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Mycobacterium chimaera and cardiac surgery

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Recent reports from the United Kingdom, Europe and the United States have described a small number of invasive infections with Mycobacterium chimaera associated with cardiac surgery that have been associated with high mortality. M. chimaera is likely to have been transmitted to patients by aerosols generated from contaminated heater–cooler units used during cardiopulmonary bypass. Here we describe the outbreak and discuss the relevance for Australian clinicians. Our primary objective is to raise awareness locally of this rare but serious health care-associated infection so that patients can be promptly diagnosed and optimally treated.

To formulate an evidence-based overview of the topic, as applied to clinical practice, we conducted a PubMed search of original papers and review articles in the period 2004–2016 using the term “Mycobacterium chimaera”, along with publications released by government agencies, public health bodies and medical device regulatory authorities, and selected conference presentations.

Initial outbreak description

In 2012, clinicians at the University Hospital Zurich, Switzerland, diagnosed two patients with ultimately fatal infections due to M. chimaera, a member of the M. avium complex (MAC) group of slow-growing non-tuberculous mycobacteria.1,2