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Cardiac machines linked to infection

Cardiac machines linked to infection - Featured Image

Health departments around the country are contacting open heart surgery patients who may have been exposed to a rare infection that can be found in some heater-cooler units used in surgery.

According to international reports the design and manufacture of some heart bypass heater-cooler units made by Sorin have made them susceptible to harbouring the rare bacterium mycobacterium chimaera.

M. chimaera infections in cardiac surgery patients overseas have been linked to the heater-cooler units made by medical equipment manufacturer Sorin. It is thought that the units were contaminated during their manufacture.

It’s a common bacterium that occurs naturally in the environment and only causes rare infection. The infections tend to be slow to develop (it can take from several months to over a year for an infection to develop) and often affect people with compromised immune systems.

There has been one reported possible patient infection following an open cardiac surgery in 2015.

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According to a statement by the Therapeutic Goods Association: “These infections have been associated with the use of heater-cooler devices which are used within the operating theatre to control the temperature of blood diverted to cardio-pulmonary bypass machines. Heater-cooler devices contain water tanks that provide temperature-controlled water for the operation of the device. This water does not come in contact with the patient.”

The TGA says it’s monitoring the situation and has updated its advice for health facilities regarding how to manage devices that test positive for mycobacterium chimaera.

In NSW, the hospitals that have used the potentially contaminated machines are Prince of Wales, St George, Sydney Children’s Hospital and The Children’s Hospital at Westmead.

All machines have been cleaned or replaced and the risk to patients is low.

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“The risk of infections to an individual patient is very small, but it’s important that we’ve alerted clinicians to the risk and put systems in place to reduce the risk further,” infectious disease specialist Dr Kate Clezy, from the NSW Clinical Excellence Commission, said in a statement.

In Victoria, Fairfax media reports that the bacterium has been detected in heater-cooler units at The Alfred, Austin and Cabrini hospitals in Melbourne.

“All the units were decommissioned and replaced once the test results were known,” a department spokesman said.

It’s believed doctors are checking patient records to see whether anyone has been harmed by the bacterium.

According to director of infectious diseases and microbiology at the Austin Hospital Professor Lindsay Grayson, there is about a 1 in 10 000 chance of the bacterium causing an infection.

“If you think about this, the chances of having a car accident are one in 4000, so it is very rare.”

He said the infection could be cured with surgery and use of specific antibiotics.

According to NSW Health, the signs of possible M. chimaera infection include:
fatigue
difficulty breathing
persistent cough or cough with blood
fever
night sweats
redness, heat, or pus at the surgical site
muscle pain
joint pain
abdominal pain
weight loss
nausea
vomiting

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