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

van Ingen, Jakko and Kohl, Thomas A. and Kranzer, Katharina and Hasse, Barbara and Keller, Peter M. and Katarzyna Szafrańska, Anna and Hillemann, Doris and Chand, Meera and Schreiber, Peter Werner and Sommerstein, Rami and Berger, Christoph and Genoni, Michele and Rüegg, Christian and Troillet, Nicolas and Widmer, Andreas F. and Becker, Sören L. and Herrmann, Mathias and Eckmanns, Tim and Haller, Sebastian and Höller, Christiane and Debast, Sylvia B. and Wolfhagen, Maurice J. and Hopman, Joost and Kluytmans, Jan and Langelaar, Merel and Notermans, Daan W. and Ten Oever, Jaap and van den Barselaar, Peter and Vonk, Alexander B. A. and Vos, Margreet C. and Ahmed, Nada and Brown, Timothy and Crook, Derrick and Lamagni, Theresa and Phin, Nick and Smith, E. Grace and Zambon, Maria and Serr, Annerose and Götting, Tim and Ebner, Winfried and Thürmer, Alexander and Utpatel, Christian and Spröer, Cathrin and Bunk, Boyke and Nübel, Ulrich and Bloemberg, Guido V. and Böttger, Erik C. and Niemann, Stefan and Wagner, Dirk and Sax, Hugo. (2017) Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study. The Lancet infectious diseases, 17 (10). pp. 1033-1041.

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Official URL: http://edoc.unibas.ch/57817/

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Abstract

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.; 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.; 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.; 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.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Eco System Health Sciences > Health Impact Assessment (Utzinger)
UniBasel Contributors:Becker, Sören Leif
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:1473-3099
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:21 Dec 2017 15:09
Deposited On:21 Dec 2017 15:09

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