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Volume 23, Number 5—May 2017

Invasive Nontuberculous Mycobacterial Infections among Cardiothoracic Surgical Patients Exposed to Heater–Cooler Devices1

Meghan M. LymanComments to Author , Cheri Grigg, Cara Bicking Kinsey, M. Shannon Keckler, Heather Moulton-Meissner, Emily Cooper, Minn M. Soe, Judith Noble-Wang, Allison Longenberger, Shane R. Walker, Jeffrey R. Miller, Joseph F. Perz, and Kiran M. Perkins
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.M. Lyman, C. Grigg, C. Bicking Kinsey, M.S. Keckler, H. Moulton-Meissner, M.M. Soe, J. Noble-Wang, J.R. Miller, J.F. Perz, K.M. Perkins); Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA (C. Bicking Kinsey, A. Longenberger, J.R. Miller); WellSpan York Hospital, York, Pennsylvania, USA (E. Cooper, S.R. Walker)

Main Article

Table 4

Results from logistic regression models to evaluate exposure length variables in investigation of invasive extrapulmonary NTM infections among patients who underwent cardiothoracic surgery, York, Pennsylvania, USA, 2015*

Regression models Odds ratio (95% CI) p value
Univariable models†
Patient characteristics
Age, per 1-y increase 1.0 (1.0–1.1) 0.4
Male sex 3.0 (0.7–16.8) 0.2
White race 1.8 (0.2–244.3) 0.7
Chronic lung disease: yes 2.9 (0.7–11.4) 0.1
Diabetes: yes 0.3 (0.03–1.5) 0.2
Immunocompromised: yes
1.5 (0.3–6.0)
Length of surgical exposure
   Surgical time with HCD, h
     0 Referent
     >0 to <4 1.8 (0.2–15.4) 0.6
     ≥4 to <5 2.6 (0.2–23.6) 0.4
     ≥5 15.6 (3.2–103.9) 0.002
   Time on bypass, h
     0 Referent
     >0 to <2 1.7 (0.2–12.2) 0.6
19.0 (3.7–133.0)
Final logistic model‡
Model 1.1, only surgical time with HCD retained in the final model:
Surgical time with HCD >5 h 13.2 (3.2–62.9) 0.0008
Model 1.2, includes surgical time with HCD and immunocompromised status
     Surgical time with HCD >5h 13.6 (3.3–68.8) 0.001
     Immunocompromised: yes 2.2 (0.4–12.2) 0.4
Model 2.1, only time on bypass retained in the final model:
Time on bypass >2 h 16.5 (3.8–84.0) 0.0004
Model 2.2, includes time on bypass and immunocompromised status
     Time on bypass >2h 16.6 (3.8–88.4) 0.0006
     Immunocompromised: yes 2.1 (0.3–12.0) 0.4

*HCD, heater–cooler device; NTM, nontuberculous mycobacteria.
†Regression models for factors considered in the multivariable model; each regression model used Firth’s penalized maximum likelihood method.
‡Each final regression model used Firth’s penalized maximum likelihood method; other variables (sex, age, immunocompromised status, chronic lung disease) were removed because of nonsignificance.

Main Article

1Preliminary results from this study were presented at the Epidemic Intelligence Service conference, May 2–5, 2016, Atlanta, Georgia, USA; and the American Society for Microbiology Microbe conference, June 16–20, 2016, Boston, Massachusetts, USA.

Page created: April 17, 2017
Page updated: April 17, 2017
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