Baker AW, Maziarz EK, Lewis SS, et al. - In view of recent mitigation of a clonal outbreak of hospital-acquired Mycobacterium abscessus complex (MABC), which included a large cluster of adult patients who developed invasive infection after exposure to heater-cooler units during cardiac surgery, researchers here investigated the epidemiology and clinical courses of cardiac surgery patients with invasive MABC infection. They retrospectively evaluated clinical data on 10 patients who underwent cardiac surgery at their hospital and subsequently had positive cultures for MABC from 2013-2016. A first positive culture was evident following a median time of 53 days (interquartile range [IQR], 38-139 days) from presumed inoculation in the operating room. They commonly observed disseminated infection; mediastinum (n = 7) and blood (n = 7) were the most frequent culture-positive sites. A median of 24 weeks (IQR, 5-33 weeks) of combination antimicrobial therapy that included multiple intravenous agents was provided to patients. Due to adverse events attributed to amikacin, linezolid, or tigecycline, antibiotic changes were made in six patients. Surgical management was undertaken in eight patients, and multiple sternal debridements were performed in six patients. Death of eight patients was reported within 2 years of diagnosis, including 4 deaths directly attributable to MABC infection. These findings suggest encountering substantial morbidity and mortality in correlation with invasive MABC infection after cardiac surgery despite aggressive medical and surgical management.