Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass J. Walker, G. Moore,

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Presentation transcript:

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass J. Walker, G. Moore, S. Collins, S. Parks, M.I. Garvey, T. Lamagni, G. Smith, L. Dawkin, S. Goldenberg, M. Chand Journal of Hospital Infection Volume 96, Issue 3, Pages 209-220 (July 2017) DOI: 10.1016/j.jhin.2017.04.014 Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 1 Schematic of a typical heater–cooler unit, oxygenator and cardioplegia equipment. Journal of Hospital Infection 2017 96, 209-220DOI: (10.1016/j.jhin.2017.04.014) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 2 Two overflow pipes which can be used to vary the volume of water in LivaNova 3T heater–cooler unit (HCU) tanks. The lower pipe takes the overflow (and visible debris) from the tank to the overflow bottle that is attached to the rear of the HCU. The upper pipe is blocked at the top and contains stagnant water, biofilm and debris. Journal of Hospital Infection 2017 96, 209-220DOI: (10.1016/j.jhin.2017.04.014) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 3 Presence of extensive biofilm on materials in the water tanks of the LivaNova PLC, Sorin 3T heater–cooler unit, studied at Public Health England, Porton Down, UK. Journal of Hospital Infection 2017 96, 209-220DOI: (10.1016/j.jhin.2017.04.014) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 4 Location of the gaps in the water tank top plates that contributed to the release of aerosols from the heater–cooler unit studied by Public Health England, Porton Down, UK. Journal of Hospital Infection 2017 96, 209-220DOI: (10.1016/j.jhin.2017.04.014) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 5 Use of a smoke tracer to visualize air flow path as it is extracted from the pumps/gaps associated with the water tanks and exiting the heater–cooler unit via the rear fan. Journal of Hospital Infection 2017 96, 209-220DOI: (10.1016/j.jhin.2017.04.014) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 6 Positioning of the heater–cooler unit outside the operating theatre with tubing passing through modular plates in the wall. Journal of Hospital Infection 2017 96, 209-220DOI: (10.1016/j.jhin.2017.04.014) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 7 Position of the tubing through the wall into the operating theatre, using anti-slip matt housing and connection to the cardiopulmonary bypass equipment. Journal of Hospital Infection 2017 96, 209-220DOI: (10.1016/j.jhin.2017.04.014) Copyright © 2017 The Healthcare Infection Society Terms and Conditions