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‘Superbug’ Linked to Two Deaths at UCLA Hospital; 100 Potentially Exposed

Officials blame contaminated duodenoscopes

More than 100 patients at the University of California, Los Angeles’ (UCLA) Ronald Reagan Medical Center may have been exposed to a potentially deadly bacterium from contaminated medical scopes after similar outbreaks at other hospitals across the country.

The Los Angeles Times has learned that seven patients at the UCLA center have been infected by carbapenem-resistant Enterobacteriaceae (CRE), and the bacteria may have contributed to two of those patients’ deaths. Those numbers may grow as more patients get tested, the paper says.

University officials reported that the exposed patients were treated between October and January.

In response to questions from the Times, UCLA said it became aware of the outbreak late last month and has begun to notify patients and to offer them medical tests. By some estimates, if the infection spreads to a person’s bloodstream, CRE can kill 40% to 50% of infected individuals.

At issue is a specialized endoscope used in approximately 500,000 patients annually to treat cancers, gallstones, and other ailments of the digestive system. These duodenoscopes are minimally invasive, and doctors credit them for saving lives through early detection and treatment.

Medical experts say the design of some scopes causes them to retain bacteria that can be difficult to disinfect through conventional cleaning, thereby allowing infections to be transmitted from patient to patient. These instruments are not the same type used in routine endoscopies and colonoscopies.

The procedure in question is known as endoscopic retrograde cholangiopancreatography (ERCP).

State and federal officials are looking into the situation at UCLA as they wrestle with how to respond to the problem industry-wide, the Times says. A handful of outbreaks have infected up to 150 patients since 2012 in Illinois and Pennsylvania, and most recently at a well-known Seattle medical center, according to experts.

These outbreaks are raising questions about whether hospitals, medical-device companies, and regulators are doing enough to protect patient safety, according to the Times. Some consumer advocates are also calling for greater disclosure to patients of the increased risks for infection before undergoing these procedures.

Dr. Alex Kallen, an epidemiologist in the Center for Disease Control and Prevention’s Division of Healthcare Quality Promotion, said the outbreaks are serious given how difficult CRE infections can be to treat and the fact that more cases might be going undetected.

“This bacterium is emerging in the U.S., and it’s associated with a high mortality rate,” Kallen said in an interview. “We don't want this circulating anywhere in the community.”

Source: Los Angeles Times; February 19, 2015.


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