Please use this identifier to cite or link to this item: doi:10.22028/D291-36551
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Title: Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study
Author(s): van Ingen, Jakko
Kohl, Thomas A.
Kranzer, Katharina
Hasse, Barbara
Keller, Peter M.
Katarzyna Szafrańska, Anna
Hillemann, Doris
Chand, Meera
Schreiber, Peter Werner
Sommerstein, Rami
Berger, Christoph
Genoni, Michele
Rüegg, Christian
Troillet, Nicolas
Widmer, Andreas F.
Becker, Sören L.
Herrmann, Mathias
Eckmanns, Tim
Haller, Sebastian
Höller, Christiane
Debast, Sylvia B.
Wolfhagen, Maurice J.
Hopman, Joost
Kluytmans, Jan
Langelaar, Merel
Notermans, Daan W.
ten Oever, Jaap
van den Barselaar, Peter
Vonk, Alexander B. A.
Vos, Margreet C.
Ahmed, Nada
Brown, Timothy
Crook, Derrick
Lamagni, Theresa
Phin, Nick
Smith, E. Grace
Zambon, Maria
Serr, Annerose
Götting, Tim
Ebner, Winfried
Thürmer, Alexander
Utpatel, Christian
Spröer, Cathrin
Bunk, Boyke
Nübel, Ulrich
Bloemberg, Guido V.
Böttger, Erik C.
Niemann, Stefan
Wagner, Dirk
Sax, Hugo
Language: English
Title: The Lancet Infectious Diseases
Volume: 17
Issue: 10
Pages: 1033-1041
Publisher/Platform: Elsevier
Year of Publication: 2017
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Background 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. Methods 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. Findings 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. Interpretation 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. Funding 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.
DOI of the first publication: 10.1016/S1473-3099(17)30324-9
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-365518
ISSN: 1473-3099
Date of registration: 22-Jun-2022
Description of the related object: Supplementary Material
Related object:
Faculty: M - Medizinische Fakultät
Department: M - Infektionsmedizin
Professorship: M - Prof. Dr. Sören Becker
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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