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Resistant Bacterial Infection Outbreak At California Hospital
puddingebola writes From the article: "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. " UCLA says the infections occurred via contaminated endoscopes that were sterilized according to the manufacturer's specifications.
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flexible endoscopes have been around since the 1960's, and they cannot go through an autoclave. Rigid endoscopes can go through an autoclave, but they are more limited in application.
Maybe a camera endoscope could be designed to last in an autoclave, if you can make one you should patent it and demands the FDA no longer approve older designs as they are difficult to sterilized and have literally killed people already.
A flexible endoscope is cleaned in a machine more like a kitchen dishwasher than an autoclave. The scope has internal channels for shooting air and water out of a nozzle on the tip. It has a large channel to pass instruments into the patient (biopsy forceps, cauterizers, even other more narrow endoscopes). An ERCP scope has an additional channel that carries a stiff wire that is used to deflect instruments coming out the end. This channel and wire is a very tight fit, so it is more difficult to clean.
Attachments to the channel ports should circulate the sterilizing fluids through all the channels. It's not difficult to imagine a clog preventing the fluid from circulating. Testing for leaks and clogs is part of the cleaning procedure, but in practice, of course, errors happen often:
Similar story from just last month:
http://www.modernhealthcare.co...
A biggy at the VA a few years ago:
http://health.usnews.com/healt...
Acid, chlorine, etc. all kill bacteria in ways that are unlikely to result in resistant strains.
The compounds in anti-bacterial soap (triclosan for example) are not used to treat internal
infections. Antibiotics are more specalized compounds which target bacteria and are (relatively) harmless to humans.
The problem (if there is one) with anti-bacterial soap seems to be that a certain amount of exposure to
bacteria is apparently good for the human immune system and widespread use of anti-bacterial compounds
works against this. It is the widespread addition of antibiotics to the feed for livestock which is of
most concern. Thie same compounds are feed to livestock as are used to treat human infections and
the animals become breeding ground for antibiotics resistant bacteria.
I'm seriously regretting any anti-bacterial soap I've used over the years right about now.
Don't be. We may breed triclosan-resistant bacteria by using antibacterial soap, but that doesn't mean we're breeding carbapenem-resistant bacteria -- the C in CRE -- by using triclosan. There is very little evidence that developed resistance to one type of antibiotic increases resistance to another completely unrelated antibiotic. Triclosan inhibits fatty acid synthesis, carbapenem inhibits synthesis of the peptidoglycans used in bacterial cell walls.
Nostalgia's not what it used to be.
This entire thread is wrong from the very beginning, actual Tyndallization is for things that can't be boiled. You heat it to just below 100C for 15 minutes to kill active bacteria, then you store it in a damp environment for a day to encourage the spores that don't die to germinate into active bacteria and start growing again over the next 24 hours. Then you heat it again. You repeat this every day until you feel you have it clean enough. Any spores that didn't de-cloak will still be there and will become active when the environment allows it.
It's not used anymore because it takes days and can't kill spores.