Heater-cooler devices in open-heart surgery, contaminated?
More than one-third of 89 heater-cooler units used during open-heart surgery in hospitals in the US and Canada were found to be contaminated with deadly Mycobacterium chimaera in an assessment conducted between July 2015 and December 2016, according to new research findings presented at the 44th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).
The units contain water tanks that provide temperature-controlled water during surgery. Although used to control the temperature of a patient’s blood and organs during heart bypass surgery, the water does not come into direct contact with the patient. However, the water can aerosolize and bacteria can be transmitted into the surgical environment by air.
The researchers assessed 653 water samples taken from 89 units used in 23 hospitals before and after decontamination. The aim of the study was to test for the presence of non-tuberculous mycobacteria, including M. chimaera.
Thirty-three (37 percent) units were positive for M. chimaera and four for Legionella. Numerous other mycobacteria were also detected, and 97 cultures could not be interpreted because of the extent of bacterial and fungal contamination. In some units, M. chimaera contamination was present for months, indicating that decontamination may be difficult.The researchers commented that their findings highlight the importance of decontamination monitoring and routine testing as well as strict adherence to the cleaning and disinfection instructions provided by the manufacturer.