Hospital warns open-heart patients of nontuberculous mycobacteria risk

A hospital in Iowa warned thousands of open-heart surgery patients that they may have been exposed to nontuberculous mycobacteria, or NTM, via contaminated heater-cooler units used with heart-lung machines after two such patients were diagnosed with the infection.

Following a 4-year time period recommended by the CDC, Mercy Medical Center in Des Moines notified approximately 2,600 patients who underwent surgery from July 2012 to July 2016 of potential exposure.

“We have taken immediate action and are following CDC guidelines,” Tommy Ibrahim, MD, chief physician officer and vice president of medical affairs at the hospital, said in a news release. “We are proactively engaging with health officials as we inform and support our patient and provider community.”

Heater-cooler units regulate body temperature during cardiothoracic surgeries and other medical procedures. Last October, the FDA linked the devices to NTM infections following an increase in reports about contamination, mostly from Western Europe. Patients can become infected with NTM when the slow-growing bacteria is aerosolized by the units.

Following the FDA’s report, the CDC issued an alert to health departments and providers around the country about the risk associated with the units and issued interim practical guidance that advised facilities to remove contaminated units, maintain those in service, and track reports about potential infections.

Mercy Medical Center said it already was following manufacturer guidelines about disinfecting and maintaining its heater-cooler units when it implemented the CDC’s recommendations.

According to the hospital, the CDC estimates that the risk for infection is less than 1% and is limited to patients who have undergone open-heart surgery in which the devices were used. The hospital said it consulted with the CDC after learning about the two infected patients and has implemented further recommendations by the agency to eliminate the risk associated with the heater-cooler units.

“While the risk of infection is extremely low, we want to be upfront and transparent with our patients,” Daniel Gervich, MD, medical director of health care epidemiology and chief infection control officer at Mercy Medical Center, said in the release. “Our highest priority is always the safety and health of our patients. We are committed to making sure they have all the information they need regarding this issue.” – by Gerard Gallagher

Reference: CDC. Nontuberculous mycobacterium (NTM) infections and heater-cooler devices interim practical guidance: updated October 27, 2015. http://www.cdc.gov/hai/pdfs/outbreaks/cdc-notice-heater-cooler-units-final-clean.pdf. Accessed Aug. 25, 2016.

Disclosures: Gervich and Ibrahim are employees of Mercy Medical Center.