Hospitals can lower the risk of M. chimaera outbreaks by keeping heater-cooler devices out of the clinical area.
Hospitals should remove heater-cooler devices (HCD) used in cardiac surgery from operating rooms and other clinical areas to reduce the risk of M. chimaera outbreaks.
However, moving HCDs might entail "engineering solutions," a study in the journal Infection Control & Hospital Epidemiology advises.
Researchers from Bern University Hospital in Switzerland offered several steps hospitals can take to prevent outbreaks linked to HCDs. M. chimaera is bacterium known to cause lung infections that have been fatal in half of the 70 cases identified in the US and Europe, the study noted.
The Food and Drug Administration issued a "safety communication" in 2015 offering guidance to hospitals on how to prevent the infections, which have been linked to aerosolization of M. chimaera by fans in the HCD.
The timing and source of contamination of the HCDs remain unknown, the Swiss researchers acknowledged.
"While our understanding of the causes and the extent of the M. chimaera outbreak is growing, several aspects of patient management, device handling, and risk mitigation still require clarification," they wrote.
Heart Surgery Machines Tied to M. chimaera Outbreak
The FDA recommended that hospitals direct the HCD's vent exhaust away from the surgical field to mitigate the risk of aerosolizing heater-cooler tank water into the sterile field and exposing the patient.
However, the Swiss researchers instead suggested "strict separation of the HCD from operating room air is necessary to ensure patient safety, and these efforts may require engineering solutions."
Keeping HCD exhaust out of OR air might involve constructing a custom-built housing for the device that sucks the HCD's exhaust out of the operating room. Another way would be to keep the HCD outside the OR in a room with a separate air ventilation system, although this solution presents logistical challenges.
Hospitals that can't immediately remove the HCD from the OR should position the device so the airflow is directed away from the patient as an interim solution. However, "these hospitals should be aware of the potentially increased infectious risk," they wrote.
"For the long term, separation of the exhaust air of any potentially aerosol-generating device from critical areas in the OR should be achieved."