literature. Similar to the recently reported cases of infection associated with Mycobacterium chimaera in predominately adult patients after cardiac bypass surgery, we hypothesize that water-containing devices such as the heater chiller unit and water blanket acted as a reservoir for other NTM. With increasing awareness of NTM, we analyzed the 2015-2016 culture data on our fleet of eight heater chiller units. We identified an association between persistent positive cultures and the connection of a water mattress to the heater chiller unit circuit. This led us to abandoning the use of the mattress in pediatric cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Prosthetic Conduit Endocarditis With Nontuberculous Mycobacteria in a Child: Associated With the Water Mattress and Heater Chiller Unit

Sargent

Crouch

Roberts

et al. 2019

World J Pediatr Congenit Heart Surg

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“…Clinically, human infection by M. chimaera is characterized by a long latency period (up to 6 years), disseminated forms, and a high mortality rate [ 2 ]. Intrinsic resistance against disinfectants and antibiotics makes recovery unlikely [ 11 ]. Since 2013, more than 100 cases of HCU device-related M. chimaera infection have been reported [ 2 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of a Novel Diagnostic Approach Combining the VersaTREK™ System for Recovery and Real-Time PCR for the Identification of Mycobacterium chimaera in Water Samples

et al. 2021

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Mycobacterium chimaera is an emerging pathogen associated with endocarditis and vasculitis following cardiac surgery. Although it can take up to 6–8 weeks to culture on selective solid media, culture-based detection remains the gold standard for diagnosis, so more rapid methods are urgently needed. For the present study, we processed environmental M. chimaera infected simulates at volumes defined in international guidelines. Each preparation underwent real-time PCR; inoculates were placed in a VersaTREK™ automated microbial detection system and onto selective Middlebrook 7H11 agar plates. The validation tests showed that real-time PCR detected DNA up to a concentration of 10 ng/µL. A comparison of the isolation tests showed that the PCR method detected DNA in a dilution of ×102 CFU/mL in the bacterial suspensions, whereas the limit of detection in the VersaTREK™ was <10 CFU/mL. Within less than 3 days, the VersaTREK™ detected an initial bacterial load of 100 CFU. The detection limit did not seem to be influenced by NaOH decontamination or the initial water sample volume; analytical sensitivity was 1.5 × 102 CFU/mL; positivity was determined in under 15 days. VersaTREK™ can expedite mycobacterial growth in a culture. When combined with PCR, it can increase the overall recovery of mycobacteria in environmental samples, making it potentially applicable for microbial control in the hospital setting and also in environments with low levels of contamination by viable mycobacteria.

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Mycobacterium chimaera in heater-cooler units used during cardiac surgery – growth and decontamination

Cited by 2 publications

References 27 publications

Prosthetic Conduit Endocarditis With Nontuberculous Mycobacteria in a Child: Associated With the Water Mattress and Heater Chiller Unit

Prosthetic Conduit Endocarditis With Nontuberculous Mycobacteria in a Child: Associated With the Water Mattress and Heater Chiller Unit

Validation of a Novel Diagnostic Approach Combining the VersaTREK™ System for Recovery and Real-Time PCR for the Identification of Mycobacterium chimaera in Water Samples

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