Josh O'Leary

joleary@press-citizen.com

University of Iowa Hospitals and Clinics has sent letters to about 1,700 patients warning them of an infection risk caused by a device used in certain major heart, lung and liver surgeries.

UIHC leaders acknowledged Thursday that one patient has developed the infection but emphasized the overall risk is low, with the U.S. Centers for Disease Control and Prevention estimating a less than 1 percent chance of it occurring in those who had the surgeries.

The hospital this week began notifying patients who may have been exposed to a bacterium, nontuberculous mycobacteria, or NTM, while undergoing surgery using a specific bypass-related device after Jan. 1, 2012.

The bacterium, which UIHC says is commonly found in the environment and typically not harmful, can grow in the water in the heater-cooler devices on heart and lung bypass machines. The bacterium can then become airborne in the operating room through a fan on the device and pose a small risk of getting into an open incision and infecting the patient.

The infection, which is treatable but can be fatal, has symptoms that include a fever lasting more than one week, pain, redness, heat, pus around a surgical incision, night sweats, joint pain, muscle pain, loss of energy and failure in infants to gain weight or grow.

The CDC issued a national advisory warning about the infection risk in October, and UIHC says it immediately began implementing the CDC's recommendations for more stringent disinfection protocol of the devices.

Theresa Brennan, UIHC's chief medical officer, said the hospital could not discuss the specifics of the case involving the infected patient. But she said, in general, NTM is a serious infection that requires prolonged treatment with multiple medications.

"The risk is very low, and the reason we want to make sure patients know is if they have symptoms they can get the treatment," Brennan said. "We've spoken to several patients personally, and they seem to be responding very well. But we recognize this could cause anxiety, and that is not the intent."

UIHC said the infection can be slow, meaning it could be months or years after surgery before it manifests. The hospital says patients who had other procedures — including stents, pacemakers, defibrillators, ablations and biopsies — are not at risk.

UIHC spokesman Tom Moore said the CDC has advised hospitals to check with patients who have had the at-risk surgeries within the past four years to see if they have any infection symptoms.

"We're essentially telling them this is a new and emerging bacteria, no one really knew it could cause a problem, but now that we've found it we want you to take this letter to your primary care physician if you have these types of symptoms," Moore said. "If you do, call us and we'll get you in and tested and see what we can do to help."

Moore said UIHC now situates the heating and cooling devices outside of operating rooms, with the water traveling back and forth via tubes — a change the CDC says should eliminate the risk.

Hospitals nationally have reported NTM infections related to the heater-cooler devices. In October, a hospital in York, Pennsylvania, identified eight patients with an NTM infection, four of whom had died. In November, Penn State Milton S. Hershey Medical Center in Pennsylvania identified three infected patients, two of whom have died.

In May 2014, Greenville Memorial Hospital in South Carolina said 15 patients were infected with NTM, four of whom died, though it's unclear if the heater-cooler devices were to blame.

The USA Today Network contributed to this story. Reach Josh O’Leary at joleary@press-citizen.com or 887-5415, and follow him on Twitter at @JD_OLeary.

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