Summary
This retrospective analysis describes an outbreak of invasive Mycobacterium abscessus complex infection in ten cardiac surgery patients, likely acquired from heater-cooler units in the operating theatre. Despite aggressive combination antimicrobial therapy and repeated surgical intervention including sternal debridement, eight patients died within two years, with four deaths directly attributable to MABC infection. The authors conclude that novel treatment strategies are urgently needed alongside strict adherence to infection prevention protocols in perioperative settings.
UK applicability
The findings are relevant to NHS cardiac surgery centres, particularly regarding infection control and outbreak prevention related to heater-cooler unit contamination during cardiopulmonary bypass. Similar outbreaks and clinical management challenges may occur in UK hospitals, making the epidemiological and therapeutic insights applicable to British cardiac surgery practice.
Key measures
Time from presumed inoculation to first positive culture; culture-positive sites; duration and composition of antimicrobial therapy; adverse events from specific antibiotics (amikacin, linezolid, tigecycline); number of surgical debridements; mortality at 2 years; deaths directly attributable to MABC
Outcomes reported
The study documented clinical characteristics, antimicrobial therapy regimens, surgical interventions, and mortality outcomes in ten cardiac surgery patients with invasive MABC infection from a hospital outbreak. Disseminated infection patterns, time to diagnosis, adverse events from antimicrobial agents, and two-year mortality rates were analysed.
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