First Australian case of disseminated Mycobacterium chimaera infection post-cardiothoracic surgery

Bursle, Evan; Playford, E. Geoffrey; Coulter, Chris; Griffin, Paul

doi:10.1016/j.idh.2017.01.003

Cited by 10 publications

(14 citation statements)

References 14 publications

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“…Delay in symptom onset and diagnosis of infection (3,10,14,23,32) • Documented time from exposure to diagnosis was between 0.1-6.3 years (mean of 1.6 years).…”

Section: Resultsmentioning

confidence: 99%

“…To date, all cases of M. chimaera infection reported internationally have been associated with Stöckert 3T HCDs manufactured in Germany by LivaNova before September 2014 (3,9,13,15,(21)(22)(23). Phylogenetic analysis by whole genome sequencing and other means showed that isolates from infected patients and from water and exhaust air of used and new Stöckert 3T HCDs were closely related, suggesting global distribution of contaminated HCDs and a hospital-independent, common source for the current outbreak (5,9,12,22,(24)(25)(26).…”

Section: Source Of Exposurementioning

confidence: 99%

“…Signs and/or symptoms of invasive M. chimaera infection following exposure to aerosols from an HCD may not occur for months or years after exposure, with a mean time between exposure and diagnosis of 1.6 years (range: 0.1-6.3 years) (3,10,14,23,32). The infection usually presents as prosthetic valve endocarditis, vascular graft infection or disseminated infection although a variety of extracardiac sites may also be infected ( Table 1) (9)(10)(11)13,18,29,33).…”

Section: Signs and Symptoms Of Infectionmentioning

confidence: 99%

“…The infection usually presents as prosthetic valve endocarditis, vascular graft infection or disseminated infection although a variety of extracardiac sites may also be infected ( Table 1) (9)(10)(11)13,18,29,33). Clinical manifestations of infection are diverse and symptoms may be nonspecific (12,23). In some cases, extracardiac manifestations preceded cardiovascular disease (11).…”

Section: Signs and Symptoms Of Infectionmentioning

confidence: 99%

See 3 more Smart Citations

Mycobacterium chimaera infections in post–operative patients exposed to heater–cooler devices: An overview

Ogunremi

Taylor

Johnston

et al. 2017

Canada Communicable Disease Report

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A multi-country outbreak of Mycobacterium chimaera infection associated with contaminated heater-cooler devices (HCDs) has been reported, with more than 70 cases in Europe and the United States and two cases in Canada to date. The epidemiological and microbiological characteristics of this outbreak provide evidence for common-source transmission of M. chimaera from the exhaust air of intrinsically contaminated HCDs to patients during cardiac surgery. To date, all reported cases have been associated with Stöckert 3T HCDs manufactured at one plant by LivaNova prior to September 2014. Implantation of prosthetic material increases the risk of infection. Infections usually present as prosthetic valve endocarditis, vascular graft infection or disseminated infection. Reported mortality rates have varied, but were often over 40%.Several measures are recommended to facilitate case-finding and mitigate risk of exposure. The feasibility of some risk mitigation measures and their effectiveness in reducing the risk of exposure are yet to be determined. Until HCDs are redesigned in a manner that prevents water contamination and aerosolization, separating the HCD exhaust air from the operating room air during surgery may be the most effective risk mitigation strategy. However, possible unintended consequences of this approach should be considered. This overview summarizes findings from peer-reviewed and other relevant national documents on key features of the outbreak, including the source, identified risk factors for infection, signs and symptoms of infection, burden of disease, risk mitigation measures, management challenges and knowledge gaps.Affiliations

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“…Delay in symptom onset and diagnosis of infection (3,10,14,23,32) • Documented time from exposure to diagnosis was between 0.1-6.3 years (mean of 1.6 years).…”

Section: Resultsmentioning

confidence: 99%

Section: Source Of Exposurementioning

confidence: 99%

Section: Signs and Symptoms Of Infectionmentioning

confidence: 99%

Section: Signs and Symptoms Of Infectionmentioning

confidence: 99%

See 2 more Smart Citations

Mycobacterium chimaera infections in post–operative patients exposed to heater–cooler devices: An overview

Ogunremi

Taylor

Johnston

et al. 2017

Canada Communicable Disease Report

View full text Add to dashboard Cite

show abstract

“…A worldwide clonal outbreak of more than 100 cases of Mycobacterium chimaera infection after cardiac surgery associated with aerosolised M. chimaera from contaminated heater–cooler units (HCU) has been recognised . The most serious infections have involved insertion of prosthetic material .…”

Section: Patient Characteristics At Time Of Original Cardiac Surgery mentioning

confidence: 99%

Cluster of invasive Mycobacteria chimaera infections following cardiac surgery demonstrating novel clinical features and risks of aortic valve replacement

Overton

Mennon

Mothobi

et al. 2018

Internal Medicine Journal

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There is a global outbreak of infections due to Mycobacterium chimaera associated with cardiac surgery. The most serious infections involve prosthetic material implantation, and all have followed surgical procedures involving cardiopulmonary bypass. We describe a cluster of four cases following cardiac surgery at a tertiary referral centre in Sydney, Australia. We report novel clinical findings, including haemolysis and kidney rupture possibly related to immune reconstitution inflammatory syndrome. The positive effect of corticosteroids on haemodynamic function in two cases and the failure of currently recommended antimicrobial therapy to sterilise prosthetic valve material in the absence of surgery despite months of treatment are also critically examined. Positron emission tomography was positive in two cases despite normal transoesophageal echocardiograms. The proportion of cases with M. chimaera infection after aortic valve replacement (4/890, 0.45%; 95% confidence interval 0.18–1.15%) was significantly higher than after all other cardiothoracic surgical procedures (0/2433, 0%; 95% confidence interval 0–0.16%).

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Clinical characteristics and outcome of Mycobacterium chimaera infections after cardiac surgery: systematic review and meta-analysis of 180 heater-cooler unit-associated cases

Wetzstein¹,

Köhl²,

Diricks³

et al. 2023

Clinical Microbiology and Infection

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First Australian case of disseminated Mycobacterium chimaera infection post-cardiothoracic surgery

Cited by 10 publications

References 14 publications

Mycobacterium chimaera infections in post–operative patients exposed to heater–cooler devices: An overview

Mycobacterium chimaera infections in post–operative patients exposed to heater–cooler devices: An overview

Cluster of invasive Mycobacteria chimaera infections following cardiac surgery demonstrating novel clinical features and risks of aortic valve replacement

Clinical characteristics and outcome of Mycobacterium chimaera infections after cardiac surgery: systematic review and meta-analysis of 180 heater-cooler unit-associated cases

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