The use of contaminated endoscopes infected scores of patients in Pittsburgh, Seattle and Chicago hospitals with a deadly, drug-resistant infection, according to recent reports, underscoring the danger posed by the "looming global crisis" of such superbugs.
Carbapenem-resistant Enterobacteriaceae (CRE), the infection the patients contracted, has risen to prominence along with its superbug brethren due to the overuse of antibiotics. And at least one expert has said hospitals aren't doing enough to screen for CRE, which can lead to infections in the lungs, urinary tract and blood, FierceHealthcare has reported.
The CRE outbreak, which began in 2012, spread among patients treated with a duodenoscope, a specialized endoscope that clinicians thread down patients' throats to treat gallstones, cancers and other disorders of the digestive system, according to USA Today. The infection was transmitted from patient to patient because CRE can survive on the duoendocopes even after conventional cleaning.
Investigators have identified at least 35 cases of duodenoscope-related infections and 11 deaths through March 2014, the Seattle Times reports, though many of the patients were critically ill, making it difficult to definitively pin their deaths on CRE.
In addition, "there's a likelihood that we're just seeing a very small subset of the universe of infections from these types of scopes," Jeffrey Duchin, M.D., head of communicable disease control at the Seattle and King County Public Health Department, told USA Today.
Despite the risk, the Food and Drug Administration hasn't issued a warning about it or recalled the scopes, which are typically used in endoscopic retrograde cholangiopancreatography (ERCP) procedures, citing their importance in clinical care and the "low" risk of infection, according to the Seattle Times.
"The FDA feels that the lifesaving nature of ERCP, performed on more than 500,000 patients annually in the U.S., makes it important for these devices to remain available," FDA spokeswoman Leslie Wooldridge told the newspaper.
But at least one Seattle hospital, Virginia Mason, has taken matters into its own hands, choosing to culture and quarantine each ERCP device for 48 hours after use to make sure it's free of CRE and other infections, according to the article.
As more and more facilities look to reduce hospital-acquired infections, yet also fight antibiotic resistance, a recent study published in the Journal of the American Medical Association sheds some light on how to balance the sometimes-warring concepts. In examining the use of chlorhexidine to control infections in intensive care units, researchers found in the first trial that daily wipe-downs didn't reduce infections, but the wipe-downs were effective when used every other day.
The study authors also note that such "universal decolonization strategies" don't necessarily produce better infection-control results than "a simpler, less expensive approach that focuses on basic hygiene practices" such as hand-washing.