Mycobacterium chimaera and cardiac surgery

Summary

• There is an ongoing investigation into infections with non-tuberculous mycobacteria associated with contaminated heater–cooler units used in cardiac surgery.
• The overall risk is low, but surgical site and disseminated infections have been reported, including one possible case in Australia, mainly with surgery involving implantation of prosthetic material.
• Mycobacterium chimaera infection should be considered in patients who have previously undergone surgery with cardiopulmonary bypass and who present with cardiac or disseminated infection or sternal wound infection unresponsive to standard antibiotic therapy.
• Where cases are suspected, patients should be investigated and managed in consultation with an infectious diseases physician and/or clinical microbiologist.
• If cases are confirmed or heater–cooler devices are found to be contaminated, details should be reported to the hospital infection control team, the jurisdictional health department, the Therapeutic Goods Administration and the Australian distributor of the affected heater–cooler unit(s).
• Measures to manage risk should include communicating with relevant hospital departments, ensuring that the manufacturer’s updated instructions for use are followed, regular testing of machines, and reviewing the location of machines when in use.