Cardiac surgery: Why there are so many infections after cardiac surgery

Cardiac surgery: Why there are so many infections after cardiac surgery

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Source of infection found after heart surgery
In recent years, open heart surgery has led to numerous infections worldwide, some of which have become life-threatening. An international team of researchers has now found the reason for the infections: According to this, bacterial pathogens came into a medical device during manufacture and infected so many patients.

Life-threatening infections after heart surgery
Years ago it was found that patients who had to undergo open heart surgery developed infections that were sometimes life-threatening. Scientists from the U.S. Center for Disease Control and Prevention said in a press release last year that the infections could be attributed to contaminated devices in cardiac surgery. A global genetic analysis under the co-direction of the Freiburg University Hospital has now shown that bacterial pathogens could get into the medical devices during production.

The suspicion of a heater cooler came early
Since 2013, over 100 patients in Europe, the USA and Australia have been diagnosed with an illness with the pathogen Mycobacterium chimaera after open heart surgery, reports the University Hospital Freiburg in a message.

In many cases, this infection has developed into a life-threatening infection affecting the heart valves used during the operation. Until then, such an inflammation of the heart valves from this pathogen was not known.

Shortly after the first infections became known, a heating cooler was suspected, which is used in operations with a heart-lung machine.

Contamination of the devices caused during their manufacture
An international team of scientists, with the significant participation of doctors from the Freiburg University Hospital, has now clarified the genetic makeup of 250 isolates from Mycobacterium chimaera and has been able to demonstrate that almost all of the infections examined were caused by contamination of the devices during their manufacture.

The researchers published the results in the journal "The Lancet Infectious Diseases".

“Our genetic analysis enabled us to find the cause of this global outbreak. It is now clear what the patient's risk was and how to avoid this route of infection, ”said co-study leader Prof. Dr. Dirk Wagner, senior physician in the infectious diseases department of the Clinic for Internal Medicine II at the University Hospital Freiburg.

Affected devices removed for security reasons
At the Freiburg University Hospital, only one patient was affected who underwent surgery in 2011. He was healed despite lengthy treatment. No other patients with the infection were identified at the university hospital.

In Freiburg, the affected devices were removed from all operating theaters in 2014 for safety reasons.

"Thanks to the precautionary removal of the heating cooler and additional new diagnostic tests, patient safety was quickly restored," said Prof. Wagner.

However, "there is a residual risk, since some of the infections can lead to the disease very late (several years) after the operation," warned the doctor.

Manufacturers have to change their production fundamentally
In the current study, the researchers examined the pathogen genome of 250 samples, which came from sick patients, from the water tanks of the heating coolers from different manufacturers and their production locations.

The air in the operating rooms with the heating cooler running as well as other medical devices, tap water and drinking water dispensers and other controls were also examined in the analysis.

"The genetic similarity of almost all patient samples to the samples from the heat coolers and their production facilities is so great that the latter is extremely likely as a source of infection," explained Prof. Wagner.

"Manufacturers have to fundamentally change their production to prevent contamination of the devices from the outset." (Ad)

Author and source information

Video: Cardiac Surgery Discharge 2019 (August 2022).