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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Rapid Identification of Clinically Relevant Mycobacterium Species by Multicolor Melting Curve Analysis
Ye Xu,Bin Liang,Chen Du,Xueshan Tian,Xingshan Cai,Yanjie Hou,Hui Li,Rongrong Zheng,Junlian Li,Yuqin Liu,Kaili Wang,Muhammad Ammar Athar,Yaoju Tan,Qingge Li +13 more
TL;DR: The results of this study confirmed the efficacy of this assay in the reliable identification of mycobacteria, suggesting that it might potentially be used as a screening tool in regions endemic for tuberculosis.
Journal ArticleDOI
Rapid detection of invasive Mycobacterium chimaera disease via a novel plasma-based next-generation sequencing test
Jim H. Nomura,Gunter Rieg,Gary Bluestone,Townson Tsai,Andrew Lai,Dawn Terashita,Sivan Bercovici,David K. Hong,Brian P. Lee +8 more
TL;DR: Plasma NGS can accurately detect M. chimaera noninvasively and significantly faster than AFB culture, making it a promising new diagnostic tool.
Journal ArticleDOI
Genomic Analysis of Cardiac Surgery-Associated Mycobacterium chimaera Infections, United States.
Nabeeh A. Hasan,L. Elaine Epperson,Adrian Lawsin,Rachael R Rodger,Kiran M. Perkins,Alison Laufer Halpin,K. Allison Perry,Heather Moulton-Meissner,Daniel J. Diekema,Matthew B. Crist,Joseph F. Perz,Max Salfinger,Charles L. Daley,Michael J. Strong +13 more
TL;DR: Whole-genome sequencing corroborated a risk for surgical heater–cooler units acting as a reservoir for Mycobacterium chimaera infections among cardiac surgery patients in the United States.
Journal ArticleDOI
Nontuberculous Mycobacteria: Epidemiology and the Impact on Pulmonary and Cardiac Disease.
TL;DR: The prevalence of nontuberculous pulmonary disease in the United States is much higher than that of Mycobacterium tuberculosis, and estimates support an annual increase in incidence of 8% per year.
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