Mycobacterium chimaera and cardiac surgery.

Area of Science:

• Infectious Diseases
• Medical Device Contamination
• Public Health Surveillance

Background:

• Contaminated heater-cooler units (HCUs) in cardiac surgery pose a risk for non-tuberculous mycobacteria (NTM) infections.
• Surgical site and disseminated infections, including Mycobacterium chimaera, have been reported, particularly with prosthetic material implantation.
• The overall risk is low, but clinical vigilance is crucial.

Purpose of the Study:

• To investigate the association between HCUs and NTM infections in cardiac surgery patients.
• To provide guidance on suspecting, diagnosing, and reporting Mycobacterium chimaera infections.
• To outline risk management strategies for healthcare facilities.

Main Methods:

• Ongoing investigation and surveillance of NTM infections.
• Clinical case reporting and microbiological investigation.
• Review of device contamination and adherence to manufacturer guidelines.

Main Results:

• Confirmed reports of Mycobacterium chimaera infections linked to HCUs.
• Identification of specific patient populations at higher risk (e.g., post-cardiopulmonary bypass).
• Recommendations for diagnostic workup and management in consultation with specialists.

Conclusions:

• Mycobacterium chimaera infection should be considered in patients with specific clinical presentations post-cardiac surgery.
• Prompt reporting to health authorities and infection control teams is essential.
• Implementing updated manufacturer instructions and regular machine testing can mitigate risks.