Transmission of Mycobacterium chimaera from Heater–Cooler Units during Cardiac Surgery despite an Ultraclean Air Ventilation System

Rami Sommerstein
Christian Rüegg
Philipp Kohler
Guido V. Bloemberg
Stefan P. Kuster
Hugo Sax

Open link

Publication date

June 2016

DOI

10.3201/eid2206.160045

Publisher

Centers for Disease Control and Prevention (CDC)

Journal

Emerging Infectious Diseases

Abstract

Heater–cooler units (HCUs) were recently identified as a source of Mycobacterium chimaera causing surgical site infections. We investigated transmission of this bacterium from HCUs to the surgical field by using a thermic anemometer and particle counter, videotape of an operating room equipped with an ultraclean laminar airflow ventilation system, and bacterial culture sedimentation plates in a nonventilated room. Smoke from the HCU reached the surgical field in 23 s by merging with ultraclean air. The HCU produced on average 5.2, 139, and 14.8 particles/min in the surgical field at positions Off, On/oriented toward, and On/oriented away, respectively. Culture plates were positive for M. chimaera <5 m from the HCU in the test room. These ex...