First Australian case of disseminated Mycobacterium chimaera infection post-cardiothoracic surgery

Bursle, Evan, Playford, E. Geoffrey, Coulter, Chris and Griffin, Paul (2017) First Australian case of disseminated Mycobacterium chimaera infection post-cardiothoracic surgery. Infection, Disease and Health, 22 1: 1-5. doi:10.1016/j.idh.2017.01.003


Author Bursle, Evan
Playford, E. Geoffrey
Coulter, Chris
Griffin, Paul
Title First Australian case of disseminated Mycobacterium chimaera infection post-cardiothoracic surgery
Formatted title
First Australian case of disseminated Mycobacterium chimaera infection post-cardiothoracic surgery
Journal name Infection, Disease and Health   Check publisher's open access policy
ISSN 2468-0451
Publication date 2017-02-22
Sub-type Article (original research)
DOI 10.1016/j.idh.2017.01.003
Open Access Status Not yet assessed
Volume 22
Issue 1
Start page 1
End page 5
Total pages 5
Place of publication Amsterdam, Netherlands
Publisher Elsevier BV
Language eng
Subject 2739 Public Health, Environmental and Occupational Health
2725 Infectious Diseases
Abstract A 68 year old female patient was diagnosed with disseminated Mycobacterium chimaera infection 13 months following open cardiothoracic surgery that involved the insertion of a mitral annuloplasty ring. Multiple imaging modalities, including echocardiography and PET computed tomography, failed to demonstrate any definitive evidence of annuloplasty ring involvement, endocarditis or other focal infection. The patient was initially misdiagnosed with possible sarcoidosis, however bone marrow and blood cultures subsequently grew M. chimaera. The patient was treated with ethambutol, clarithromycin and moxifloxacin without surgical reintervention, and remains on therapy with negative blood cultures after 3 months of treatment. Whole genome sequencing (WGS) has shown the patient's isolate to be identical to isolates obtained from a heater cooler unit in use at the time of the index operation [11]. This is the first case report of M. chimaera infection linked to cardiothoracic surgery outside of the USA or Europe, and highlights the difficulties in diagnosing this emerging infection with significant public health implications.
Formatted abstract
A 68 year old female patient was diagnosed with disseminated Mycobacterium chimaera infection 13 months following open cardiothoracic surgery that involved the insertion of a mitral annuloplasty ring. Multiple imaging modalities, including echocardiography and PET computed tomography, failed to demonstrate any definitive evidence of annuloplasty ring involvement, endocarditis or other focal infection. The patient was initially misdiagnosed with possible sarcoidosis, however bone marrow and blood cultures subsequently grew M. chimaera. The patient was treated with ethambutol, clarithromycin and moxifloxacin without surgical reintervention, and remains on therapy with negative blood cultures after 3 months of treatment. Whole genome sequencing (WGS) has shown the patient's isolate to be identical to isolates obtained from a heater cooler unit in use at the time of the index operation [11]. This is the first case report of M. chimaera infection linked to cardiothoracic surgery outside of the USA or Europe, and highlights the difficulties in diagnosing this emerging infection with significant public health implications.
Keyword Atypical mycobacterial infection, disseminated
Cardiac surgery
Endocarditis
Health-care associated infection
Infection control
Mycobacterium
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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