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Nontuberculous Mycobacterium Infections Associated With Heater-Cooler Devices
Keith B Allen1, David D Yuh2, Suzanne B Schwartz3
1Department of Cardiothoracic Surgery, St. Luke's Mid America Heart Institute, Kansas City, Missouri.
The Annals of Thoracic Surgery
|August 20, 2017
Summary
Nontuberculous mycobacterium infections linked to heater-cooler devices (HCDs) after surgery can emerge years later and be fatal. Physician awareness is crucial for managing this public health risk.
Area of Science:
- Infectious Diseases
- Medical Device Safety
- Public Health
Background:
- Nontuberculous mycobacterium (NTM) infections have been linked to surgical procedures using extracorporeal circulation.
- Contaminated water from heater-cooler devices (HCDs) is suspected as the source of these infections.
Purpose of the Study:
- To evaluate the public health concern of NTM infections associated with HCDs.
- To educate physicians on identifying and managing these infections in at-risk patients.
Main Methods:
- A review of the Food and Drug Administration Medical Device Reporting (MDR) database from January 2010 to August 2016.
- Analysis of reports for patient infections and HCD contaminations, including infection type, patient data, and time to event.
Main Results:
- 339 MDR reports identified 107 patient infections (86 patients) and 232 device contaminations.
- Nontuberculous mycobacterium, particularly M. chimaera, was the most common organism.
- Infections were linked to cardiothoracic surgery, with a latency period up to 60 months post-procedure.
Conclusions:
- NTM infections from HCDs used in cardiothoracic surgery can have a long latency and be lethal.
- Increased awareness among cardiothoracic surgeons is vital for mitigating this public health threat.
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