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Common procedure at Los Angeles hospital may have exposed 179 patients to lethal ‘superbug’

A “superbug” has killed two people and infected at least five more at UCLA’s Ronald Reagan Medical Center, where hospital officials fear as many as 179 others also may have been exposed to the drug-resistant strain.

After one patient tested positive for the infection in late January, the hospital began contacting other patients who were potentially exposed through the same medical procedure between October and January. They found that close to 200 people had been exposed to the infection, which is called carbapenem-resistant Enterobacteriaceae, or CRE, and has led to similar outbreaks at hospitals around the country in recent years.

UCLA officials told the Los Angeles Times a piece of medical equipment used for routine endoscopic procedures may have served as the catalyst for the outbreak. The duodenoscope in question is inserted into patients’ throats to monitor problems affecting the digestive tract in a procedure known as endoscopic retrograde cholangiopancreatography, or ERCP.

The procedure is considered non-invasive and is performed more than 500,000 times annually in the United States. Although the device is meticulously cleaned between uses according to industry and manufacturer guidelines, it now appears the bacteria may still be able to grow in some of its more difficult-to-reach sections.

“The two scopes involved with the infection were immediately removed and UCLA is now utilizing a decontamination process that goes above and beyond the manufacturer and national standards,” UCLA spokeswoman Dale Tate told the Times.

According to the Centers for Disease Control and Prevention, CRE typically only affects patients already in a health care setting and particularly those regularly using medical devices like ventilators and catheters or taking certain antibiotics for extended periods. Some reports estimate that CRE can kill up to 50 percent of those infected if it spreads to the bloodstream.

UCLA said it is working with federal and state authorities to address the problem.

The FDA issued a statement Thursday raising concerns over the design of ERCP duodenoscopes in response to the outbreak. The warning advised health care providers to continue following cleaning instructions, paying particularly attention to the recesses around the device’s elevator mechanism, which is suspected to be most hospitable to the bacteria’s growth.

“Some parts of the scopes may be extremely difficult to access and effective cleaning of all areas of the duodenoscope may not be possible,” the warning said, adding that patients should be made fully aware of any risks and benefits prior to the procedure.

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