Ronald Reagan UCLA Medical Center officials insisted Thursday they followed all required procedures in the handling of a “superbug” outbreak traced to a pair of medical scopes, and were even reaching out to patients who underwent procedures that may not have involved the two infected pieces of equipment.
The hospital announced Wednesday that it was notifying 179 patients who underwent endoscopic procedures between Oct. 3, 2014, and Jan. 28 that they may have been exposed to the potentially deadly carbapenem-resistant Enterobacteriaceae, or CRE, bacteria.
Seven patients have been infected with the bacteria, and two of them have died, hospital officials said.
According to UCLA, the infection was traced to a pair of Olympus- manufactured duodenoscopes used in the procedures — which are conducted to diagnose and treat diseases of the liver, bile ducts and pancreas. UCLA, however, has been notifying 179 people who underwent procedures using any of seven scopes used by the hospital.
“We’re being very cautions and we’re actually contacting all patients who underwent (endoscopic procedures) … even if another scope was used on them,” said Dr. Zachary Rubin, the hospital’s director of infection prevention.
Dr. Robert Cherry, the hospital’s chief medical and quality officer, said a wider range of notification was done in “an abundance of caution.
“Even though there were additional scopes that did not have a CRE bacteria embedded in them, we took the added precaution … all those patients that had a procedure done using all those seven scopes, not just the two that were found to have a bacteria concern, were essentially notified that there may be a potential risk,” Cherry said. “We’ve sent letters out, we’ve placed phone calls to each of those patients. We are offering free testing for those patients as well as any type of potential treatment options and discussions about those options.”
The Food and Drug Administration this morning issued a warning to hospitals through its safety communications systems about duodenoscopes. The FDA said the design of the scopes may make them more difficult to clean, and it urged that they be washed meticulously.
UCLA officials said they had been following all the required steps for sterilizing the scopes, which are inserted through the throat and considered minimally invasive, but the infections still managed to spread. The hospital has no switched to a more thorough cleaning system, involving a disinfection process at the hospital then an off-site process that uses ethylene oxide gas to sterilize the equipment.
“Our heart goes out to the people who were involved and the patients who passed away as the result of this infection,” Rubin said.
By some estimates, if the infection spreads to a person’s bloodstream, the bacteria can kill 40 to 50 percent of patients, the Los Angeles Times reported.
Potentially exposed patients at UCLA are being offered a home testing kit that will then be analyzed at the hospital.
Hospital officials said similar exposures to CRE have been reported at other U.S. hospitals that use the same type of scopes.
As soon as the infection was identified at UCLA, hospital officials said they notified the county Department of Public Health.
Dr. Benjamin Schwartz, deputy chief of acute communicable disease control at the county DPH, hailed the work done by UCLA to identify the infection and reach out to patients, saying the hospital “followed the procedures appropriately throughout.”
He also stressed that the outbreak “is not a threat to the health of the public in L.A. County.”
Officials at the U.S. Centers for Disease Control and Prevention said they are assisting the Los Angeles County Department of Public Health in its investigation of the UCLA infections.
CRE is a family of bacteria that is resistant to many common antibiotics. The bacteria can cause infections in patients who have other serious medical problems or who are “undergoing operations or other invasive procedures,” hospital officials said.
Since 2012, there have been about a half-dozen outbreaks affecting up to 150 patients in Illinois, Pennsylvania and Washington State, The Times reported.
Last month, Virginia Mason Medical Center in Seattle acknowledged that 32 patients were sickened by contaminated endoscopes from 2012 to 2014 with a bacterial strain similar to CRE. Eleven died. But, according to The Times, Virginia Mason said other factors may have contributed to their deaths because many of them were already critically ill.
— City News Service