Falkinham J O
Department of Biological Sciences, Virginia Tech, Blacksburg, VA, USA.
J Hosp Infect. 2020 May 15. doi: 10.1016/j.jhin.2020.05.005.
Non-tuberculous mycobacteria (NTM) infections in cardiac surgery patients, caused by Mycobacterium chimaera or Mycobacterium abscessus, have been traced to NTM-aerosols produced by heater-cooler units of cardiopulmonary bypass equipment.
To develop a protocol to disinfect the water reservoir(s) of heater-coolers to reduce NTM numbers and thereby prevent potential NTM aerosolization; and to devise an approach to disrupt surface biofilms of heater-coolers to reduce reinoculation of the heater-cooler reservoir(s) after disinfection.
A laboratory-scale Centers for Disease Control and Prevention bioreactor and a heater-cooler were inoculated with M. chimaera or M. abscessus to measure the ability of different disinfection protocols to reduce NTM colony-forming units in water and biofilm samples and to delay the reappearance of NTM after disinfection.
The combination of an enzyme detergent cleaning agent and Clorox® were equivalent to Clorox alone in reducing M. chimaera cfu in heater-cooler water reservoir samples. However, reappearance of those bacteria was delayed by 12 weeks by the combination of enzyme detergent cleaning agent and Clorox exposure compared to Clorox disinfection alone.
A combination of an enzyme detergent and Clorox was an effective disinfection treatment and significantly delayed the reappearance of M. chimaera in the heater-cooler reservoir.
心脏手术患者中由嵌合体分枝杆菌或脓肿分枝杆菌引起的非结核分枝杆菌（NTM）感染已追溯到体外循环设备加热 - 冷却装置产生的NTM气溶胶。
制定一种对加热 - 冷却器储水箱进行消毒的方案，以减少NTM数量，从而防止潜在的NTM气溶胶化；并设计一种方法来破坏加热 - 冷却器的表面生物膜，以减少消毒后加热 - 冷却器储水箱的再次接种。
在实验室规模的美国疾病控制与预防中心生物反应器和加热 - 冷却器中接种嵌合体分枝杆菌或脓肿分枝杆菌，以测量不同消毒方案减少水和生物膜样本中NTM菌落形成单位的能力，以及消毒后延迟NTM再次出现的能力。
在减少加热 - 冷却器储水箱样本中的嵌合体分枝杆菌cfu方面，酶洗涤剂清洁剂和高乐氏消毒剂（Clorox®）的组合与单独使用高乐氏消毒剂效果相当。然而，与单独使用高乐氏消毒剂消毒相比，酶洗涤剂清洁剂和高乐氏消毒剂联合使用可使这些细菌的再次出现延迟12周。
酶洗涤剂和高乐氏消毒剂的组合是一种有效的消毒处理方法，可显著延迟加热 - 冷却器储水箱中嵌合体分枝杆菌的再次出现。
