B.C. surgery patients warned of exposure to bacteria
Heart or lung procedures may have used bacteria-compromised devices
Just over 20,000 heart or lung surgery patients across B.C. are being told they may have been exposed to a rare but risky bacteria during operations in the past five years.
Mycobacterium chimaera, a bacterium also known as nontuberculous mycobacterium, has been found in devices called heatercoolers, which are used to control the blood temperature of patients on heart-lung bypass machines during surgery.
There are 33 of the machines in six B.C. hospitals — Vancouver General, St. Paul’s in Vancouver, Royal Columbian in New Westminster, Kelowna General, Royal Jubilee in Victoria and B.C. Children’s in Vancouver — and they are used around the world.
A global outbreak of the slowgrowing bacterium was reported last month and Health Canada, the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration have all issued alerts. No infections have been detected in B.C., and only two cases have been reported in Canada, both at the Montreal Heart Institute. Cases have been reported in North America and Europe.
“It is surprising that a global outbreak like this could go unnoticed for years,” said Rami Sommerstein, a Swiss researcher who has led the latest research. “This dangerous infection has put many patients at risk all over the world.”
He urged hospitals to remove contaminated units from operating rooms as the only way to completely protect patients from an infection that requires long-term antibiotics and even surgery.
It is believed the units became contaminated with the bacteria when they were manufactured in Germany.
B.C. health officials have been checking through medical records and have yet to find any reports of infections, although it is possible some may surface now that notices are going out to patients and doctors advising them to be on the lookout for such infections. It can take a long time for the infection to be noticeable — as long as five years, but usually about 18 months.
Patients who may have been exposed include those who have had heart or lung transplants, open heart surgery, valve replacements, annuloplasty, left ventricular assist devices or cardiac or thoracic aortic grafts. Doctors are also receiving letters telling them to consult medical microbiologists or infectious disease experts if they have any concerns about a patient.
Nontuberculous mycobacteria are common in the environment, so patients, especially those with compromised immune systems, may be susceptible to such infections from sources like soil and tap water. Such infections are not contagious.
Dr. Linda Hoang, a medical microbiologist at the B.C. Centre for Disease Control and co-director of the Provincial Infection Control Network, said 20,000 cardiac charts have been looked at and no wound infections arising from the implicated equipment were identified.
Hoang said the bacteria can build up in tubes and other areas of the heater-cooler units if they are not maintained and disinfected properly.
Whilesomehospitalsmaynotuse filtered water in the machines, B.C. hospitals do and that is believed to lower the risk as does the sterilization methods used by health professionals called perfusionists. Since the bacteria exists in the environment, individuals could be exposed to it through showering, but it would not pose a risk to healthy individuals. Hoang said infections would occur only in im- munocompromised individuals or in cases where the bacteria enters through open chests, as in the case of heart, heart transplant and lung transplant surgeries. Hoang said individuals who are concerned by the notification can call 811, a provincial nurses line that is prepared to handle any queries.
It is surprising that a global outbreak like this could go unnoticed for years. This dangerous infection has put many patients at risk.