We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Mycobacterium chimaera Genomics With Regard to Epidemiological and Clinical Investigations Conducted for an Open Chest Postsurgical Mycobacterium chimaera Infection Outbreak.
- Authors
Lecorche, Emmanuel; Daniau, Côme; La, Kevin; Mougari, Faiza; Benmansour, Hanaa; Kumanski, Sylvain; Robert, Jérôme; Fournier, Sandra; Lebreton, Guillaume; Carbonne, Anne; Cambau, Emmanuelle; CNR-MyRMA
- Abstract
Background Postsurgical infections due to Mycobacterium chimaera appeared as a novel nosocomial threat in 2015, with a worldwide outbreak due to contaminated heater-cooler units used in open chest surgery. We report the results of investigations conducted in France including whole-genome sequencing comparison of patient and heater-cooler unit isolates. Methods We sought M. chimaera infection cases from 2010 onwards through national epidemiological investigations in health care facilities performing cardiopulmonary bypass, together with a survey on good practices and systematic heater-cooler unit microbial analyses. Clinical and heater-cooler unit isolates were subjected to whole-genome sequencing analyzed with regard to the reference outbreak strain Zuerich-1. Results Only 2 clinical cases were shown to be related to the outbreak, although 23% (41/175) of heater-cooler units were declared positive for M. avium complex. Specific measures to prevent infection were applied in 89% (50/56) of health care facilities, although only 14% (8/56) of them followed the manufacturer maintenance recommendations. Whole-genome sequencing comparison showed that the clinical isolates and 72% (26/36) of heater-cooler unit isolates belonged to the epidemic cluster. Within clinical isolates, 5–9 nonsynonymous single nucleotide polymorphisms were observed, among which an in vivo mutation in a putative efflux pump gene was observed in a clinical isolate obtained for 1 patient on antimicrobial treatment. Conclusions Cases of postsurgical M. chimaera infections have been declared to be rare in France, although heater-cooler units were contaminated, as in other countries. Genomic analyses confirmed the connection to the outbreak and identified specific single nucleotide polymorphisms, including 1 suggesting fitness evolution in vivo.
- Subjects
FRANCE; ZURICH (Switzerland); MYCOBACTERIAL diseases; HEALTH facilities; SINGLE nucleotide polymorphisms; GENOMICS; NUCLEOTIDE sequencing; MYCOBACTERIUM avium paratuberculosis; INFECTION
- Publication
Open Forum Infectious Diseases, 2021, Vol 8, Issue 6, p1
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofab192