Department of Cardiac Surgery, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China.
Department of Pharmacy, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Antimicrob Resist Infect Control. 2021 Oct 7;10(1):141. doi: 10.1186/s13756-021-01003-9.
Mycobacterium chimaera infections subsequent to cardiac surgery are related to contaminated heater-cooler devices, with high mortality. Nevertheless, few studies have been reported in Asia.
We described the case of a 55-year-old man with Mycobacterium chimaera infection following cardiac surgery in the mainland of China. He was diagnosed with endocarditis caused by Mycobacterium chimaera subsequent to open heart surgery. Metagenomic next-generation sequencing (mNGS) and 16S rRNA gene PCR analysis were used to identify potential pathogens. The patient underwent redo valve replacement surgery and received combination therapy with azithromycin, ethambutol, linezolid, and amikacin. No signs of relapse were observed during the 11-month follow-up visit.
This is the first documented case of Mycobacterium chimaera infection following cardiac surgery in the mainland of China and the first documented transnational imported case worldwide. Moreover, mNGS is a novel diagnostic technology that can guide antimicrobial therapy prior to obtaining fluid/tissue culture results for Mycobacterium chimaera, providing a new approach for the detection of potential Mycobacterium chimaera infection.
心脏手术后感染奇美拉分枝杆菌与受污染的热交换器设备有关，死亡率很高。然而，亚洲地区的相关报道较少。
我们描述了中国大陆 1 例心脏手术后感染奇美拉分枝杆菌的 55 岁男性病例。该患者因开胸心脏手术后罹患奇美拉分枝杆菌心内膜炎而被确诊。采用宏基因组下一代测序（mNGS）和 16S rRNA 基因 PCR 分析来鉴定潜在病原体。患者接受了再次瓣膜置换手术，并接受阿奇霉素、乙胺丁醇、利奈唑胺和阿米卡星联合治疗。在 11 个月的随访中未观察到复发迹象。
这是中国大陆首例心脏手术后感染奇美拉分枝杆菌的病例，也是全球首例跨国输入性病例。此外，mNGS 是一种新型诊断技术，可在获得奇美拉分枝杆菌液体/组织培养结果之前指导抗菌治疗，为潜在奇美拉分枝杆菌感染的检测提供了新方法。
