Heart surgery patients may be at infection risk: AHS
No cases in Alberta reported to date, but patients alerted to symptoms
About 11,500 patients who had open-heart surgery in Edmonton and Calgary during the last five years may have been exposed to a dangerous bacteria during their operation, Alberta Health Services announced Thursday.
Though the risk of infection from Mycobacterium chimaera is considered extremely low, the health authority said it has decided to send letters to patients to suggest they watch for symptoms.
“This is the type of infection that would begin slowly, and would gradually get worse,” said Dr. Mark Joffe, AHS’s senior medical director of infection prevention and control.
The advisory is directed at adults and children who received open heart surgery at the Mazankowski Alberta Heart Institute or the Stollery Children’s Hospital in Edmonton any time since Jan. 1, 2012, along with patients who had cardiac surgery at the Foothills Medical Centre in Calgary since Jan. 1, 2013.
Of the 11,500 patients affected, about 10 per cent are believed to be children.
Joffe said AHS is not aware of any infections in Alberta to date. There are two cases in Quebec under investigation.
Jurisdictions around the world are dealing with the same issue, since it stems from a design flaw in the heater-cooler units used in cardiac surgeries to keep a patient’s blood warm while surgeons work on the heart.
He said agencies are now waiting on the manufacturer to come up with a fix — likely a better filtration system that prevents bacteria from escaping — expected in the next few months.
In the meantime, AHS has no choice but to continue to use the heater-cooler devices for surgeries, despite the risk, he said.
Joffe said extra safeguards have been implemented in terms of cleaning and maintaining the units, and by ensuring the exhaust is turned away from patients in the operating room. Patients are being told of the concern prior to their surgeries.
“We believe the risk of this infection is less than one in 1,000,” he said.
The problem with the units was first identified in Europe, followed by the United States, which issued an advisory about six weeks ago. Health Canada issued its own advisory about five weeks ago.
A Mycobacterium chimaera infection can develop anywhere from three months to five years after surgery, although the average time is about 18 months. Symptoms can be subtle and develop slowly, but will generally worsen over several weeks.
Signs of the disease include fever, persistent night sweats, weight loss, muscle aches, fatigue and redness, heat or pus at the site of the surgical incision.
Joffe said the appearance of such symptoms is most likely due to some other health condition, but patients should consult with their doctor.
The bug is difficult to manage and can ultimately be fatal, but antibiotic treatments are available. It cannot be spread by person-to-person contact.
In addition to sending letters to patients, Alberta Health Services has also notified doctors and other professionals to be on the lookout for potential infections.