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Microbiological problems and biofilms associated with Mycobacterium chimaera in heater-cooler units used for cardiopulmonary bypass.
Walker, J; Moore, G; Collins, S; Parks, S; Garvey, M I; Lamagni, T; Smith, G; Dawkin, L; Goldenberg, S; Chand, M.
Afiliación
  • Walker J; Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Porton Down, Salisbury, UK. Electronic address: jimmy.walker@phe.gov.uk.
  • Moore G; Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Porton Down, Salisbury, UK.
  • Collins S; Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Porton Down, Salisbury, UK.
  • Parks S; Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Porton Down, Salisbury, UK.
  • Garvey MI; Infection Prevention and Control Team, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK.
  • Lamagni T; Healthcare-Associated Infection & Antimicrobial Resistance Department, National Infection Service, Public Health England, Colindale, London, UK.
  • Smith G; Public Health England National Mycobacterial Reference Service, Birmingham Public Health Laboratory, Birmingham, UK.
  • Dawkin L; Estates and Facilities, University Hospitals Coventry and Warwickshire NHS Trust, Walsall, UK.
  • Goldenberg S; Centre for Clinical Infection and Diagnostics Research, King's College, London and Guy's & St Thomas' NHS Foundation Trust, London, UK.
  • Chand M; Reference Microbiology, National Infection Service, Public Health England, Colindale, London, UK; Guy's & St Thomas' NHS Foundation Trust, London, UK; National Institute for Health Research, Health Protection Research Unit in Respiratory Infections, Imperial College, London, UK.
J Hosp Infect ; 96(3): 209-220, 2017 Jul.
Article en En | MEDLINE | ID: mdl-28532976
The role of heater-cooler units (HCUs) in the transmission of Mycobacterium chimaera during open heart surgery has been recognized since 2013. Subsequent investigations uncovered a remarkable global outbreak reflecting the wide distribution of implicated devices. HCUs are an essential component of cardiopulmonary bypass operations and their withdrawal would severely affect capacity for life-saving cardiac surgery. However, studies have demonstrated that many HCUs are contaminated with a wide range of micro-organisms, including M. chimaera and complex biofilms. Whole genome sequencing of M. chimaera isolates recovered from one manufacturer's HCUs, worldwide, has demonstrated a high level of genetic similarity, for which the most plausible hypothesis is a point source contamination of the devices. Dissemination of bioaerosols through breaches in the HCU water tanks is the most likely route of transmission and airborne bacteria have been shown to have reached the surgical field even with the use of ultraclean theatre ventilation. Controlling the microbiological quality of the water circulating in HCUs and reducing biofilm formation has been a major challenge for many hospitals. However, enhanced decontamination strategies have been recommended by manufacturers, and, although they are not always effective in eradicating M. chimaera from HCUs, UK hospitals have not reported any new cases of M. chimaera infection since implementing these mitigation strategies. Water safety groups in hospitals should be aware that water in medical devices such as HCUs may act as a vector in the transmission of potentially fatal water-borne infections.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Microbiología del Agua / Puente Cardiopulmonar / Biopelículas / Equipos y Suministros / Mycobacterium / Infecciones por Mycobacterium Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: J Hosp Infect Año: 2017 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Microbiología del Agua / Puente Cardiopulmonar / Biopelículas / Equipos y Suministros / Mycobacterium / Infecciones por Mycobacterium Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: J Hosp Infect Año: 2017 Tipo del documento: Article Pais de publicación: Reino Unido