Mycobacterium chimaera Genomics With Regard to Epidemiological and Clinical Investigations Conducted for an Open Chest Postsurgical Mycobacterium chimaera Infection Outbreak
| Autor: | CNR-MyRMA, Côme Daniau, Kevin La, Sandra Fournier, Faiza Mougari, Sylvain Kumanski, Hanaa Benmansour, Emmanuelle Cambau, Guillaume Lebreton, Anne Carbonne, Jérôme Robert, Emmanuel Lecorche |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Nonsynonymous substitution mmpL medicine.medical_specialty 030106 microbiology Single-nucleotide polymorphism Disease cluster molecular epidemiology Major Articles 03 medical and health sciences Internal medicine Epidemiology medicine heater-cooler units (HCUs) biology Molecular epidemiology business.industry nontuberculous mycobacteria (NTM) Outbreak biology.organism_classification 030104 developmental biology Infectious Diseases AcademicSubjects/MED00290 Oncology Chimaera (genus) business Mycobacterium |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| Popis: | Background Postsurgical infections due to Mycobacterium chimaera appeared as a novel nosocomial threat in 2015, with a worldwide outbreak due to contaminated heater-cooler units used in open chest surgery. We report the results of investigations conducted in France including whole-genome sequencing comparison of patient and heater-cooler unit isolates. Methods We sought M. chimaera infection cases from 2010 onwards through national epidemiological investigations in health care facilities performing cardiopulmonary bypass, together with a survey on good practices and systematic heater-cooler unit microbial analyses. Clinical and heater-cooler unit isolates were subjected to whole-genome sequencing analyzed with regard to the reference outbreak strain Zuerich-1. Results Only 2 clinical cases were shown to be related to the outbreak, although 23% (41/175) of heater-cooler units were declared positive for M. avium complex. Specific measures to prevent infection were applied in 89% (50/56) of health care facilities, although only 14% (8/56) of them followed the manufacturer maintenance recommendations. Whole-genome sequencing comparison showed that the clinical isolates and 72% (26/36) of heater-cooler unit isolates belonged to the epidemic cluster. Within clinical isolates, 5–9 nonsynonymous single nucleotide polymorphisms were observed, among which an in vivo mutation in a putative efflux pump gene was observed in a clinical isolate obtained for 1 patient on antimicrobial treatment. Conclusions Cases of postsurgical M. chimaera infections have been declared to be rare in France, although heater-cooler units were contaminated, as in other countries. Genomic analyses confirmed the connection to the outbreak and identified specific single nucleotide polymorphisms, including 1 suggesting fitness evolution in vivo. |
| Databáze: | OpenAIRE |
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