Skip to main content

Table 1 Summary of patients with invasive M. chimaera disease

From: Rapid detection of invasive Mycobacterium chimaera disease via a novel plasma-based next-generation sequencing test

Patient

Preceding cardiac surgery (months prior to presentation)

Presenting symptoms (duration in months)

Clinical scenario (disease type)

Specimen source

Days to positive AFB culture

Days to identify MAC from AFB culture

Days to speciate M. chimaera from AFB culture

Days to detect M. chimaera by plasma NGSa

Additional organisms detected by plasma NGS

Days on MAC therapy at time of plasma NGS (regimen)

Patient outcome

1 (illus-trative case)

AVR, ARR (17)

Fatigue, weight loss, night sweats (4)

Pancytopenia, renal failure, severe aortic insufficiency and rocking of prosthetic valve (disseminated)

Blood (1 of 3 positive)

43

47

62

6c

None

0

(azithromycin, ethambutol, rifabutin, amikacin)

Alive (s/p redo surgery)

Valve

5

6

Not done

2

AVR, ARR (14)

Fatigue, weight loss, cough, fever, night sweats (4)

Pancytopenia, granulomatous hepatitis and nephritis (disseminated)

Blood (4)

Negative

N/A

N/A

3c

None

12

(azithromycin, ethambutol, rifampin)

Expired

Bone marrow

Negative

N/A

N/A

Liver

14

17

43

Urine

18

20

41

3

AVR, MVR (22)

Nausea and chills (3)

Pancytopenia, large MV vegetation, granulomatous hepatitis and bone marrow granulomas (disseminated)

Blood (2)

Negative

N/A

N/A

5c

EBV

0

(azithromycin, ethambutol, rifabutin, amikacin)

Expired

Bone marrow

20

22

Not done

Valve

6

8

23

4

AVR (17)

Lower back pain (2)

T11-T12 diskitis and vertebral osteomyelitis (disseminated)

Disk

20

23

39

2

EBV

22

(azithromycin, ethambutol, rifabutin)

Expired

5

AVR, ARR (21)

Fatigue, fever, night sweats (3)

Fluid collection surrounding aorta (localized)

Blood (3)

Negative

N/A

N/A

Negative

None

0

(azithromycin, ethambutol, rifampin, amikacin, moxifloxacin)

Alive

(s/p redo surgery)

Graft/valve

24

27

41

6

AVR (14)

Weakness, weight loss, fever, night sweats (3)

Thrombocyto-penia, granulomatous hepatitis (disseminated)

Liver

26

35

92

6

Actinomyces oris, Prevotella corporis, Prevotella buccalis, Gardnerella vaginalis, Acinetobacter baumannii

103

(clarithromycin, ethambutol, rifabutin)

Expired

7

AVR, ARR (27)

Dyspnea, lower extremity edema, weight loss (5)

Anemia, thrombocyto-penia, cholestatic hepatitis, aortic root abscess (disseminated)

Blood (1 of 5 positive)

28

28

Not done

2c

N/Ab

0

(azithromycin, ethambutol, rifampin, moxifloxacin)

Expired

Sputum

17

20

38

Bone marrow

25

26

34

8

AVR (25)

Weakness, cough, fever (0.75)

Pancytopenia, cholestatic hepatitis (disseminated)

Blood (1)

Negative

N/A

N/A

3c

N/Ab

3

(azithromycin, ethambutol, rifampin, moxifloxacin, amikacin)

Alive

(s/p redo surgery)

Sputum

23

Not done

42

Bone marrow

27

29

Not done

Liver

24

27

Not done

Valve

6

10

34

9

AVR, ARR (12)

Chest pain, weight loss, fatigue (9)

Anemia, mediastinal mass (localized)

Blood (4)

Negative

N/A

N/A

4c

N/Ab

0

(azithromycin, ethambutol, rifampin, moxifloxacin)

Alive

(s/p redo surgery)

Urine (2)

Negative

N/A

N/A

Mediastinal lymph node

15

24

43

10

AVR, ARR (21)

Weakness, fatigue, weight loss, fever (2)

Pancytopenia, bone marrow granulomas (disseminated)

Blood (2 of 2 positive)

14

17

46

4c

N/Ab

0

(azithromycin, ethambutol, rifabutin)

Expired

15

18

Not done

  1. AVR = aortic valve replacement, ARR = aortic root replacement, MVR = mitral valve replacement, AFB = acid-fast bacilli, MAC = Mycobacterium avium complex, NGS = next-generation sequencing
  2. aIncludes only the first positive plasma NGS
  3. bDedicated M. chimaera plasma NGS
  4. cNGS provided the first microbiological confirmation of M. chimaera infection. For patients 4 and 6, the plasma NGS was not performed until approximately 6 weeks and 4.5 months after AFB cultures had been collected