'Superbug' Outbreak At UCLA Medical Center: Here's What We Know

LOS ANGELES (CNS/FOX 11) - 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.

From Phil Shuman:

When something is nicknamed the ''superbug'', and it's already killed two people, not to mentioning infecting perhaps as many as 200 more, there is reason to be alarmed.

Yet at UCLA Medical Center today doctors were trying to reassure people that there is ''no threat to the general public'. They said they followed all proper procedures in cleaning and sterilizing the ''scopes'' used that go into your mouths and other body openings to probe inner organs. Cleaning those devices is a very detailed process, and UCLA's Dr. Zacahary Rubin said they checked their procedures and protocols and didn't find anything wrong, suggesting something is amiss in the manufacturers guidelines for cleaning.

Rubin, and a couple of other doctors from UCLA as well as the LA County Department of Public Health fielded questions from a huge number of journalists this afternoon, after saying all morning that no one would be available to talk. Well they did talk but they didn't say much beyond we found out about it, we alerted public health (though not the public until last night ) and we aren't sure what went wrong. They're offering free testing for the people who had various endoscopic type procedures recently, and offered condolences to the two families who lost loved ones.

They wouldn't say when that was, they did congratulate themselves for (seriously) raising the level of national dialogue about the potentially dangerous and growing problem of bacteria that is resistant to antibiotics, the so called "Superbug''. A veteran I met today said he was infected with a type of that bug at a VA facility, Christopher Li saying "It's exactly the same thing, (as what happened at UCLA) . I had the same procedures.. they used the endoscope on me... after that.. felt sick.. couldn't breathe.. kept complaining.. something was wrong.

He takes about 20 pills a day, though he does have other issues. The point is this is big news and it probably isn't going away. Personally I'd appreciate it if our medical health professionals were more proactive and less reactive, and stuck around long enough to answer all our questions about complex medical issues, not race off like they have a plane to catch and leave all of us needing more information about a bug that's killing people. But that's just me.

Earlier Today:
Seven patients have been infected with the bacteria, and two of them have died, hospital officials said.

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.

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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.

The UCLA Health System Statement:

"The UCLA Health System is in the process of notifying more than 100 patients that they may have been infected by a "superbug" bacteria during complex endoscopic procedures that took place between October 2014 and January 2015. The patients are being offered a free home testing kit that would be analyzed at UCLA. 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 a contributing factor in the death of two patients. A total of seven patients were infected. Similar CRE exposures using the same type of scope recently have been reported in other hospitals in the United States. The two scopes involved with the infection were immediately removed and UCLA is now utilizing a decontamination process that goes above and beyond the manufacturer and national standards. Both the Los Angeles County Department of Health and the California Department of Public Health were notified as soon as the bacteria were detected."

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