Invasive <i>Mycobacterium abscessus</i> Complex Infection After Cardiac Surgery: Epidemiology, Management, and Clinical Outcomes

Summary

This retrospective study documented a hospital outbreak of invasive Mycobacterium abscessus complex infection in 10 cardiac surgery patients exposed to contaminated heater-cooler units, with median symptom onset 53 days post-surgery. Despite prolonged combination antimicrobial therapy (median 24 weeks) and aggressive surgical management including multiple sternal debridements, eight patients died within two years, with four deaths directly attributable to MABC infection. The findings underscore the substantial morbidity and mortality associated with invasive MABC cardiac infections and the need for improved treatment strategies and stringent infection prevention in operating theatres.

Regional applicability

This outbreak-focused clinical case series from a United States cardiac surgery centre has direct relevance to UK infection prevention practice, particularly regarding heater-cooler unit decontamination protocols in operating theatres. The findings support implementation of robust environmental monitoring and infection control measures in UK cardiac surgical facilities to mitigate similar healthcare-associated infection risks.

Key measures

Time from presumed inoculation to first positive culture (median 53 days); culture-positive sites (mediastinum, blood); duration of antimicrobial therapy (median 24 weeks); adverse events requiring therapy changes; requirement for surgical debridement; mortality within 2 years (n=8 deaths, 4 attributable to MABC)

Outcomes reported

The study reported clinical characteristics, antimicrobial therapy regimens, surgical interventions, and mortality outcomes in 10 cardiac surgery patients with invasive MABC infection from a hospital outbreak. Median time to first positive culture, culture-positive sites, duration of therapy, adverse events, and two-year mortality rates were measured.

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