Superbug alert in LA after two patients die

Improperly sterilised scopes used in throat endoscopies may be cause of infection

Zachary Rubin, medical director of clinical epidemiology speaks at a news conference by UCLA Health System and county officials at the Ronald Reagan UCLA Medical Center in Los Angeles. The large Los Angeles teaching hospital has told scores of patients they were possibly exposed to a drug-resistant bacterial “superbug” during endoscopy procedures that infected seven patients. Photo: Jonathan Alcorn/Reuters

Zachary Rubin, medical director of clinical epidemiology speaks at a news conference by UCLA Health System and county officials at the Ronald Reagan UCLA Medical Center in Los Angeles. The large Los Angeles teaching hospital has told scores of patients they were possibly exposed to a drug-resistant bacterial “superbug” during endoscopy procedures that infected seven patients. Photo: Jonathan Alcorn/Reuters

 

Federal officials warned health care providers Thursday that difficult-to-clean medical scopes inserted down the throat might be infecting patients with deadly drug-resistant bacteria. The alert from the Food and Drug Administration came a day after California hospital officials reported seven patients had fallen ill and two had died from what they said were improperly sterilized scopes at Ronald Reagan UCLA Medical Center.

The likely cause was a superbug that may have been transmitted during procedures using the devices, the hospital said. The family of germs, known as CRE, which stands for carbapenem-resistant Enterobacteriaceae, are deadly because they are resistant to almost all antibiotics.

The CRE germs usually strike people receiving medical care in hospitals or nursing homes, including patients on breathing machines or dependent on catheters. Healthy people are rarely, if ever, affected. But the bugs attack broadly, and the infections they cause are not limited to people with severely compromised immune systems, such as those with cancer, said Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention.

“This is exactly what we are worried about,” Frieden said of the California infections in an interview. “CRE is becoming increasingly common in hospitals around the US If we aren’t careful, it may well get out into the community and make common infections, like urinary infections, and cuts, potentially deadly.”

The devices implicated in the California cases are inserted down the throat and through the stomach to the top of the small intestine, an area called the duodenum. Called duodenoscopes, they were used to diagnose and treat diseases of the liver, bile ducts and pancreas.

“Residual body fluids and organic debris may remain in these crevices after cleaning and disinfection,” the FDA warned. “If these fluids contain microbial contamination, subsequent patients may be exposed to serious infections.” The UCLA Health System, of which the Ronald Reagan hospital is a part, has identified and notified at least 179 patients who may have been exposed during procedures performed between October and January, it said in a statement. CRE germs often begin as a normal part of the human gut bacteria, but they can develop a certain enzyme and become resistant. The CDC has estimated they account for about 9,300 infections and 610 deaths a year.

New York Times