A team of researchers have put forth interim guidance for hospitals and health systems after analyzing outbreaks of Mycobacterium chimaera linked heater-cooler devices, commonly used during cardiac surgery, in several countries on different continents.
For the study, published in the journal of Infection Control & Epidemiology, researchers examined outbreaks of M. chimaera and identified common characteristics. The team found infections associated with the devices to be commonly characterized by delayed diagnosis, inadequate treatment response to antimicrobial agents and poor prognosis. They also found M. chimaera inside the heater-coolers and in air samples taken near the devices, suggesting the infections are the result of airborne transmission.
M. chimaera are a species of nontuberculous mycobacterium. The bacteria are commonly found in soil and water. While typically harmless, the bacteria can cause infections in people with weakened immune systems.
"This dangerous infection has put many patients at risk all over the world," said Rami Sommerstein, MD, of Inselspital, Bern University Hospital in Switzerland, lead author of the study.
To prevent future cases of M. chimaera infections, researchers made three recommendations.
1. Ensure contaminated heater-coolers are completely separated from the operating room.
2. Educate clinicians on the risk and dangers associated with M. chimaera contamination.
3. Screen recent heart surgery patients demonstrating prolonged, unexplained fevers for M. chimaera.
The CDC and the Food and Drug Administration have also issued separate guidance documents on the heater-cooler machines.
In the U.S., the Mayo Clinic in Rochester, Minn., is the latest hospital of many to warn heart surgery patients about their potential exposure to NTM bacteria.
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