Professional Documents
Culture Documents
Clinical Manifestations
Prosthetic valve endocarditis
Vascular graft infection
Disseminated infection
Splenomegaly
Arthritis
Osteomyelitis
Cytopenias (bone marrow involvement)
Chorioretinitis
Lung involvement
Hepatitis
Nephritis
Myocarditis
16: Ventilation
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm466963.htm
10/15/15.
CDC Guidance
The most important action to protect
patients will be to remove contaminated
heater-coolers from operating rooms, and
ensure that those in service are correctly
maintained.
http://www.cdc.gov/HAI/pdfs/outbreaks/CDC-Notice-Heater-Cooler-Units-final-clean.pdf.
10/27/15.
PA DOH Advisory
Risk: approximately 1:10,000 to possibly 1:100 among
patients undergoing open heart surgery on CPB.
Patients and providers should not delay cardiac
surgeries after appropriate informed consent.
Several important unknowns:
Whether the risk of NTM infection can be completely
eliminated
The degree to which only certain models of HCUs will
aerosolize bacteria or whether all HCUs have the potential to
aerosolize bacteria
The ability of stated disinfection procedures to adequately
decontaminate a colonized machine
Pennsylvania Department of Health, Advisory #322, 12/11/15.
Challenges
Case finding: Many patients receive follow-up care
locally, not at UIHC
Symptoms can be very nonspecific (fever, fatigue,
arthralgias, myalgias)
Symptoms can present up to 4 years after the
exposure (long incubation period)
Mycobacterial cultures are not routinely performed,
but are required for diagnosis
For above reasons, the true extent of this
problem is not currently known
Very difficult to treat (multiple drug therapy, surgical
removal of involved devices)