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A Year in the Life of a Contaminated Heater-Cooler Unit With Mycobacterium chimaera?

Published online by Cambridge University Press:  05 May 2017

Mark I. Garvey ,
Craig W. Bradley  and
Jimmy Walker
Mark I. Garvey*
Affiliation:
Public Health England, National Infection Service, Biosafety, Air, and Water Microbiology Group, Salisbury, United Kingdom
Craig W. Bradley
Affiliation:
Public Health England, National Infection Service, Biosafety, Air, and Water Microbiology Group, Salisbury, United Kingdom
Jimmy Walker
Affiliation:
Public Health England, National Infection Service, Biosafety, Air, and Water Microbiology Group, Salisbury, United Kingdom
*
Address correspondence to Mark I. Garvey. University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2WB ([email protected]).
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Abstract

OBJECTIVE

Heater-cooler units (HCUs) have been shown to be a source of Mycobacterium chimaera infections. For the past year, weekly water samples have been taken from HCUs used at University Hospitals Birmingham (UHB) NHS Foundation Trust. We report the microbial contamination of the HCUs over a year detailing the decontamination regimes applied at UHB to reduce the microbial load.

DESIGN

Observational study

SETTING

UHB is a tertiary referral teaching hospital in Birmingham, United Kingdom, that provides clinical services to nearly 1 million patients every year. The UHB Cardiac department is one of the largest in the United Kingdom and provides treatment for adult patients with a wide range of cardiac diseases.

METHODS

Water samples taken from HCUs used at UHB for cardiopulmonary bypass surgery were sampled over a year to determine the number of microorganisms by membrane filtration. Various decontamination processes were employed throughout the year.

RESULTS

Varying total viable counts containing a wide variety of microorganisms were obtained from water inside the HCUs. No M. chimaera were isolated after replacement of the HCU internal tubing. Stringent decontamination regimes resulted in degradation of the HCUs and increased TVCs after several months.

CONCLUSION

More work is required to ensure effective decontamination processes to reduce the microbial load within the HCUs. Our studies indicate that weekly water sampling for TVC will be required indefinitely to monitor the water quality in these units as well as regular replacement of the tubing to control the build-up of biofilm.

Infect Control Hosp Epidemiol 2017;38:705–711

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 6 , June 2017 , pp. 705 - 711
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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