Abstract
Following the reported link between heater–cooler unit (HCU) colonisation with Mycobacterium chimaera and endocarditis, mycobacterial sampling of all HCUs in use in Western Australia was initiated from August 2015, revealing M. chimaera colonisation in 10 of 15 HCUs. After M. chimaera was isolated from a pleural biopsy from a cardiothoracic patient who may have been exposed to a colonised HCU, a whole genome sequencing investigation was performed involving 65 specimens from 15 HCUs across five hospitals to assess if this infection was related to the HCU. Genetic relatedness was found between the 10 HCU M. chimaera isolates from four hospitals. However the M. chimaera isolate from the cardiothoracic patient was not genetically related to the HCU M. chimaera isolates from that hospital, nor to the other HCU isolates, indicating that the HCUs were not the source of the infection in this patient.
Highlights
Mycobacterium chimaera is a slow growing mycobacterium from the Mycobacterium avium complex
Sixty-five specimens from 15 heater–cooler unit (HCU) used in five Western Australia (WA) hospitals were cultured for mycobacteria over a 12-month period from August 2015 to July 2016
Single mycobacterial isolates from 10 different HCUs from four hospitals, as well as the patient isolate and the second clinical isolate from a non-cardiothoracic patient were confirmed as M. chimaera by Whole genome sequencing (WGS)
Summary
Mycobacterium chimaera is a slow growing mycobacterium from the Mycobacterium avium complex. In 2004, M. chimaera was identified as a new species within the complex group [1] and has been associated with pulmonary infections, predominantly in immunosuppressed patients and in patients with pre-existing lung conditions such as chronic obstructive pulmonary disease and cystic fibrosis [2,3]. In June 2015, an HCU manufacturer issued a warning, instructing hospitals to follow updated disinfection and maintenance procedures on HCUs and perform mycobacterial sampling. Private and public hospitals in Western Australia (WA) commenced mycobacterial sampling of their HCUs (all HCUs in WA have been purchased from the same manufacturer) in August 2015. This finding triggered an investigation to assess if this infection was related to the HCU
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Schedule a callMore From: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
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