Notes from the Field:Mycobacterium chimaeraContamination of Heater-Cooler Devices Used in Cardiac Surgery—United States

Perkins, Kiran M.; Lawsin, Adrian; Hasan, Nabeeh A.; Strong, Michael; Halpin, Alison Laufer; Rodger, Rachael R; Moulton-Meissner, Heather; Crist, Matthew B.; Schwartz, Suzanne; Marders, Julia; Daley, Charles L.; Salfinger, Max; Perz, Joseph F.

doi:10.15585/mmwr.mm6540a6

Cited by 105 publications

(94 citation statements)

References 3 publications

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“…Chand et al, sampled 45 HCUs across 12 different UK hospitals and nineteen (42%) were positive for M. chimaera. The results of these and other studies suggest that M. chimaera is a common contaminant of HCUs and that contaminated water within a HCU could be the source of M. chimaera infections 2,3,49,54 .…”

Section: Determining the Source Of Infections Related To Hcusmentioning

confidence: 64%

“…Of the 261 isolates examined by Chand et al, 94%, including all those from probable cases and 86% of isolates from 3T HCUs clustered very closely (mean pairwise distance of 10 SNPs) 4 . In comparison, a minimum of 2,900 SNPs were detected between any single outbreak isolate and an epidemiologically unlinked isolate 3 . Such data strongly indicate a point source for the contamination of HCUs i.e.…”

Section: Determining the Source Of Infections Related To Hcusmentioning

confidence: 99%

“…Cases have been reported worldwide reflecting the global problem of microbial colonisation and the need for effective management of HCUs [1][2][3][4] . This review summaries the knowledge to date as well as the challenges faced by those who have to prevent and control infection.…”

Section: Introductionmentioning

confidence: 99%

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Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Walker

Moore

Collins

et al. 2017

Journal of Hospital Infection

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Summary:The role of heater cooler units (HCUs) in the transmission of Mycobacterium chimaera during open heart surgery has been recognised since 2013. Subsequent investigations uncovered a remarkable global outbreak reflecting the wide distribution of implicated devices. HCUs are an essential component of cardiopulmonary bypass operations and their withdrawal would severely affect capacity for life-saving cardiac surgery. However, studies have demonstrated that many HCUs are contaminated with a wide range of microorganisms, including M. chimaera and complex biofilms. Whole genome sequencing of M. chimaera isolates recovered from one manufacturer's HCUs, worldwide, has demonstrated a high level of genetic similarity, for which the most plausible hypothesis is a point source contamination of the devices. Dissemination of bioaerosols through breaches in the HCU water tanks is the most likely route of transmission and airborne bacteria have been shown to have reached the surgical field even with the use of ultraclean theatre ventilation. Controlling the microbiological quality of the water circulating in HCUs and reducing biofilm formation has been a major challenge for many hospitals. However, enhanced decontamination strategies have been recommended by manufacturers and while not always effective in eradicating M. chimaera from HCUs, UK hospitals have not reported any new cases of M. chimaera infection, since implementing these mitigation strategies. Water safety groups in hospitals should be aware that water in medical devices such as HCUs can act as a vector in the transmission of potentially fatal water-borne infections.

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Section: Determining the Source Of Infections Related To Hcusmentioning

confidence: 64%

Section: Determining the Source Of Infections Related To Hcusmentioning

confidence: 99%

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Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Walker

Moore

Collins

et al. 2017

Journal of Hospital Infection

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“…[1][2][3] Infections have been publicly reported in five countries, and it has been noted that these infections developed after the Stöckert 3T heating and cooling unit manufactured by Sorin Group Deutschland (now LivaNova) had been used to regulate the body temperature of patients during coronaryartery bypass grafting. [1][2][3][4][5] Infections are presumed to be acquired through airborne transmission of aerosolized bacteria from water tanks. 1 After these reports in the Northern Hemisphere of infections associated with heating and cooling units, health care institutions in Australia and .…”

Section: Mycobacterium Chimaera Spread From Heating and Cooling Unitsmentioning

confidence: 99%

“…3 Various long-standing inflammatory conditions such as autoinflammatory and rheumatic disorders may lead to the deposition of AA amyloid. [3][4][5] Serum amyloid and C-reactive protein are both acute-phase proteins that are often elevated during inflammation. The formation of serum amyloid can be expected in IgG4-related disease, with elevations in C-reactive protein in approximately 40% of patients, 2 although the incidence and magnitude of elevated serum amyloid levels remain unknown.…”

mentioning

confidence: 99%

Mycobacterium chimaera Spread from Heating and Cooling Units in Heart Surgery

2017

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Airborne and Emerging Infectious Diseases

Chiang

Palmore

2021

Patty's Industrial Hygiene

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Airborne transmission of infections pathogens can occur in a wide range of occupational settings. Tuberculosis is a particular concern for personnel in health care and allied fields. The risk from exposure to infectious aerosols or droplet nuclei depends in part on characteristics of the source, the pathogen, and the aerosol droplets, as well as host susceptibility. The movement of infectious droplets is determined by their size and the flow of air. Many pathogens that are not classically airborne can be transmitted via aerosols under certain circumstances. Special consideration should be given to workers with immune impairment, who may be at higher risk of infection. Emerging pathogens that are not airborne but have had recent and significant public health consequences are also discussed.

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Notes from the Field:Mycobacterium chimaeraContamination of Heater-Cooler Devices Used in Cardiac Surgery—United States

Cited by 105 publications

References 3 publications

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Mycobacterium chimaera Spread from Heating and Cooling Units in Heart Surgery

Airborne and Emerging Infectious Diseases

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