Journal ArticleDOI
Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study
Jakko van Ingen,Thomas Kohl,Katharina Kranzer,Barbara Hasse,Peter M. Keller,Anna K. Szafrańska,Doris Hillemann,Meera Chand,Meera Chand,Meera Chand,Peter W Schreiber,Rami Sommerstein,Rami Sommerstein,Christoph Berger,Michele Genoni,Christian Rüegg,Nicolas Troillet,Andreas F. Widmer,Sören L. Becker,Sören L. Becker,Mathias Herrmann,Tim Eckmanns,Sebastian Haller,Christiane Höller,Sylvia B. Debast,Maurice J H M Wolfhagen,Joost Hopman,Jan Kluytmans,Merel Langelaar,Daan W. Notermans,Jaap ten Oever,Peter van den Barselaar,Alexander B.A. Vonk,Margreet C. Vos,Nada Ahmed,Tim Brown,Derrick W. Crook,Derrick W. Crook,Theresa Lamagni,Nick Phin,E. Grace Smith,Maria Zambon,Annerose Serr,Tim Götting,W. Ebner,Alexander Thürmer,Christian Utpatel,Cathrin Spröer,Boyke Bunk,Ulrich Nübel,Guido V. Bloemberg,Erik C. Böttger,Stefan Niemann,Dirk Wagner,Hugo Sax +54 more
TLDR
HCU contamination with M chimaera at the LivaNova factory seems a likely source for cardiothoracic surgery-related severe M chimeera infections diagnosed in Switzerland, Germany, the Netherlands, the UK, the USA, and Australia.Abstract:
Summary Background Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater–cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of these patients' disease. Methods We included 24 M chimaera isolates from 21 cardiac surgery-related patients in Switzerland, Germany, the Netherlands, and the UK, 218 M chimaera isolates from various types of HCUs in hospitals, from LivaNova (formerly Sorin; London, UK) and Maquet (Rastatt, Germany) brand HCU production sites, and unrelated environmental sources and patients, as well as eight Mycobacterium intracellulare isolates. Isolates were analysed by next-generation whole-genome sequencing using Illumina and Pacific Biosciences technologies, and compared with published M chimaera genomes. Findings Phylogenetic analysis based on whole-genome sequencing of 250 isolates revealed two major M chimaera groups. Cardiac surgery-related patient isolates were all classified into group 1, in which all, except one, formed a distinct subgroup. This subgroup also comprised isolates from 11 cardiac surgery-related patients reported from the USA, most isolates from LivaNova HCUs, and one from their production site. Isolates from other HCUs and unrelated patients were more widely distributed in the phylogenetic tree. Interpretation HCU contamination with M chimaera at the LivaNova factory seems a likely source for cardiothoracic surgery-related severe M chimaera infections diagnosed in Switzerland, Germany, the Netherlands, the UK, the USA, and Australia. Protective measures and heightened clinician awareness are essential to guarantee patient safety. Funding Partly funded by the EU Horizon 2020 programme, its FP7 programme, the German Center for Infection Research (DZIF), the Swiss National Science Foundation, the Swiss Federal Office of Public Health, and National Institute of Health Research Oxford Health Protection Research Units on Healthcare Associated Infection and Antimicrobial Resistance.read more
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Microbial Air Quality in Healthcare Facilities.
Lucia Bonadonna,Rossella Briancesco,Anna Maria Coccia,Pierluigi Meloni,Giuseppina La Rosa,Umberto Moscato +5 more
TL;DR: In this paper, airborne and aerosolized microorganisms and their presence in hospital environments are taken into consideration, and the factors that collectively contribute to defining the infection risk in these facilities are illustrated.
Journal ArticleDOI
Mycobacterium chimaera Infection After Aortic Valve Replacement Presenting With Aortic Dissection and Pseudoaneurysm.
Conar R. O’Neil,Geoffrey Taylor,Geoffrey Taylor,Stephanie Smith,Stephanie Smith,A M Joffe,A M Joffe,K Antonation,Stephen D. Shafran,Dennis Kunimoto +9 more
TL;DR: Clinicians should consider M. chimaera infection in those presenting with aortic dissection as a late complication of cardiovascular surgery, especially in men with a past history of aortIC valve replacement.
Journal ArticleDOI
Genomic Epidemiology of an Outbreak of Klebsiella pneumoniae ST471 Producing Extended-Spectrum β-Lactamases in a Neonatal Intensive Care Unit
Yuan Wang,Chunyu Luo,Pengcheng Du,Jinrui Hu,Xiaowei Zhao,Dianjun Mo,Xiaoli Du,Xin Xu,Man Li,Hong Lu,Zhiqiang Zhou,Zhigang Cui,Haijian Zhou +12 more
TL;DR: The genomic epidemiological investigation revealed that the outbreak was caused by the introduction of the bacteria one month before the first case appeared and that K. pneumoniae strains isolated from the same outbreak contain sufficient genomic differences to refine epidemiological linkages on the basis of genetic lineage.
Journal ArticleDOI
Genomic analysis of cardiac surgery-associated Mycobacterium chimaera infections in Italy
Arash Ghodousi,Emanuele Borroni,Marta Peracchi,Giorgio Palù,Loredana Fallico,Mario Rassu,Vinicio Manfrin,Paola Mantegani,Vincenzina Monzillo,Riccardo Manganelli,Enrico Tortoli,Daniela Maria Cirillo +11 more
TL;DR: One Mycobacterium chimaera strain investigated in this study proved distant from every previously known Myc Cobacterium Chimaera Groups and is proposed to assign to a novel group, named “Group 5”.
Posted ContentDOI
Mycobacterium riyadhense clinical isolates provide insights into ancestry and adaptive evolution in tuberculosis
Qingtian Guan,Musa A. Garbati,Sara Mfarrej,Talal AlMutairi,Alicia Smyth,Albel Singh,Shamsudeen F. Fagbo,John A. Browne,Muhammad Amin urRahman,Alya Alruwaili,Anwar Hoosen,Chie Nakajima,Yasuhiko Suzuki,Apoorva Bhatt,Stephen V. Gordon,Stephen V. Gordon,Faisal A. Alasmari,Arnab Pain,Arnab Pain +18 more
TL;DR: It is concluded that M. riyadhense is an emerging mycobacterial pathogen that can serve as an experimental model to study the evolution and pathogenesis of tubercle bacilli.
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