Dataset Information

Mycobacterium chimaera Genomics With Regard to Epidemiological and Clinical Investigations Conducted for an Open Chest Postsurgical Mycobacterium chimaera Infection Outbreak.

ABSTRACT:

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.

SUBMITTER: Lecorche E

PROVIDER: S-EPMC8231370 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundIn the absence of a comprehensive review, we conducted a systematic review on the use of systematic approach in outbreak investigation using reports from India.ObjectivesThe primary objective was to estimate the proportion of outbreak reports from India during 2008-16, that reported the steps in outbreak investigation. The secondary objectives were to (1) describe the outbreak reports by selected characteristics (source, investigating agency, disease, time, place and person) (2) estimate the proportion of outbreaks that conducted analytical and additional studies.MethodsWe searched eight electronic databases and grey literature for outbreak investigation reports among humans at community settings from India during 2008-2016. We developed a check-list based on the 10-steps approach used by Field Epidemiology Training Programme (FETP) of ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India. This checklist was used to independently screen and extract data on general characteristics of the outbreak investigation reports and the steps completed. We adopted The Joanna Briggs Institute (JBI) check list for prevalence studies to examine the credibility and consistency. The protocol was registered at Prospero (CRD42017065038). We calculated proportion of reports that followed the steps in their investigation and descriptive statistics on selected characteristics.ResultsOf 10,657 articles screened, 136 articles were included for the review. Completion of the ten steps in the outbreak investigations was seen in 16% of reports. The highest level of completion was for drawing conclusion in outbreak investigation (98%) and the lowest completion (29%) was for developing a case definition by time, place and person followed by conducting an analytic study (24%).ConclusionsOutbreak reports from India either lacked application of systematic steps for investigation or failed to report the actual procedures followed. We recommend improving systematic investigation of outbreaks through training and supervision of outbreak response teams and encouraging publications.