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NSW Health replaces machines and alerts cardiologists to rare infection risk

As a precaution, NSW Health has replaced a small number of machines used in cardiac surgery following international reports of a rare infection.

NSW Health has also advised clinicians to consider infections due to the M. chimaera bacteria in patients who have undergone open heart surgery in the last five years.

Infection of cardiac surgery patients with Mycobacterium chimaera associated with a particular piece of open heart surgery equipment (specifically heater-cooler units made by Sorin) was first recognised in 2012 in Switzerland. The devices, which are widely used around the world, are thought to have been contaminated during manufacture.

The TGA (Therapeutic Goods Administration) has advised of a possible patient infection linked to the contaminated units in Australia. There have been no reported patient infections to date in NSW.

These infections are rare and the risk to patients is very low. The risk of a patient contracting an M. chimaera infection following valve replacement is estimated to be about one in 100,000.

Internationally around 50 patients have been identified as developing this infection between three months and five years after their operation where this contaminated equipment was used.

The four NSW public hospitals which used potentially contaminated heater-cooler units are Prince of Wales, St George, Sydney Children’s Hospital, Randwick, and The Children’s Hospital, Westmead.

There is a very small risk that patients who underwent open heart surgery at these hospitals in the past five years could develop this unusual infection in or near their surgical wound.

There is no ongoing risk in NSW public hospitals. The contaminated units have either been verified as clear after rigorous cleaning or have been replaced with new units.

Dr Kate Clezy, an infectious disease specialist working the NSW Clinical Excellence Commission, said: “The contamination of heater-cooler devices with this mycobacteria is associated with only one brand and we’ve contacted all facilities using this device to ensure they were being rigorously cleaned or replaced.”