Heart Perfusion and Heater/Cooler Units
Heart perfusion systems require stringent disinfection and water maintenance practices. Improper water maintenance and disinfection can lead to biofilm formation with other water pathogens like Mycobacterium species, non-fermenting gram negative bacteria, Pseudomonas aeruginosa and coliforms. Formation of biofilms can lead to aerosolisation of bacteria leading to contamination of the sterile surgical area and indirectly may come in contact with the patients. Proper maintenance include cleanliness of water, regular monitoring of perfusion systems and surgical area water monitoring for typical microorganism including Mycobacterium species like Mycobacterium chimaera. Recommendations for testing reflect national drinking water standards of HPC, E.coli, coliforms and water quality indicator bacteria, Mycobacterium species and Pseudomonas aeruginosa. Also recommendations are to implement microbiological monitoring of the water quality:
» If units are not properly maintained, test every 2 weeks and once acceptable, test monthly.
» If units properly maintained, test monthly.
» If 3 months of testing shows successful results, then quarterly testing may be performed
Testing includes:
1. Speciation: Test Code 1142 (5-10 days after 7 weeks incubation)
2. Heterotrophic plate count (HPC): Test code 3056 (TAT: 48 hrs.)
3. E. coli and total coliforms (P/A): Test code 3011 (TAT: 48 hrs.)
4. Pseudomonas aeruginosa (P/A): Test code 6009.1 (TAT: 48hrs)
Sample requirements:
Collection of both samples at the same time is optional and depends on the hospital protocol and disinfection methods. It is preferable to collect sample before disinfection and after disinfection.
500 ml water sample prior to disinfection (1 bottle for all the tests mentioned above) 500 ml water sample after disinfection (1 bottle for all the tests mentioned above).
To request your free Heater/Cooler Testing kit please visit the AeroSTORE:
We only accept samples on Monday, Tuesday and Wednesday due to the 24 – 48 hour test period and the laboratory is not open on the weekends. Weekend work must be pre-arranged with additional fees.
Contaminated Devices Putting Open-Heart Surgery Patients at Risk
The Centers for Disease Control and Prevention (CDC) is warning healthcare providers and patients about the potential risk of infection from certain devices used during open heart (open-chest) surgery.
Patients who have had open heart surgery should seek medical care if they are experiencing symptoms associated with infections, such as night sweats, muscle aches, weight loss, fatigue, or unexplained fever. This advice follows new information indicating that some LivaNova PLC (formerly Sorin Group Deutschland GmbH) Stöckert 3T heater-cooler devices, used during many of these surgeries, might have been contaminated during manufacturing which could put patients at risk for life-threatening infections.
More than 250,000 heart bypass procedures using heater-cooler devices are performed in the United States every year. Heater-cooler units are an essential part of these life-saving surgeries because they help keep a patient’s circulating blood and organs at a specific temperature during the procedure. Approximately 60 percent of heart bypass procedures performed in the U.S. utilize the devices that have been associated with these infections. CDC
estimates that in hospitals where at least one infection has been identified, the risk of a patient getting an infection from the bacteria was between about 1 in 100 and 1 in 1,000. While these infections can be severe, and some patients in this investigation have died, it is unclear whether the infection was a direct cause of death. Available information suggests that patients who had valves or prosthetic products implanted are at higher risk of these infections.
CDC also released today a Health Alert Network advisory to help hospitals and healthcare providers identify and inform patients who might have been put at risk.
Aerobiology Laboratory can provide your facility with the microbial analysis for water heater/cooler systems to protect your patients and staff. The CDC and FDA follow recommendations for testing that reflect national drinking water standards of HPC, E. coli, coliforms and water quality indicator bacteria, Mycobacterium species and Pseudomonas aeruginosa. Also, recommendations are to implement microbiological monitoring of the water quality:
» If Heater/Cooler units are not properly maintained, test every 2 weeks and once acceptable, test monthly.
» If Heater/Cooler units are properly maintained, test monthly.
» If 3 months of testing show successful disinfecting results, then quarterly testing may be performed.