'Superbug' Outbreak at California Hospital, More Than 160 Exposed

[Earthnut]

https://gma.yahoo.com/superbug-outbreak-california-hospital-more-160-exposed-122224996--abc-news-health.html

'Superbug' Outbreak at California Hospital, More Than 160 Exposed

A potentially deadly "superbug" resistant to antibiotics has infected seven patients, including two who died, and more than 160 others were exposed at Ronald Reagan UCLA Medical Center through contaminated medical instruments, the hospital revealed.

The drug-resistant superbug known as CRE was likely transmitted to the Los Angeles patients by contaminated medical scopes during endoscopic procedures that took place between October 2014 and January 2015, a university statement said.

The bacteria may have been a “contributing factor” in the deaths of two patients, according to the university.

UCLA says it sterilized the scopes according to manufacturer standards, but it is now using a decontamination process “that goes above and beyond the manufacturer and national standards.”

Fears linger that more confirmed cases of the bacteria could emerge.

By one estimate, CRE, or carbapenem-resistant enterobacteriaceae, can contribute to death in up to half of seriously infected patients, according to the national Centers for Disease Control and Prevention.

The bacteria can cause infections of the bladder or lungs, leading to coughing, fever or chills. CRE infections have been reported in every state except Idaho, Alaska and Maine, according to the CDC.

UCLA said infections may have been transmitted through two endoscopes used during the diagnosis and treatment of pancreatic and bile-duct problems.

"We notified all patients who had this type of procedure, and we were using seven different scopes,” UCLA spokeswoman Dale Tate said. “Only two of them were found to be infected. In an abundance of caution, we notified everybody.”

A similar outbreak from contaminated medical scopes infected 32 people in Seattle from 2012 to 2014. Other superbug cases have been previously reported in cities such as Pittsburgh and Chicago.

Federal, state and local health officials are investigating the outbreak in Los Angeles, and warning letters, as well as home testing kits, have been sent to those potentially at risk.

The Associated Press contributed to this report.

[Libby]

This sort of thing is very worrying. We've ended up with bacteria resistant to antibiotics because of misuse of antibiotic drugs. Now it seems that methods to sterilise medical implements aren't good enough, yet people need those medical implements for diagnostic and treatment purposes. Though I wonder what the manufacturer's recommendations were, and whether they did sufficient testing; or whether the hospital followed the protocol properly.

[Beerbelch]

BEER---> They just make you itch a lot.

BELCH

[Earthnut]

https://news.yahoo.com/superbug-outbreak-raises-questions-medical-205819018.html

'Superbug' outbreak raises questions about medical tool

'Superbug' outbreak at hospital raises questions about medical tool and cleaning process

Associated Press By Alicia Chang, AP Science Writer

LOS ANGELES (AP) -- A "superbug" outbreak suspected in the deaths of two Los Angeles hospital patients is raising disturbing questions about the design of a hard-to-clean medical instrument used on more than half a million people in the U.S. every year.

At least seven people — two of whom died — have been infected with a potentially lethal, antibiotic-resistant strain of bacteria after undergoing endoscopic procedures at Ronald Reagan UCLA Medical Center between October and January. More than 170 other patients may also have been exposed, hospital officials said.

The infections may have been transmitted through two contaminated endoscopes that were used to diagnose and treat pancreatic and bile-duct problems. The instruments were found to have "embedded" infections even though they had been cleaned according to manufacturer's instructions, said Dr. Robert Cherry, the hospital's chief medical and quality officer. Five other scopes were cleared.

Hospital officials said they immediately removed contaminated medical devices and adopted more stringent sterilization techniques.

At a news conference Thursday afternoon, health officials sought to reassure the public that there is no broad danger.

"This outbreak is not a threat to public health," said Dr. Benjamin Schwartz, deputy director of acute communicable disease control and prevention for the LA County Department of Public Health.

Infections of carbapenem-resistant Enterobacteriaceae, or CRE, have been reported at hospitals around the country, and some have been linked to the type of endoscope used at UCLA. The duodenoscope is a thin, flexible fiber-optic tube that is inserted down the throat to enable a doctor to examine an organ. It typically has a light and a miniature camera.

Doctors first discovered the problem in mid-December when a patient underwent an endoscopic procedure and developed an infection that couldn't be treated with antibiotics.

An investigation was launched and doctors employed high-tech techniques to find other cases — a process that took several weeks, said Dr. Zachary Rubin, medical director of clinical epidemiology and infection prevention.

It was determined that CRE infections had been passed on from one "source case" patient between Oct. 3 and Jan. 28, Rubin said.

The hospital has notified potentially exposed patients through letters and phone calls and is offering free testing and treatment options.

Attorney Kevin Boyle said Thursday that one of his clients, an 18-year-old student, was among those infected after he entered the hospital for a procedure that involved using an endoscope to examine his pancreas.

"After he had the procedure he was released. Then he came down with his illness, and when they studied him and noticed he had the CRE bacteria in him they quickly put two and two together," he said.

Boyle declined to release the teenager's name or say where he attends school but said he spent 83 days in the hospital at one point and was released but recently relapsed and is currently hospitalized. He said the family doesn't blame UCLA but is considering suing the endoscope's manufacturer.

Health inspectors visited UCLA after being notified and found "no breaks and no breaches" in its disinfection process, Schwartz said.

"You can very easily do everything right and still have some contamination," said Dr. Deverick Anderson, an infectious-disease expert at Duke University. "We're finding this is a problem, but it's probably one that we don't have a very good solution to right now."

The U.S. Food and Drug Administration on Thursday issued an advisory warning doctors that even when a manufacturer's cleaning instructions are followed, germs may linger. The device's complex design and tiny parts make complete disinfection extremely difficult, the advisory said.

In a statement, the FDA said it is trying to determine what more can be done to reduce such infections. But it said that pulling the device from the market would deprive hundreds of thousands of patients of "this beneficial and often life-saving procedure."

"The FDA believes at this time that the continued availability of these devices is in the best interest of the public health," the agency said.

The manufacturer of the devices, Olympus Corp. of the Americas, an arm of Japan's Olympus Corp., said in a statement that it emphasizes the importance of meticulous manual sterilization of its instruments. It says it is giving new supplemental instructions to users of the endoscopes and is working with the FDA on the infection problem.

The company is also being investigated for possible violations of false claims and anti-kickback laws. It disclosed Feb. 6 that it has been under federal investigation since 2011 for possible violations of laws that typically ban improper payments to doctors or other customers.

That statement said the company is talking with the Justice Department to "resolve the matters under investigation."

[seesthru]

That particular style of instrument has one spot that is very difficult to clean. I think they should re-think the design. I had an endoscopic procedure some months back, and suffered excessive pain and pressure afterwards. I'd wondered if they gave me some kind of infection but after MONTHS it has eased up . It did the usual thing, gave me fits until I finally made an appointment to get it seen about, then it went away. No I'm not in California! LOL HOwever my dad got a superbug during a heart bypass procedure that left him nearly comatose for months, and resulted in him losing his breastbone and also having minimal lung function due to all the tubes they had to stick in his lungs to drain the infective fluids. They tried at one point to claim he was brain dead, and had pretty much written him off, but I made him laugh in front of a nurse. THen it was all hands on deck to get him awake, and all. It shortened his life I am sure, and all it took to give him that infection was exposure to a surgical room that hadn't been sterilized properly. Staph and MRSA ran rampant thorugh that hospital while he was there. Seemed no one was safe from it.

[Walkabout]

my Dad had two 'superbugs' at the same time , from being the hospital for a urinary procedure. He responded to new antibiotics but the bugs or the antibiotics damaged his immune system . In less than six months he got pneumonia and could not fight it off. I survived surgery 4 years ago , but would think twice before going in again .

[Beerbelch]

BEER----> Hospitals are only for sick people - IMHO.

BELCH

[Earthnut]

https://gma.yahoo.com/super-bug-linked-antibiotic-kills-nearly-30-000-220328760--abc-news-health.html

'Super Bug' Linked to Antibiotic Use Kills Nearly 15,000 Annually

A stubborn, hard-to-treat “super bug” causes more than 450,000 infections a year and is directly responsible for nearly 15,000 deaths in the United States, a report from the Centers for Disease Control and Prevention revealed today.

Clostridium difficile, or C. Diff, is a bacterial infection that leads to inflammation of the colon, the agency explained. The bacterium is found in feces, the agency said, and is spread by hand contact or contaminated surfaces.

"It’s the most common infection picked up in hospitals," said ABC News Chief Health and Medical Editor Dr. Richard Besser. "The thing about this infection is you can pick it up and it can cause no problems. Then, you take an antibiotic and it takes over."

More than 80 percent of C. Diff deaths were people 65 or older, with residents of nursing homes especially vulnerable to infection, the report said.

“C. difficile infections cause immense suffering and death for thousands of Americans each year,” CDC Director Dr. Tom Frieden said.

Hospital stays and especially long-term antibiotic use seem to up the risk of C. Diff infection.

“Antibiotics kill off beneficial bacteria in the gut which fight infection, leaving space for C. Diff to come in and release its toxins,” explained Dr. William Schaffner, an infectious disease expert with Vanderbilt University School of Medicine in Nashville, Tennessee.

Studies show that more than half of patients receive antibiotics at some point in their stay, and up to 50 percent of antibiotic use is unnecessary. Over-prescribing antibiotics, combined with poor infection control, may allow the spread of C. diff and other bacteria within a facility and to other facilities when a sick patient is transferred, the CDC report speculated.

The CDC report said preventing and controlling C. Diff should be a national priority. The infection costs up to $4.8 billion each year in excess health care costs, the agency reported.

“You can fight it with hand hygiene, early diagnosis, isolating sick patients and curtailing excessive antibiotic use,” Schaffner said.

Meticulously cleaning surgical instruments would also help, Schaffner noted. Seven people were diagnosed last week with another drug-resistant "super bug" known as CRE at Ronald Reagan UCLA Medical Center after undergoing endoscopy procedures with instruments that may have been contaminated.

[Walkabout]

since these super bugs are most caught at hospitals , it does make one wonder why . Why aren't they in public places if the main reason is over use of antibiotics ?? Why mostly hospitals where they should more carefu land follow better sanitation proceedures ? Hospitals today are as deadly as they were late 1800s - early 1900s.

[Walkabout]

update on Clostridium difficile . https://www.dailymail.co.uk/news/article-2969283/Study-Nasty-stomach-bug-common-thought-US.html