Dirty endoscopes blamed for superbug outbreak

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 © zilliNBC News has recently reported on the CDC findings regarding a superbug outbreak in Illinois.  Government health officials have found that contaminated exam tools were to blame for an alarming outbreak of a drug-resistant superbug in Illinois last year.  Endoscopes that use cameras attached to long tubes to snake through the gut, examining the liver, bile ducts and pancreas, weren’t properly disinfected and wound up infecting patients with a dangerous type of CRE (carbapenem-resistant Enterobacteriaceae) a family of germs highly resistant to antibiotics.

Health officials were worried that such cases have jumped sharply since 2009, when they were first reported in the U.S. From 2009 through 2012, 27 patients with NDM-producing CRE were confirmed by the CDC. But last year, there were 69 cases, including 44 from northeastern Illinois alone.

The large number of cases was surprising.  Even more surprising was that the germs were eventually traced to patients who had a history of endoscopic liver and pancreas exams known as ERCPs ” and then to dirty tools.   It turns out that the endoscopes, which had undergone high-level disinfection, still tested positive for the NDM CRE and another bad bug, KPC-producing Klebsiella pneumoniae, also highly resistant to nearly all antibiotics.   The CDC review found no lapses in cleaning technique on the part of hospital staffers. They’re not sure why the tools stayed dirty even after disinfection and think it may be a design flaw. Health officials are urging hospitals to make sure they’re following proper protocol for cleaning tools to prevent more outbreaks of the drug-resistant superbugs.  In the meantime, the Illinois hospital switched to a new sterilization procedure; no new cases have been reported since.

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Infection control specialist Lawrence F. Muscarella, PhD, told Medscape Medical News that the ERCP-associated infection risk identified in the CDC report might be just the tip of the iceberg. Dr. Muscarella said the problem might extend to other infectious agents (and types of gastrointestinal endoscopes) but has gone unrecognized in patients already being treated with antibiotics or with healthy immune systems. “This bacterium’s resistance apparently caused a ‘perfect storm’ to present itself and to reveal the problem,” he said.

 

3 Comments

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