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Message to community paediatricians and cardiologists

Dec. 15, 2016

As you may be aware, the Centers for Disease Prevention and Control (CDC) and Health Canada have issued advisories about an association between heater-cooler devices used during cardiac bypass surgery and Mycobacterium chimaera infections, a nontuberculous mycobacterium (NTM). We are not aware of any cases at SickKids to date and understand, as reported, that the risk of infection is very low.

Reported infections in the literature include prosthetic valve endocarditis, prosthetic valve graft infections, sternotomy wound infections, mediastinitis, bloodstream infections and disseminated infections.  We, like many other centres, use the heater-cooler machines mentioned in the advisory and have recently notified patients who may have been exposed to the affected heater-coolers (purchased in December 2013). A link to our notification is available at http://www.sickkids.ca\heater-cooler.

Although we have set up an information phone line for patients, as health-care providers for some of our patients, you may be approached by families with symptoms or concerns. The Public Health Agency of Canada has developed recommendations for testing. Identifying this type of infection requires specific testing which is only indicated in symptomatic patients. Testing should be directed towards individuals with prolonged illness in the absence of an alternate diagnosis. In addition, samples should be clearly identified on the requisition as being related to this exposure to ensure that optimal methods are used to identify this organism.  Treatment for M. chimaera should be done in consultation with Infectious Diseases.

More information is also available on the SickKids website, including Frequently Asked Questions. In addition, the Infectious Disease service at SickKids is available for questions regarding suspect cases.