The contaminated medical devices blamed for a series of superbug outbreaks are also linked to an outbreak of a drug-resistant Escherichia coli (E. coli) strain in a Washington state hospital. These endoscopes may infect more patients if hospitals use the company's recommended cleaning procedures, according to a study published in Infection Control & Hospital Epidemiology.
At Seattle's Virginia Mason Medical Center, 32 patients were infected with an antibiotic-resistant strain of E. coli between November 2012 and August 2013, even though the hospital followed the company's procedure for cleaning the scopes. Recent evidence suggests the manufacturer's cleaning instructions may not be enough to fully sterilize the devices, similar to concerns about contaminated scopes that contributed to an outbreak of Carbapenem-resistant Enterobacteriaceae (CRE).
More than 3 in 10 infected patients died over the course of the investigation, with seven deaths occurring during hospitalization within 30 days of the hospital identifying the superbug as E. coli.
"In the wake of the recent outbreak of CRE due to contaminated endoscopes, we suspect endoscope-associated transmission of bacteria is more common than recognized and not adequately prevented by current reprocessing guidelines," Kristen Wendorf, M.D., of King County, Seattle's public health department, said in an announcement.
Moreover, a review of Virginia Mason's scopes by Olympus, manufacturer of the devices, found seven of eight contained mechanical defects that may have contributed to the bacteria's spread, the study noted. The hospital has since begun manually to clean the scopes, taking measures beyond the company's recommendations, followed by a 48-hour quarantine period, according to the Los Angeles Times. After the process, the hospital found 3 percent of scopes were still contaminated, leading staff to repeat the process.
"No scope is used at Virginia Mason until the cultures are negative," Virginia Mason spokesman Gale Robinette told the Los Angeles Times.
In February, the U.S. Food and Drug Administration issued a warning about the scopes in response to California's outbreaks of CRE. It later released a set of guidelines for hospital staff that recommended they take scopes out of service until they were verified to be pathogen-free, a course of action that went beyond its response to similar outbreaks in Seattle and Chicago, FierceHealthcare previously reported. In March, the FDA also tightened its guidelines for manufacturers of the scopes, requiring that they prove they can be adequately cleaned before the scopes enter the market.