Invasive Nontuberculous Mycobacterial Infections among Cardiothoracic Surgical Patients Exposed to Heater–Cooler Devices1

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Lyman, Meghan M. ; Grigg, Cheri ; Kinsey, Cara Bicking ; Keckler, M. Shannon ; Moulton-Meissner, Heather ; Cooper, Emily ; Soe, Minn M. ; Noble-Wang, Judith ; Longenberger, Allison ; Walker, Shane R. ; Miller, Jeffrey R. ; Perz, Joseph F. ; Perkins, Kiran M.
• Description:
  Invasive nontuberculous mycobacteria (NTM) infections may result from a previously unrecognized source of transmission, heater-cooler devices (HCDs) used during cardiac surgery. In July 2015, the Pennsylvania Department of Health notified the Centers for Disease Control and Prevention (CDC) about a cluster of NTM infections among cardiothoracic surgical patients at 1 hospital. We conducted a case-control study to identify exposures causing infection, examining 11 case-patients and 48 control-patients. Eight (73%) case-patients had a clinical specimen identified as Mycobacterium avium complex (MAC). HCD exposure was associated with increased odds of invasive NTM infection; laboratory testing identified patient isolates and HCD samples as closely related strains of M. chimaera, a MAC species. This investigation confirmed a large US outbreak of invasive MAC infections in a previously unaffected patient population and suggested transmission occurred by aerosolization from HCDs. Recommendations have been issued for enhanced surveillance to identify potential infections associated with HCDs and measures to mitigate transmission risk.
• Subjects:
  Adult Aged Aged, 80 And Over Cardiac Surgical Procedures Case-Control Studies Equipment Contamination Female Health Care Surveys Humans Logistic Models Male Middle Aged Mycobacterium Infections, Nontuberculous Nontuberculous Mycobacteria Odds Ratio Research Risk Factors Thoracic Surgical Procedures Young Adult

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• Source:
  Emerg Infect Dis. 23(5):796-805.
• Pubmed ID:
  28418290
• Pubmed Central ID:
  PMC5403026
• Document Type:
  Journal Article
• Volume:
  23
• Issue:
  5
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:ba8df22fb9344db1d15d4858f204220d132214c75a6791cb55a39fa082c7c05e
• Download URL:
  https://stacks.cdc.gov/view/cdc/45638/cdc_45638_DS1.pdf
• File Type:
  [PDF - 1.99 MB ]