Abstract
Mycobacterium chimaera is a nontuberculous mycobacterium that was identified as causative agent in a global
outbreak of severe infections following open-chest cardiothoracic surgery. Heater-cooler
units (HCUs), which were contaminated during the manufacturing process, were elucidated
as the origin of this outbreak. Regular surveillance of water-containing HCUs used
for cardiac surgery was recommended as one preventive measure. We present data on
the occurrence of M. chimaera and other mycobacterial pathogens in different HCUs from one surgical center in Germany
over a 42-month period. Water samples and swabs from seven different HCUs were taken
between 2015 and 2018, and mycobacteria were detected in 50.6% (78/154) of water samples
and 21.1% (4/19) of swabs. M. chimaera accounted for the majority of detected pathogens (77/83 isolates in water samples),
but other species such as Mycobacterium gordonae were also found. Despite strict adherence to an intensified, regular disinfection
procedure, the majority of HCUs remained positive for mycobacteria until the end of
the study. In conclusion, additional measures are needed to reduce the risk of intraoperative
transmission of M. chimaera, and our observations underscore the inherent infections risks associated with water-containing
medical devices.
Keywords
aerosol - atypical mycobacteria - microbiology - infection - infection prevention
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Mycobacterium chimaera
