Mycobacterium chimaera Outbreak Associated With Heater-Cooler Devices: Piecing the Puzzle Together

Rami Sommerstein; Peter W Schreiber; Daniel J Diekema; Michael B Edmond; Barbara Hasse; Jonas Marschall; Hugo Sax

doi:10.1017/ice.2016.283

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Mycobacterium chimaera Outbreak Associated With Heater-Cooler Devices: Piecing the Puzzle Together

Journal article

Open access

Peer reviewed

Mycobacterium chimaera Outbreak Associated With Heater-Cooler Devices: Piecing the Puzzle Together

Rami Sommerstein, Peter W Schreiber, Daniel J Diekema, Michael B Edmond, Barbara Hasse, Jonas Marschall and Hugo Sax

Infection control and hospital epidemiology, Vol.38(1), pp.103-108

01/2017

DOI: 10.1017/ice.2016.283

PMID: 27839530

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Abstract

An outbreak of invasive Mycobacterium chimaera infections associated with heater-cooler devices (HCDs) has now affected patients in several countries on different continents. Clinical infections are characterized by delayed diagnosis, inadequate treatment response to antimicrobial agents, and poor prognosis. Outbreak investigators found M. chimaera in HCD water circuits and air samples while HCDs were running, suggesting that transmission from the HCD to the surgical site occurs via the airborne route. New HCDs at the manufacturing site were also contaminated with M. chimaera, and recent whole-genome sequencing data suggest a point source. Some guidance on screening for M. chimaera colonization in HCD water and exhaust air is available. In contrast, reliable disinfection procedures are not well described, and it is not yet known whether eradication of M. chimaera from a contaminated HCD can be achieved. Meanwhile, strict separation of the HCD from operating room air is necessary to ensure patient safety, and these efforts may require engineering solutions. While our understanding of the causes and the extent of the M. chimaera outbreak is growing, several aspects of patient management, device handling, and risk mitigation still require clarification. Infect Control Hosp Epidemiol 2016;1-6.

Cross Infection - transmission

Mycobacterium Infections, Nontuberculous - transmission

Nontuberculous Mycobacteria

Disease Outbreaks

Humans

Cardiac Surgical Procedures - adverse effects

Equipment Contamination

Infection Control - methods

Details

Title: Subtitle: Mycobacterium chimaera Outbreak Associated With Heater-Cooler Devices: Piecing the Puzzle Together
Creators: Rami Sommerstein - 1Department of Infectious Diseases,Bern University Hospital,University of Bern,Switzerland
Peter W Schreiber - 2Division of Infectious Diseases and Hospital Epidemiology,University Hospital Zurich,University of Zurich,Switzerland
Daniel J Diekema - 3Division of Infectious Diseases,University of Iowa Carver College of Medicine,Iowa
Michael B Edmond - 3Division of Infectious Diseases,University of Iowa Carver College of Medicine,Iowa
Barbara Hasse - 2Division of Infectious Diseases and Hospital Epidemiology,University Hospital Zurich,University of Zurich,Switzerland
Jonas Marschall - 1Department of Infectious Diseases,Bern University Hospital,University of Bern,Switzerland
Hugo Sax - 2Division of Infectious Diseases and Hospital Epidemiology,University Hospital Zurich,University of Zurich,Switzerland
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.38(1), pp.103-108
DOI: 10.1017/ice.2016.283
PMID: 27839530
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 1559-6834
eISSN: 1559-6834
Publisher: United States
Language: English
Date published: 01/2017
Academic Unit: Infectious Diseases; Pathology; Internal Medicine
Record Identifier: 9983905640902771

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