Two dead, 179 exposed to superbug at UCLA Medical Center

Dirty scopes believed to be the root cause
By Bernie Monegain
10:42 AM
Superbug CRE

Two people who died at the UCLA's Ronald Reagan Medical Center are among seven patients that UCLA has identified as infected by the deadly superbug CRE, the Los Angeles Times reports today.

CRE, or carbapenem-resistant Enterobacteriacea. "Healthy people usually do not get CRE infections – they usually happen to patients in hospitals, nursing homes and other healthcare settings," the Centers for Disease Control and Prevention explains on its website. "Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections."

In the case of UCLA, the devices being looked at in the recent deaths and exposures CRE are endoscopes that, according to the LA Times report, are inserted down the throats of about 500,000 patients annually to treat cancers, gallstones and other ailments of the digestive system.

The CDC has said that the design of the scopes make them difficult to clean.

In a statement posted on its website, the medical center addressed the issues connected to cleaning the scopes:

"UCLA sterilized the scopes according to the standards stipulated by the manufacturer. However, an internal investigation determined that carbapenem-resistant Enterobacteriaceae (CRE) bacteria may have been transmitted during a procedure that uses this specialized scope to diagnose and treat pancreaticobiliary diseases and may have been a contributing factor in the death of two patients. A total of seven patients were infected."

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, according to the LA Times. Eleven of those patients died.

Hospitals have long struggled with how best to deal with all types of healthcare acquired infections, or HAIs. Many have applied technology, such as real-time monitoring, to help control even some of the more common infections, such as the intestinal bacteria C.difficile.

Hand-washing is considered to be the best preventive measure. A pilot project launched last year at OhioHealth employs IBM technology – a network of wireless sensors and real-time big data analytics – to give hospital administrators information aimed at moving the needle on hand washing.

[See also: OhioHealth battles deadly infection.]

Hand washing is also considered effective in avoiding deadly infections, such as MRSA, or methicillin-resistant staphylococcus aureus, and C.difficile, which affect 1 in 20 patients in U.S. healthcare facilities.

The Centers for Disease Control and Prevention estimates nearly 2 million U.S. patients contract HAIs each year, and 90,000 die as a result.

HAIs are costly, too, estimated to cost the U.S. healthcare system $4.5 billion in related medical expenses every year.

[See also: HAI monitoring technology use is lacking.]

The Centers for Disease Control's National and State Healthcare Associated Infections Progress Report, released in January 2015, showed some progress on the HAI front.

On the national level, the report found:

  • A 46 percent decrease in CLABSI between 2008 and 2013
  • A 19 percent decrease in SSIs related to the 10 select procedures tracked in the report between 2008 and 2013
  • A 6 percent increase in CAUTI between 2009 and 2013; although initial data from 2014 seem to indicate that these infections have started to decrease
  • An 8 percent decrease in hospital-onset MRSA bacteremia between 2011 and 2013
  • A 10 percent decrease in hospital-onset C. difficile infections between 2011 and 2013

The $4 trillion proposed 2015 budget President Obama submitted to Congress on Feb. 2 included $1.2 billion to fight hospital acquired infections produced by superbugs.

The request would double current funding levels for reducing the impact of superbugs, the Washington Post reported.

Read the LA TImes article here.

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