Desde el año 2015 sabemos que existe un brote de infección por Mycobacterium chimaera en pacientes que han sido sometidos a operación de corazón abierto. Ahora esta mas claro que es un brote internacional. En el programa de hoy vamos a hacer un recuento de lo que sabemos hasta ahora de este brote el cual no es solo importante en los Estados Unidos y Europa sino también en el resto del mundo donde es posible que existan casos aun no identificados o reportados.

 

Unidad Frio-Calor Sorin Stockert 3T

 

Esquema de uso de las unidades de frio-calor:

 

 

 

Clue echocardiographic findings of patient four and five with M. chimaera prosthethic valve endocarditis after open-heart surgery (A–D). Histopathological findings of pulmonary (E) and cardiac tissue (F) of Patient 2. Biofilm formation on mitral ring of Patient 3 after 12 months of antimycobacterial therapy (G), and fundoscopy of Patient 5 while being on treatment for almost 6 months (H). (A) Patient 4 at presentation. Mid-oesophageal biplane view of the aortic mechanical prosthesis (ATS 24 mm) with a paravalvular abscess as well as an anteroseptal pseudoaneurysm. (B) Patient 5 at presentation. Midesophageal long-axis view showing an echo-dense structure around the aortic valve prosthesis suggesting a local inflammation as well as multiple sparse and thin filaments with a maximal length of 10 mm. (C) Patient 4 after replacement of the mechanical prosthesis with a Freestyle bioprosthesis 25 mm in 2013 and after more than 6-month of antibiotic therapy. A mid-oesophageal biplane view focusing on aortic root and interatrial septum is shown. A moderately echodense and slightly inhomogenous mass surrounds the aortic valve, extends into the interatrial septum, and protrudes into the right atrium consistent with a persistent infection. (D) Patient 5- after 6-month of therapy. Mid-oesophageal view showing multiple, persistent, sparse, and thin filaments correlating with therapy-recalcitrant endocarditis.

From:  Philipp Koheler y colaboradores. Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery. Eur Heart J. 2015

 

Referencias:

1. Paul Sax y colaboradores. Prolonged Outbreak of Mycobacterium chimaera Infection After Open-Chest Heart Surgery. Clin Infect Dis. 2015; 61(1) 67-75
2. S. Haller y colaboradores. Contamination during production of heater-cooler units by Mycobacterium chimaera potential cause for invasive cardiovascular infections: results of an outbreak investigation in Germany, April 2015 to February 2016. Eurosurveillance.org. 2016
3. Nicholas Tan y colaboradores. Disseminated Mycobacterium Chimaera Infection Following Cardiothoracic Surgery. Open Forum Infect Dis. 2016
4. Philipp Koheler y colaboradores. Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery. Eur Heart J. 2015