Patient Safety and Quality Improvement Service, Clinical Excellence Division, Department of Health, Brisbane, Queensland, Australia.
Patient Safety and Quality Improvement Service, Clinical Excellence Division, Department of Health, Brisbane, Queensland, Australia.
J Hosp Infect. 2018 Nov;100(3):e77-e84. doi: 10.1016/j.jhin.2018.07.024. Epub 2018 Jul 21.
The index case of Mycobacterium chimaera infection in a patient following open cardiac surgery in the state of Queensland, Australia prompted a centralized coordinated response to mitigate the risk.
To describe the public health response to M. chimaera contamination of heater-cooler units (HCUs) and patient infection.
A public health sector strategy was developed with national and international consultation to respond to the threat of HCUs contaminated with M. chimaera. Data linkage of non-tuberculous mycobacterium notifications and selected procedures was undertaken where potential use of HCUs was identified through hospitalization records. Water sampling and testing protocols were standardized. Public disclosure and patient notification were undertaken.
A single case of disseminated M. chimaera infection in a patient has been diagnosed to date in Queensland, Australia. Ten of 12 (83%) LivaNova Stockert 3T HCUs from five hospitals tested positive for M. chimaera. In total, 5650 patients were notified by post of their potential risk of exposure. Use of the telehealth call centre was modest. M. chimaera was also found in extracorporeal membrane oxygenation heater units produced by two other device manufacturers, four of which tested positive prior to commissioning for use.
Rapid international collaboration optimized the Queensland Health response to potential M. chimaera exposure during cardiac surgery. State-wide collaboration ensured a transparent, consistent approach to contacting patients and informing the public of the potential risk. A framework for ongoing risk management, clinical awareness and laboratory diagnosis was established. No further cases of M. chimaera infection have been identified in Queensland.
在澳大利亚昆士兰州，一名接受开放式心脏手术后的患者感染了奇美拉分枝杆菌，这促使了集中协调的应对措施，以降低风险。
描述针对热交换器（HCU）污染和患者感染的奇美拉分枝杆菌公共卫生应对措施。
制定了一项公共卫生部门战略，通过国家和国际协商来应对 HCUs 受到奇美拉分枝杆菌污染的威胁。通过住院记录确定潜在使用 HCUs 的情况，对非结核分枝杆菌报告和选定手术进行了数据链接。标准化了水采样和测试方案。开展了公开披露和患者通知。
截至目前，澳大利亚昆士兰州仅诊断出一例患者患有播散性奇美拉分枝杆菌感染。从五家医院中抽取的 12 个利瓦诺瓦 Stockert 3T HCU 中有 10 个（83%）检测出奇美拉分枝杆菌阳性。共有 5650 名患者通过邮寄通知其潜在暴露风险。远程医疗呼叫中心的使用率较低。在另外两家设备制造商生产的体外膜氧合加热器中也发现了奇美拉分枝杆菌，其中四个在投入使用前的检测中呈阳性。
快速的国际合作优化了昆士兰卫生部门在心脏手术期间应对潜在奇美拉分枝杆菌暴露的反应。全州范围内的合作确保了一种透明、一致的方法来联系患者，并告知公众潜在的风险。建立了一个持续风险管理、临床意识和实验室诊断的框架。在昆士兰州未发现其他奇美拉分枝杆菌感染病例。
