Genomic analysis of cardiac surgery-associated mycobacterium chimaera infections in Italy

A. Ghodousi, E. Borroni, M. Peracchi, G. Palù, L. Fallico, M. Rassu, V. Manfrin, P. Mantegani, V. Monzillo, R. Manganelli, E. Tortoli, D.M. Cirillo

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One hundred and twenty-two Mycobacterium chimaera strains isolated in Italy from cardiac surgery-related patients, cardiac surgery-unrelated patients and from heater-cooler units, were submitted to whole-genome sequencing and to subsequent SNP analysis. All but one strains isolated from cardiac surgery-related patients belonged to Subgroup 1.1 (19/23) or Subgroup 1.8 (3/23). Only 28 out of 79 strains isolated from heater-cooler units belonged to groupings other than 1.1 and 1.8. The strains isolated from cardiac surgery-unrelated patients were instead distributed across the phylogenetic tree. Our data, the first on isolates from Italy, are in agreement with a recent large genomic study suggesting a common source, represented by strains belonging to Subgroups 1.1 and 1.8, of cardiac surgery-related Mycobacterium chimaera infections. The strains belonging to groupings other than 1.1 and 1.8 isolated from heather-cooler units evidently resulted from contaminations at hospital level and had no share in the Mycobacterium chimaera outbreak. One Mycobacterium chimaera strain investigated in this study proved distant from every previously known Mycobacterium chimaera Groups (1, 2, 3 and 4) and we propose to assign to a novel group, named “Group 5”. © 2020 Ghodousi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Original languageEnglish
JournalPLoS ONE
Issue number9 September
Publication statusPublished - 2020


  • adult
  • article
  • contamination
  • controlled study
  • female
  • heart surgery
  • human
  • Italy
  • major clinical study
  • male
  • Mycobacterium chimaera
  • nonhuman
  • phylogenetic tree
  • single nucleotide polymorphism
  • surgery
  • adverse event
  • atypical mycobacteriosis
  • atypical Mycobacterium
  • cross infection
  • epidemic
  • genetics
  • genomics
  • isolation and purification
  • medical device contamination
  • microbiology
  • mycobacteriosis
  • Mycobacterium
  • pathogenicity
  • whole genome sequencing
  • Cardiac Surgical Procedures
  • Cross Infection
  • Disease Outbreaks
  • Equipment Contamination
  • Female
  • Genomics
  • Humans
  • Male
  • Mycobacterium Infections
  • Mycobacterium Infections, Nontuberculous
  • Nontuberculous Mycobacteria
  • Polymorphism, Single Nucleotide
  • Water Microbiology
  • Whole Genome Sequencing


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