Mycobacterium chimaera infections associated with heater–cooler units in cardiac surgery

Current Opinion in Infectious Diseases - Tập 30 Số 4 - Trang 388-394 - 2017
Peter W. Schreiber1, Hugo Sax1,2,3,4
1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
2e-mail: [email protected]
3fax: +41 44 255 45 58
4to Hugo Sax, Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland. Tel: +41 44 255 57 31

Tóm tắt

Purpose of review Mycobacterium chimaera infections following cardiac surgery have been reported from an increasing number of countries. These infections are characterized by a poor prognosis with a case fatality rate around 50% despite treatment. Since the first description in 2013, our understanding has grown steadily. Several outbreak investigations, case series, and experiments with heater–cooler units (HCUs) have been published. This review summarizes the current knowledge. Recent findings M. chimaera transmission occurs during cardiopulmonary bypass via bioaerosols emitted from contaminated HCU water systems. Manifestations of M. chimaera infection comprise endocarditis, vascular graft infections, surgical site infections, and dissemination. So far, all cases were exposed to a single HCU brand. Samples from the manufacturing site as well as clonality of M. chimaera strains isolated from HCUs and patients suggest a contamination already at time of delivery representing the main source for the outbreak. Nevertheless, HCU contamination in hospitals cannot be excluded. Summary Improved awareness of physicians of M. chimaera infection is crucial to prompt adequate diagnostic workup in patients that have been exposed to HCU presenting with compatible symptoms. For risk mitigation, strict separation between the air volume in contact with HCUs and critical clinical areas such as operating rooms is essential.

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Tài liệu tham khảo

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Current Opinion in Infectious Diseases

Tập 30 Số 4

388-394

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