Abstract
Mycobacterium chimaera, a non-tuberculous mycobacterium, was recently identified as causative agent of deep-seated infections in patients who had previously undergone open-chest cardiac surgery. Outbreak investigations suggested an aerosol-borne pathogen transmission originating from water contained in heater-cooler units (HCUs) used during cardiac surgery. Similar thermoregulatory devices are used for extracorporeal membrane oxygenation (ECMO) and M. chimaera might also be detectable in ECMO treatment settings. We performed a prospective microbiological study investigating the occurrence of M. chimaera in water from ECMO systems and in environmental samples, and a retrospective clinical review of possible ECMO-related mycobacterial infections among patients in a pneumological intensive care unit. We detected M. chimaera in 9 of 18 water samples from 10 different thermoregulatory ECMO devices; no mycobacteria were found in the nine room air samples and other environmental samples. Among 118 ECMO patients, 76 had bronchial specimens analysed for mycobacteria and M. chimaera was found in three individuals without signs of mycobacterial infection at the time of sampling. We conclude that M. chimaera can be detected in water samples from ECMO-associated thermoregulatory devices and might potentially pose patients at risk of infection. Further research is warranted to elucidate the clinical significance of M. chimaera in ECMO treatment settings.
Highlights
Mycobacterium chimaera is a slowly growing atypical mycobacterium that is closely related to the more commonly encountered species M. avium and M. intracellulare [1]
Microbiological investigations pertaining to the presence of atypical mycobacteria in heater-cooler units (HCUs) used during cardiac surgery were initiated in March 2015, and the prospective sampling of water from devices used for extracorporeal membrane oxygenation (ECMO) treatment was subsequently started in August 2015
Between August 2015 and August 2016, a total of 18 water samples originating from 10 different thermoregulatory devices used for ECMO treatment were subjected to microbiological analyses
Summary
Mycobacterium chimaera is a slowly growing atypical mycobacterium that is closely related to the more commonly encountered species M. avium and M. intracellulare [1]. M. chimaera was identified as the causative agent of deep-seated infections such as endocarditis and vertebral osteomyelitis in patients from different European countries (e.g. Germany, the Netherlands, Switzerland) [5,6] and from North America [7]. These infections occurred up to 5 years after the patients had been exposed to cardiothoracic surgical procedures, during which heater-cooler units (HCUs) were used.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
