Minimising the risk of Mycobacterium chimaera infection during cardiopulmonary bypass by the removal of heater-cooler units from the operating room

Abstract

We show a method by which the HCU can be removed from the OR in a relatively low-cost, straightforward and practical manner.

Risk Management in the New Frontier of Professional Liability for Nosocomial Infection: Review of the Literature on Mycobacterium Chimaera

“…Based on current understanding, this is the safest approach considering the fact that transmission via aerosol from the device has been verified. However, physically moving the device may involve significant structural and technical adjustments to the healthcare facilities, which will inevitably affect operational activities in and around the operating room [ 57 ].…”

Mycobacterium chimaera in heater–cooler units: new technical approach for treatment, cleaning and disinfection protocol

“…14 An intensified cleaning and disinfection protocol succeeded in preventing detectable aerosolization of M. chimaera . 11,15 Therefore, the introduction of Puristeril and an increased frequency of water replacement changed our maintenance protocol.…”

“…To minimize patient exposure to Mycobacteria in the air droplets, it was suggested to completely remove the HCUs from the operating room. 11 To improve infection prevention, the companies introduced the use of Puristeril: its oxidation potential makes it a very efficient biocide and bleaching agent. This high reactivity means that it rapidly breaks down in the environment to benign oxygen, water and acetic acid, making it environmentally friendly, but hazardous to anyone exposed to it (class of danger H314 12 ).…”

“…To minimize patient exposure to Mycobacteria in the air droplets, it was suggested to completely remove the HCUs from the operating room. 11…”

International Society of Cardiovascular Infectious Diseases Guidelines for the Diagnosis, Treatment and Prevention of Disseminated Mycobacterium chimaera Infection Following Cardiac Surgery with Cardiopulmonary Bypass

“…Additionally, NTM can grow over a very wide temperature range (15e45 C) and survive at 55e60 C [65]. Since decontamination measures often fail [41,91,92] and since intensified cleaning and disinfection might lead to device damage [36,106], facilities can either use other HCDs or they are strongly advised to separate HCDs from the OR room air volume by: (i) placing HCDs in dedicated utility rooms adjacent to the operating room (OR) [33,102,107,108] or (ii) placing them in encasings with controlled air extraction via a duct to the theatre exhaust conduit [41]. However, products such as encasings that are engineered and built by hospitals may alter the function of the HCD and the potential for such changes in function should be taken into consideration when implementing such interventions.…”