Journal article
Long-term follow-up of post-cardiac surgery Mycobacterium chimaera infections: A 5-center case series
Journal of Infection, Vol.80(2), pp.197-203
02/01/2020
DOI: 10.1016/j.jinf.2019.12.007
PMID: 31863789
Abstract
OBJECTIVES: In multiple countries, endovascular/disseminated Mycobacterium chimaera infections have occurred in post-cardiac surgery patients in association with contaminated, widely-distributed cardiac bypass heater-cooler devices. To contribute to long-term characterization of this recently recognized infection, we describe the clinical course of 28 patients with 3-7 years of follow-up for survivors.
METHODS: Identified at five hospitals in the United States 2010-2016, post-cardiac surgery patients in the cohort had growth of Mycobacterium avium complex (MAC)/M. chimaera from a sterile site or surgical wound, or a clinically compatible febrile illness with granulomatous inflammation on biopsy. Case follow-up was conducted in May 2019.
RESULTS: Of 28 patients, infection appeared to be localized to the sternum in four patients. Among 18 with endovascular/disseminated infection who received combination anti-mycobacterial treatment and had sufficient follow-up, 39% appeared to have controlled infection (>12 months), 56% died, and one patient is alive with relapsed bacteremia. While the number of patients is small and interpretation is limited, four (67%) of six patients who had cardiac prosthesis removal/replacement appeared to have controlled infection compared to three (25%) of 12 with retained cardiac prosthesis (p >0.14; Fisher's exact test).
CONCLUSIONS: Given poor response to treatment and potential for delayed relapses, post-cardiac surgery M. chimaera infection warrants aggressive treatment and long-term monitoring.
Details
- Title: Subtitle
- Long-term follow-up of post-cardiac surgery Mycobacterium chimaera infections: A 5-center case series
- Creators
- Kathleen G JulianTonya CrookEugene CurleyA Ben AppenheimerCatharine I PaulesBarbara HasseDaniel J DiekemaCharles L DaleyJorgelina de SanctisWalter C HellingerAdrah LevinGeorge McSherryCarol FreerCynthia J Whitener
- Resource Type
- Journal article
- Publication Details
- Journal of Infection, Vol.80(2), pp.197-203
- Publisher
- Elsevier
- DOI
- 10.1016/j.jinf.2019.12.007
- PMID
- 31863789
- ISSN
- 0163-4453
- eISSN
- 1532-2742
- Language
- English
- Date published
- 02/01/2020
- Academic Unit
- Infectious Diseases; Pathology; Internal Medicine
- Record Identifier
- 9984001235502771
Metrics
14 Record Views