OC46 MYCOBACTERIUM CHIMAERA INFECTIONS FOLLOWING CARDIAC SURGERY IN ITALY: RESULTS FROM A NATIONAL SURVEY ENDORSED BY SICCH

Abstract

Background: A global outbreak of Mycobacterium Chimaera (MC) infections following cardiac surgery and linked to contaminated heater-cooler units (HCU) is currently ongoing. In 2017, since the status of this outbreak in Italy and the mitigation strategies adopted by adult cardiac surgery unit (ACSU) were not known, SICCH launched a national survey among Italian ACSUs. Methods: In Italy there are 90 ACSU across 20 regions. From May to Nov 2017 they were surveyed collecting data on a) patients diagnosed with MC infections b) ACSU workload c) used HCU models d) control measures adopted in theatres. Results: The response rate was 87.8%. The mean number of cardiac procedures at each ACSU was 508 ± 229/year and nationally the number of procedures/year exceeded 40k. In Italy 7 patients with MC infections following cardiac were reported since 2015: all had aortic or valve surgery as first procedure; the latency between first operation and infection was 2.8 ± 1.6 years. Mortality for patients requiring redo cardiac surgery was 50%. MC infections risk was 0.4–1 patient every 1000 cardiac procedures. The most common HCU model in Italy is the 3T HCU (70.9%). The most common control measures adopted were: implementing new HCU disinfection protocols, using sterile or filtrated water in the HCU and displacing HCU fans away from the patient: HCU replacement and microbiology testing were infrequent. Conclusions: In Italy the risk of contracting MC infections and the mortality reported are in line with other European countries; a significant heterogeneity exists on the mitigation strategies to prevent further MC inoculations.