A machine used to regulate a patient’s temperature during heart surgery has caused at least a dozen children to report infected incisions at Children’s Hospital New Orleans over a two-month span between May and July this year.  The equipment was evidently contaminated and has been replaced, according to Dr. John Heaton, Senior Vice President and Chief Medical Officer of the hospital.  The patients have been given intravenous antibiotics, which appears to be working to clear the infections.A letter issued by the hospital read: “This is the first time Children’s Hospital has experienced surgical site infections caused by mycobacterium…The infection is treatable and all patients are currently undergoing successful treatment in this hospital. Because a common element in the affected children was open-heart surgery requiring the use of cardiopulmonary bypass, our investigation focused on the environment and equipment used in the cardiac operating room.  We believe a piece of equipment used to regulate the temperature of patients while on bypass is the most likely source of this infection, and all suspected equipment has been removed from service and replaced.”An investigation began after three incision infections were reported within 72 hours.  The hospital contacted the families of every child (55 in total) who underwent surgery during that time period to inquire about potential infection.  Seven of the twelve were identified as having complications through the initial screening.  A few others are scheduled to meet with doctors in Louisiana.

Image Courtesy of Piron Guillaume

According to the Centers for Disease Control and Prevention, contaminated medical equipment can infect the skin and the soft tissues beneath it.  The bacteria that is to blame for the children’s infections in this particular case is common in water, dust and ground soil.  The heating and cooling units of the hospital were inspected to see if those could be linked to the outbreak as well, because of a similar one reported by Duke University in Durham, North Carolina which was traced back to the heater-cooler units on bypass machines.Physicians at Duke indicated that half of 24 patients with similar infections to those at Children’s, which occurred over a thirteen-month span between December 2014 and June 2015, were affected due to unclean water in the bypass machines’ units.  Once this water was replaced with sterile fluid, the infections stopped.  After the outbreak, the Food and Drug Administration issued a report announcing the specific model linked to the outbreak, and this model is the same as was used at Children’s Hospital.Heaton said that the staff was originally using tap water until the report was issued and they began to use filtered water for the machines.  The hospital has now replaced the troublesome model with one from another company.  Children’s is also funding the treatment of the infections and all related costs, including room and board and meals.  “We’re picking that up and making it right,” Heaton said.  “We’re going to try and make this as bearable as possible…This is a difficult thing to watch. You know, it's heartbreaking as a physician to see these families go through this because it's not only the patient, it's their entire family.”

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Child heart patients treated for surgical infection12 children contract serious infection after surgery at New Orleans hospital