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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.)
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
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!
I'm seriously regretting any anti-bacterial soap I've used over the years right about now.
Happy people make bad consumers.
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...