Mycobacterium chimaera and heater-cooler units: a briefing

This post provides a briefing on the current status of the Mycobacterium chimaera issue related to heater-cooler units (HCUs) used in cardiothoracic surgery. You can download some accompanying slides here. Also, I found this recent ICHE review on the subject very helpful to bring me up to speed.

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The silent Mycobacterium chimaera epidemic

hcu

There has been much discussion about the risk of Mycobacterium chimaera infections associated with contaminated heater-cooler units (HCUs) used in cardiothoracic surgery. A study published recently in CID explores the risk in the UK, and provides further evidence to link these tricky-to-treat infections to contaminated HCUs.

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Up-date on M. chimaera

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More and more reports and guidance (Ref) appear with regard to Mycobacterial infections associated with heater cooler units used during thoracic surgery. As mentioned in this blog before, the infections are attributed to aerosol generated by the contaminated heater cooler units that are located in or adjacent to the operating room (Ref).

Just now, researchers published 10 patients with disseminated Mycobacterium chimaera infections subsequent to open-heart surgery at three (CH, GER, NL) European Hospitals (Eur Heart J. 2015 Jul 17).

What makes this infections special, is the fact that the time to infection may takes months to years and that the micro-organism in question is easily missed by routine bacterial diagnostics.

The word is out, that other, difficult to diagnose micro-organisms e.g. Legionella are possibly causing post-operative infections, too. Thus, I believe that we can expect more cases with different pathogens in the near future.

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