Persistent contamination of heater-cooler units for extracorporeal circulation cured by chlorhexidine-alcohol in water tanks

Recently, surgical site infections due to non-tuberculous mycobacteria (NTM) have been linked to heater-cooler unit contamination. The European Centre for Disease Prevention and Control and manufacturers now recommend the use of hydrogen peroxide in filtered water to fill heater-cooler unit tanks. After implementation of these measures in our hospital, heater-cooler units became heavily contaminated by opportunistic waterborne pathogens such as Pseudomonas aeruginosa and Stenotrophomonas maltophilia. No NTM were detected but fast-growing resistant bacteria could impair their detection. The efficiency of hydrogen peroxide and chlorhexidine-alcohol was compared in situ. Chlorhexidine-alcohol treatment stopped waterborne pathogen contamination and NTM were not cultured whereas their detection efficiency was probably improved.