In hospitals across the United States, a lethal string of infections has emerged, involving a type of antibiotic-resistant bacteria known as CRE. The Los Angeles Times reports that seven patients who were treated at UCLA Medical Center were infected with the drug-resistant superbug CRE. Two of these patients died from the infection.
The CDC states that carbapenem-resistant Enterobacteriaceae (CRE) is a serious threat to public health because this type of infection is difficult or impossible to treat. If a CRE infection spreads to a person’s bloodstream, the bacteria can kill 40% to 50% of patients.
According to UCLA, 179 patients may have been exposed to CRE while undergoing an operation called endoscopic retrograde cholangiopancreatography (ERCP) at Ronald Regan UCLA Medical Center between October 3, 2014 and January 28, 2015. ERCP is “an endoscopic procedure to diagnose and treat diseases of the liver, bile ducts, and pancreas.”
Investigators at UCLA have identified the source of the transmission: two Olympus ERCP scopes. ERCP scopes are specialized endoscopes, often called duodenoscopes, which are inserted down the throats of about 500,000 patients annually to treat cancers, gallstones, and other ailments of the digestive system. These instruments are not the same type used in more routine endoscopies and colonoscopies.
Across the United States, hospitals have been uncovering challenges with fully disinfecting these scopes due to the complexity and design of the instruments. Therefore, accumulated bacteria can pass from patient to patient. In a safety alert released by the FDA on February 19, they state, “some parts of the scopes may be extremely difficult to access and effective cleaning of all areas of the duodenoscope may not be possible.”
Reportedly, the outbreak at UCLA occurred despite following both national guidelines and the manufacturer’s sterilization standards.
However, many public health officials and endoscopy experts believe that the FDA and instrument manufacturers have been slow to alert medical professionals and hospitals about the risks associated with the scopes.
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More information on CRE Superbugs: