Aortic Endograft Infection with Mycobacterium chimaera and Granulicatella adiacens, Switzerland, 2014
Andreas Plate
, Thomas A. Kohl, Peter M. Keller, Sabine Majer, Rosamaria Fulchini, Carol Strahm, Cristoforo Medugno, Zoran Rancic, Lars Husmann, Hugo Sax, Stefan Niemann, and Barbara Hasse
Author affiliations: University Hospital Zurich, Zurich, Switzerland (A. Plate, Z. Rancic, L. Husmann, H. Sax, B. Hasse); Research Center Borstel–Leibniz-Center for Medicine and Biosciences, Borstel, Germany (T.A. Kohl, S. Niemann); German Center for Infection Research, Borstel (T.A. Kohl, S. Niemann); National Center for Mycobacteria, University of Zurich, Zurich (P.M. Keller); Institute of Medical Microbiology, University of Zurich, Zurich (P.M. Keller); Cantonal Hospital Münsterlingen, Münsterlingen, Switzerland (S. Majer); Cantonal Hospital St. Gallen, St. Gallen, Switzerland (R. Fulchini, C. Strahm); Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland (C. Medugno)
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Figure 2
Figure 2. Phylogeny of isolate from case-patient who received an abdominal aortic endograft and was later diagnosed with Mycobacterium chimaera and Granulicatella adiacens infection, Switzerland, 2014, and comparison isolates. Maximum-likelihood tree was built from 14,192 single-nucleotide polymorphism positions of 437 group 1 Mycobacterium chimaera isolates mapped to the DSM-44623 M. chimaera genome (GenBank accession no. NZ_CP015278.1). DSM-44623 is shown as a rectangular phylogram with the inferred subgroups indicated. Inset box shows subgroups 1.8, 1.11, and 1.Branch1, annotated with isolate origin and the source publication. Black arrow indicates position of the patient isolate. Group 1.11 consisted mainly of samples collected at the Maquet production site in Rastatt, Germany (n = 12); 1 isolate came from an in-use Maquet HCU. Branch 1 contained primarily strains from patients with pulmonary M. chimaera infections (n = 70) and strains from LivaNova HCUs (n = 4), Maquet HCUs (n = 3), Maquet ECMOs (n = 11), a hospital-built HCU (n = 1), Maquet production site (n = 1), and a patient infected after cardiac surgery (n = 1). ECMO, extracorporeal membrane oxygenation; HCU, heater–cooler unit. Scale bars indicate numbers of substitutions per site.
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