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Another Scope-Related ‘Superbug’ Found at California Hospital

Duodenoscope procedure linked to three cases of Pseudomonas infection

Huntington Memorial Hospital in Pasadena, California, is investigating a suspected outbreak related to the same type of medical scope tied to ‘superbug’ infections across the country, according to an article in the Los Angeles Times.

The hospital said in a statement issued August 19 that it had alerted health authorities about a potential link between patients who have Pseudomonas bacteria and the Olympus Corp. duodenoscopes used to treat them.

Many forms of potentially deadly bacteria can become trapped inside the reusable devices and can get passed on to future patients, according to the Times report. Federal regulators have attributed this to a design flaw that makes the tip of these instruments difficult to clean even when following the manufacturers’ guidelines.

Huntington Memorial said that it discovered the problem in June during a review of lab samples. It has reported three patient infections to health officials so far. The hospital declined to provide further details on these cases or on the number of patients exposed to the scopes, citing medical privacy laws.

Despite the widening problem, federal officials have insisted that the troublesome scopes remain on the market because there are no better alternatives and because many critically ill patients benefit from their use. Some medical experts have said, however, that these incidents remain underreported and that the number of scope-related infections may be far higher than current reports indicate.

On August 17, the FDA issued warning letters to Olympus and two other scope makers, Fujifilm and Pentax Medical, for a range of safety-related violations. Olympus was cited for not reporting infections to authorities in a timely manner. The U.S. Justice Department is also investigating the ‘superbug’ outbreaks and has sent subpoenas to all three scope manufacturers.

The Pseudomonas bacteria uncovered at the Pasadena hospital are a common cause of infections, but some strains are resistant to all antibiotics, which can make the bug deadly for some patients. The bacteria in Pasadena are similar to the carbapenem-resistant Enterobacteriaceae (CRE) ‘superbug’ at the center of a February outbreak at UCLA’s Ronald Reagan Medical Center that sickened eight patients, including three who died.

In all of these cases, the bacteria were transmitted during endoscopic retrograde cholangiopancreatography (ERCP), in which a fiber-optic scope is threaded down the patient’s throat to diagnose and treat problems in the digestive tract, such as gallstones, cancers, and blockages in the bile duct. Nationally, more than 650,000 ERCP procedures are performed each year.

The Pasadena hospital said it has adopted safety measures, such as quarantining disinfected scopes for 48 hours before reuse to check for bacterial growth. Other hospitals with outbreaks, such as Virginia Mason Medical Center in Seattle, are also using that method to help protect patients.

In response to the recent outbreaks, the U.S. Department of Veterans Affairs examined its records to determine whether scopes sickened any of its patients. Doctors at the VA found that almost 100 patients treated with the same type of medical scope linked to the deaths of three patients at UCLA tested positive for CRE. VA officials told the Times, however, that there didn't appear to be a large-scale problem at its centers.

Source: Los Angeles Times; August 19, 2015.


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