ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Insidious Risk of Severe Mycobacterium chimaera Infection in Cardiac Surgery Patients.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 52 papers, 2 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.British journal of anaesthesia · 2025Guideline
- Usefulness of linked data for infectious disease events: a systematic review.Epidemiology and infection · 2023Pooled it
- Aerosolization of Mycobacterium chelonae from heater-cooler-devices: a continuing risk of exposure during cardiac surgery.Antimicrobial resistance and infection control · 2025Article
- The Global Outbreak ofPathogens (Basel, Switzerland) · 2025Article
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Sanitary Waters: Is It Worth Looking for Mycobacteria?Microorganisms · 2024Article
- The State-of-the-Art ofHealthcare (Basel, Switzerland) · 2024Review
- Mycobacterial Biofilm: Mechanisms, Clinical Problems, and Treatments.International journal of molecular sciences · 2024Review
- Safety and Efficacy of Extracorporeal Membrane Oxygenation Heating Units.World journal for pediatric & congenital heart surgery · 2024Article
- Epidemiological and Molecular Investigation of the Heater-Cooler Unit (HCU)-Related Outbreak of InvasiveMicroorganisms · 2023Article
- Investigating the Origin of Mycobacterium chimaera Contamination in Heater-Cooler Units: Integrated Analysis with Fourier Transform Infrared Spectroscopy and Whole-Genome Sequencing.Microbiology spectrum · 2022Article
- Next Generation and Other Sequencing Technologies in Diagnostic Microbiology and Infectious Diseases.Genes · 2022Review
- An Unfavorable Outcome ofDiagnostics (Basel, Switzerland) · 2022Article
- NGSocomial Infections: High-Resolution Views of Hospital-Acquired Infections Through Genomic Epidemiology.Journal of the Pediatric Infectious Diseases Society · 2021Review
- Population Genomics and Inference of Mycobacterium avium Complex Clusters in Cystic Fibrosis Care Centers, United States.Emerging infectious diseases · 2021Article
- Article
- Whole Genome Sequencing in the Management of Non-Tuberculous Mycobacterial Infections.Microorganisms · 2021Review
- Article
- Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: a literature review.Antimicrobial resistance and infection control · 2021Review
Corrections and comments
- Commented on by
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- Erratum issuedErratum.2017
Authors and funding
41 authors.
Funding
Abstract
backgroundAn urgent UK investigation was launched to assess risk of invasive Mycobacterium chimaera infection in cardiothoracic surgery and a possible association with cardiopulmonary bypass heater-cooler units following alerts in Switzerland and The Netherlands.
methodsParallel investigations were pursued: (1) identification of cardiopulmonary bypass-associated M. chimaera infection through national laboratory and hospital admissions data linkage; (2) cohort study to assess patient risk; (3) microbiological and aerobiological investigations of heater-coolers in situ and under controlled laboratory conditions; and (4) whole-genome sequencing of clinical and environmental isolates.
resultsEighteen probable cases of cardiopulmonary bypass-associated M. chimaera infection were identified; all except one occurred in adults. Patients had undergone valve replacement in 11 hospitals between 2007 and 2015, a median of 19 months prior to onset (range, 3 months to 5 years). Risk to patients increased after 2010 from <0.2 to 1.65 per 10000 person-years in 2013, a 9-fold rise for infections within 2 years of surgery (rate ratio, 9.08 [95% CI, 1.81-87.76]). Endocarditis was the most common presentation (n = 11). To date, 9 patients have died. Investigations identified aerosol release through breaches in heater-cooler tanks. Mycobacterium chimaera and other pathogens were recovered from water and air samples. Phylogenetic analysis found close clustering of strains from probable cases.
conclusionsWe identified low but escalating risk of severe M. chimaera infection associated with heater-coolers with cases in a quarter of cardiothoracic centers. Our investigations strengthen etiological evidence for the role of heater-coolers in transmission and raise the possibility of an ongoing, international point-source outbreak. Active management of heater-coolers and heightened clinical awareness are imperative given the consequences of infection.
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