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Journal ArticleDOI

Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study

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.

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Journal ArticleDOI

Evaluation of a Novel MALDI Biotyper Algorithm to Distinguish Mycobacterium intracellulare From Mycobacterium chimaera.

TL;DR: This work utilizes a set of 185 MAC isolates that have been characterized using rpoB locus sequencing followed by whole genome sequencing in some cases, to test the accuracy of the Bruker subtyper software to identify M. chimaera and M. intracellulare based on differential spectral peak signatures.
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Global phylogenomic analyses of Mycobacterium abscessus provide context for non cystic fibrosis infections and the evolution of antibiotic resistance.

TL;DR: In this paper, the authors construct a global dataset of 1,279 MAB whole genomes from CF or non-CF patients and utilize whole genome analysis to assess relatedness, phylogeography, and drug resistance evolution.
Journal ArticleDOI

Disseminated Mycobacterium chimaera infection associated with heater-cooler units after aortic valve surgery without endocarditis.

TL;DR: It is highlighted that disseminated infection with Mycobacterium chimaera, after valve surgery may occur without prosthetic valve involvement, and the role of surgery to remove suspected infected valve, grafts and peri-graft tissue should be considered.
Journal ArticleDOI

Detection limit of Mycobacterium chimaera in water samples for monitoring medical device safety: insights from a pilot experimental series

TL;DR: Depending on water volume and culture method, major differences exist in the detection limit of M. chimaera in water samples using laboratory-based serial dilution tests.
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