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
Citations
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Advancing Microbe Detection for Lower Respiratory Tract Infection Diagnosis and Management with Metagenomic Next-Generation Sequencing
TL;DR: Wang et al. as mentioned in this paper used next-generation sequencing (mNGS) to identify potential microorganisms in lower respiratory tract infections (LRTIs) and achieved a sensitivity of 76.6% (95% confidence interval [CI], 65.6-85.5%), and negative-predictive value of 56.7%.
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Diagnostic value of a nanopore sequencing assay of bronchoalveolar lavage fluid in smear- negative pulmonary tuberculosis
TL;DR: In this paper , the diagnostic accuracy of a nanopore sequencing assay for testing of bronchoalveolar lavage (BALF) samples or sputum samples from suspected PTB patients and compare the results to results obtained for MGIT and Xpert assays were compared.
Journal ArticleDOI
Clinical characteristics and outcome of Mycobacterium chimaera infections after cardiac surgery: systematic review and meta-analysis of 180 heater-cooler unit associated cases.
Nils Wetzstein,Thomas Kohl,Margo Diricks,Silvia Mas-Peiro,Tomas Holubec,Johanna Kessel,Christiana Graf,B. Koch,Eva Herrmann,Maria J G T Vehreschild,Michael Hogardt,Stefan Niemann,Christoph Stephan,Thomas A. Wichelhaus +13 more
TL;DR: In this article , the authors investigated the clinical characteristics and outcome of published cases of heater-cooler unit (HCU)associated M. chimaera infections after cardiac surgery.
Journal ArticleDOI
Mycobacterium chimaera Infections Associated With Contaminated Heater-Cooler Devices Among Open Cardiac Surgery Patients: A Global Outbreak
TL;DR: Whole-genome sequencing confirms that this is a common-source outbreak, with nearly identical isolates found in 3T HCDs and patients from multiple countries, and it is likely that most 3THCDs manufactured over the past decade are contaminated with the same M. chimaera strain.
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