Evidence that Mycobacterium chimaera aerosols penetrate laminar airflow and result in infections at the surgical field

• Published in: The Lancet infectious diseases Vol. 17; no. 10; p. 1019
• Main Authors: Walker, Jimmy T, Lamagni, Theresa, Chand, Meera
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.10.2017; Elsevier Limited
• Subjects: Aerosols; Air flow; Air pollution; Chimera; Heart surgery; Humans; Infections; Infectious diseases; Mycobacterium; Mycobacterium Infections; Outbreaks; Studies; Transplants & implants; Ventilation; Water pollution
• ISSN: 1473-3099; 1474-4457; 1474-4457
• DOI: 10.1016/S1473-3099(17)30519-4

Along with many other countries worldwide, we have recently been involved in investigating an outbreak of invasive Mycobacterium chimaera infections linked with surgery conducted on cardiopulmonary bypass.3 Evidence to date, including whole genome sequencing analysis, strongly implicates aerosol dispersal of contaminated water from heater-cooler units used for cardiopulmonary bypass as the source of this outbreak.3,4 A key question in identifying measures to potentially mitigate against this risk of aerosol dispersal, given that these machines cannot be readily taken out service without substantial disruption to life-saving cardiothoracic surgery, is whether laminar flow might offer a means to prevent contaminated aerosol entering the surgical field. [...]laminar flow might be insufficient to protect against microbial aerosols generated in an airflow such as from the heater-cooler unit exhaust fan, and in this particular outbreak microbial air contamination is indeed strongly implicated as the source of surgical site infection.