A spokeswoman, Roxanne Yamaguchi Moster, at Ronald Reagan UCLA Medical Center in Los Angeles said in a written statement on Feb. 18 that: “seven patients at Ronald Reagan UCLA Medical Center are known to have been infected by carbapenem-resistant Enterobacteriaceae, and CRE was a contributing factor in the death of two of them.”
The Food and Drug Administration (FDA) issued a warning to doctors and hospitals around the country on Thursday, saying a commonly used medical scope, called a duodenoscope, could be difficult to clean and “may facilitate the spread of deadly bacteria.”
The Los Angeles Times is reporting this outbreak is similar to outbreaks across the country, leaving health experts scrambling to find a solution to the problem. At the core of the outbreak in California is the specialized endoscope, used annually on over 500,000 patients to treat cancers, gallstones and as a diagnostic tool in diagnosing and treating other digestive disorders. The procedure in question is called ERCP or endoscopic retrograde cholangiopancreatography.
UCLA Medical Center is in the process of contacting the 179 other patients who had endoscopic procedures between October 2014 and January of this year. The patients will be offered tests for the deadly bacteria that they can take at home. Moster added that the two scopes were sterilized according to the manufacturer’s instructions.
“However, an internal investigation determined that CRE bacteria may have been transmitted during a procedure that uses this specialized scope to diagnose and treat pancreaticobiliary (disorders of the bile ducts, gall bladder or pancreas),” Moster said.
After the bacteria was discovered, the hospital notified the Los Angeles County and California State health departments. The Los Angeles County health department visited the hospital and reviewed their procedures, determining that no sterilization protocols had been breached.
There have been about a half-dozen outbreaks of CRE in hospitals across the country since 2012, affecting 150 patients in Illinois, Pennsylvania, and most recently, in a Seattle medical center. The carbapenem-resistant Enterobacteriaceae are a family of germs that are very difficult to treat, says the CDC.
Klebsiella species and Escherichia coli (E. coli) are examples of Enterobacteriaceae. These bacteria are part of the normal flora of the intestines and can become carbapenem-resistant. Healthy people normally do not get CRE infections. It most often occurs in hospital patients, nursing homes or other healthcare facilities.