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Mycobacterium chimaera infections following cardiac surgery in Treviso Hospital, Italy, from 2016 to 2019: Cases report.
Inojosa, Walter O; Giobbia, Mario; Muffato, Giovanna; Minniti, Giuseppe; Baldasso, Francesco; Carniato, Antonella; Farina, Francesca; Forner, Gabriella; Rossi, Maria C; Formentini, Stefano; Rigoli, Roberto; Scotton, Pier G.
Afiliação
  • Inojosa WO; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy. walteromar.inojosa@aulss2.veneto.it.
  • Giobbia M; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy.
  • Muffato G; Microbiology Unit, Treviso Hospital, Treviso 31100, Italy.
  • Minniti G; Cardiac Surgery Unit, Treviso Hospital, Treviso 31100, Italy.
  • Baldasso F; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy.
  • Carniato A; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy.
  • Farina F; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy.
  • Forner G; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy.
  • Rossi MC; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy.
  • Formentini S; Health Management Unit, Treviso Hospital, Treviso 31100, Italy.
  • Rigoli R; Microbiology Unit, Treviso Hospital, Treviso 31100, Italy.
  • Scotton PG; Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy.
World J Clin Cases ; 7(18): 2776-2786, 2019 Sep 26.
Article em En | MEDLINE | ID: mdl-31616692
ABSTRACT

BACKGROUND:

An epidemic of Mycobacterium chimaera (M. chimaera) infections following cardiac surgery is ongoing worldwide. The outbreak was first discovered in 2011, and it has been traced to a point source contamination of the LivaNova 3T heater-cooler unit, which is used also in Italy. International data are advocated to clarify the spectrum of clinical features of the disease as well as treatment options and outcome. We report a series of M. chimaera infections diagnosed in Treviso Hospital, including the first cases notified in Italy in 2016. CASE

SUMMARY:

Since June 2016, we diagnosed a M. chimaera infection in nine patient who had undergone cardiac valve surgery between February 2011 and November 2016. The time between cardiac surgery and developing symptoms ranged from 6 to 97 mo. Unexplained fever, psychophysical decay, weight loss, and neurological symptoms were common complaints. The median duration of symptoms was 32 wk, and the longest was almost two years. A new cardiac murmur, splenomegaly, choroidoretinitis, anaemia or lymphopenia, abnormal liver function tests and hyponatremia were common findings. All the patients presented a prosthetic valve endocarditis, frequently associated to an ascending aortic pseudoneurysm or spondylodiscitis. M. chimaera was cultured from blood, bioprosthetic tissue, pericardial abscess, vertebral tissue, and bone marrow. Mortality is high in our series, reflecting the poor outcome observed in other reports. Three patients have undergone repeat cardiac surgery. Five patients are being treated with a targeted multidrug antimycobacterial regimen.

CONCLUSION:

Patients who have undergone cardiac surgery in Italy and presenting with signs and symptoms of endocarditis must be tested for M. chimaera.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2019 Tipo de documento: Article