title: Mycobacterium chimaera colonisation of heater-cooler units (HCU) in Western Australia, 2015: investigation of possible iatrogenic infection using whole genome sequencing.
abstract: Following the reported link between heater-cooler unit (HCU) colonisation with Mycobacterium chimaera and endocarditis, mycobacterial sampling of all HCUs in use in Western Australia was initiated from August 2015, revealing M. chimaera colonisation in 10 of 15 HCUs. After M. chimaera was isolated from a pleural biopsy from a cardiothoracic patient who may have been exposed to a colonised HCU, a whole genome sequencing investigation was performed involving 65 specimens from 15 HCUs across five hospitals to assess if this infection was related to the HCU. Genetic relatedness was found between the 10 HCU M. chimaera isolates from four hospitals. However the M. chimaera isolate from the cardiothoracic patient was not genetically related to the HCU M. chimaera isolates from that hospital, nor to the other HCU isolates, indicating that the HCUs were not the source of the infection in this patient.
authors.affiliation: Royal Perth Hospital, Perth, Australia.|Fiona Stanley Hospital, Perth Australia.|Pathwest Laboratory Medicine WA, Fiona Stanley Hospital Network, Perth, Australia.|Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University and School of Biomedical Sciences, Curtin University, Perth, Australia.
authors.forename: James Owen
authors.initials: JO
authors.lastname: Robinson
authors.affiliation: Pathwest Laboratory Medicine WA, Fiona Stanley Hospital Network, Perth, Australia.|Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University and School of Biomedical Sciences, Curtin University, Perth, Australia.
authors.forename: Geoffrey Wallace
authors.initials: GW
authors.lastname: Coombs
authors.affiliation: PathWest Laboratory Medicine WA, Hospital Avenue, Nedlands, Australia.|School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia.
authors.forename: David John
authors.initials: DJ
authors.lastname: Speers
authors.affiliation: PathWest Laboratory Medicine WA, Hospital Avenue, Nedlands, Australia.
authors.forename: Terillee
authors.initials: T
authors.lastname: Keehner
authors.affiliation: PathWest Laboratory Medicine WA, Hospital Avenue, Nedlands, Australia.
authors.forename: Anthony David
authors.initials: AD
authors.lastname: Keil
authors.affiliation: St John of God Pathology, Perth, Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: D'Abrera
authors.affiliation: Fiona Stanley Hospital, Perth Australia.|Pathwest Laboratory Medicine WA, Fiona Stanley Hospital Network, Perth, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Boan
authors.affiliation: Pathwest Laboratory Medicine WA, Fiona Stanley Hospital Network, Perth, Australia.|Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University and School of Biomedical Sciences, Curtin University, Perth, Australia.
authors.forename: Stanley
authors.initials: S
authors.lastname: Pang
mesh_terms: D003428:Cross Infection / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D004866:Equipment Contamination; D055106:Genome-Wide Association Study; D006801:Humans; D009164:Mycobacterium Infections / Q000382:microbiology*; D009170:Nontuberculous Mycobacteria / Q000235:genetics* / Q000302:isolation & purification*; D014871:Water Microbiology; D014904:Western Australia
chemical_list: D004269:DNA, Bacterial
keywords: Heater-cooler unit; Mycobacterium Chimaera; Whole genome sequencing; endocarditis