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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. (Note: beware autoplaying video ad; adjust your volume accordingly.)

21 of 132 comments (clear)

  1. From the grave... by Nutria · · Score: 3, Funny

    Ronald Reagan's cold dead hand stretches forth again to wreak havoc across the land!

    --
    "I don't know, therefore Aliens" Wafflebox1
    1. Re:From the grave... by ColdWetDog · · Score: 4, Insightful

      But, in fact, the system works. Nothing is going to be foolproof or fail safe. There will always be screw ups or just procedures that don't fix everything. However, it is telling that the hospital's surveillance systems figured out what the problem was, identified the patients at risk and presumably stopped the 'outbreak'. 32 patients, although it sounds like a lot, is probably just a couple of days worth of scopes at a big institution.

      Although not clearly delineated in TFA, it appears that the problematic instruments were endoscopes used in ERCP procedures. These particular devices are at high risk of contamination due to their complex design.

      --
      Faster! Faster! Faster would be better!
    2. Re:From the grave... by Khyber · · Score: 2

      Contamination isn't shit. If these idiots would learn how to Tyndallize their equipment instead of relying upon shit autoclaves, this wouldn't even be an issue.

      --
      Still waiting on Serviscope_minor to wake up to fucking reality and realize that Jessica Price isn't going to fuck him.
    3. Re:From the grave... by cayenne8 · · Score: 3, Funny

      As if I didn't already have enough reasons to *NOT* have something stuck up my ass!!

      --
      Light travels faster than sound. This is why some people appear bright until you hear them speak.........
    4. Re:From the grave... by Bengie · · Score: 2

      Tyndallize requires a device to be pressure cooked at 115c for 15 minute sessions, 3 days in a row. Making devices withstand pressure and heat would increase costs quite a bit, plus the cost of having each device out of service for 3 days between uses. Sounds decent enough for simple tools that are mostly metal, but more complex devices, like endoscopes may have issues.

    5. Re:From the grave... by fsagx · · Score: 5, Informative

      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...

    6. Re:From the grave... by ShanghaiBill · · Score: 2

      instead of relying upon shit autoclaves, this wouldn't even be an issue.

      I doubt if the problem was the autoclave. It is more likely caused by sloppy procedures by a lazy operator, who didn't cook them long enough, didn't swap gloves between putting stuff in and taking stuff out, or some other dumb shortcut.

    7. Re:From the grave... by Anonymous Coward · · Score: 3, Informative

      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.

    8. Re:From the grave... by damn_registrars · · Score: 2

      I thought the main misfortune of Obama is that he was born in Liberia, or was it Haiti?

      There is no shortage of birthers out there who are still dedicated to "answering" that question.

      However, based on what many slashdot conservatives write, it appears that Obama's biggest failure is in the fact that he has the wrong consonant after his last name. His actual decisions and policies are demonstrably more conservative than their hero Reagan but he happens to be a democrat so he is automatically the antichrist.

      --
      Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    9. Re:From the grave... by cyberchondriac · · Score: 2

      Obviously you never even actually watched Fox (which really had nothing to do with this conversation) because they've talked about Putin and the Ukraine situation quite a bit, actually. 10 years ago, everything was Bush's fault, now it's Obama's fault. Seems fair.

      --

      Look back up at my post, now look back down, you're on the Internet. Now look back up. I'm a signature.
  2. Unpatched bug by jamesl · · Score: 2

    From January 9, 2014 ...
    This investigation highlights the potential for CRE transmission following ERCP. Health-care facilities with CRE outbreaks should consider the possibility of ERCP-related transmission. If ERCP-related transmission of CRE is suspected, reprocessing and preventative maintenance procedures for ERCP endoscopes should be evaluated in consultation with the manufacturer of the endoscope and automated endoscope reprocessor, if used. In addition, expertise in the evaluation and prevention of CRE transmission are available at CDC and can be accessed via state and local health departments.
    http://www.infectioncontroltod...

    So this "bug" went unpatched for at least a year.

  3. To quote Sheldon Cooper. . . by smooth+wombat · · Score: 4, Funny

    Sheldon Cooper: To a hospital? Full of sick people? Oh, I don't think so.

    Penny: Okay, well, your friend and his mother are there. We're going!

    Sheldon Cooper: I can't.

    Penny: Oh, don't tell me you're afraid of germs.

    Sheldon Cooper: Not all germs. Just the ones that will kill me. The same way I'm not afraid of all steak knives; just the ones that might be plunged in my thorax.

    Leonard Hofstadter: Ah-uh, fine, I'll tell Howard you didn't come because you're more concerned about your own well-being than his.

    Sheldon Cooper: I would think he would know that.

    Penny: Okay, you know what? You are unbelievable. You buy all these superhero T-shirts but when it's time for you to step up and do the right thing, you just hide in the laundry room.

    Sheldon Cooper: Fine, I'll go. Just for the record, my Aunt Ruth died in a hospital. She went in to visit my Uncle Roger, caught something, and bit the dust a week later. The two of them now share a coffee can on my mother's mantel.

    --
    We will bankrupt ourselves in the vain search for absolute security. -- Dwight D. Eisenhower
  4. Re:that's not good by Anonymous Coward · · Score: 2, Informative

    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.

  5. Oops by Tyler+Durden · · Score: 5, Insightful

    I'm seriously regretting any anti-bacterial soap I've used over the years right about now.

    --
    Happy people make bad consumers.
    1. Re:Oops by pnutjam · · Score: 4, Insightful

      Yeah, overuse like putting it in every day hand soap.

    2. Re:Oops by smellsofbikes · · Score: 3, Informative

      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.
  6. Re:He Was The Disease by Jason+Levine · · Score: 2, Insightful

    And the final irony? If Ronald Reagan ran for President today, he would be kicked out of the GOP today for being too liberal.

    --
    My sci-fi novel, Ghost Thief, is now available from Amazon.com.
  7. anti-bacterial (soap) != antibiotics by Anonymous Coward · · Score: 2, Informative

    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.

  8. I'm here all day... by borknado · · Score: 2

    Clearly the reason these patients died is because the "Ronald Reagen" medical center used too "conservative" an approach to their treatment.

  9. Re:He Was The Disease by NatasRevol · · Score: 2

    Tell your brother in law that Obamacare can save him, but only if he repents.

    --
    There are two types of people in the world: Those who crave closure
  10. Look up CRE by Cafe+Alpha · · Score: 3, Interesting

    Current estimates are that 3% of patients in ICU test positive and 1/3 of people in nursing homes.

    You read that right, 1/3. Also multiple types of bacteria are CRE. It means they have an enzyme that breaks down a class of antibotics.

    This has been sneaking up on us for a while.

    I think that the problem is, most bacteria are usually harmless, but these can't be killed easy, and if they ever turn into blood infections the mortality rate seems to be 50%.