Superbug kills two patients in California

An outbreak of antibiotic-resistant superbug Carbapenem-resistant Enterobacteriaceae (CRE) that already sickened patients in Pittsburgh, Seattle and Chicago now has spread to UCLA's Ronald Reagan Medical Center and caused at least two patient deaths, the L.A. Times reported.

Like in the cases in other parts of the country, the patients in California were infected by contaminated medical devices known as duodenoscopes. The devices are commonly used in endoscopic retrograde cholangiopancreatograph (ERCP) procedures, which are performed on patients with digestive system disorders, gallstones and certain types of cancers.

UPDATE: FDA issues warning about scopes linked to the superbug outbreak

CRE, which kills about 50 percent of patients who get a bloodstream infection from the superbug, has been dubbed a "nightmare bacteria" by Centers for Disease Control and Prevention Director Thomas Frieden, FierceHealthcare previously reported. CRE and other superbugs comprise a "looming global crisis," according to a previous report from the British prime minister, which called for a global innovation fund to help fight the threat.

UCLA officials discovered the outbreak last month and have since notified and offered medical tests to 179 patients who were treated with contaminated duodenoscopes from October to January, according to the L.A. Times.

"We notified all patients who had this type of procedure, and we were using seven different scopes. Only two of them were found to be infected. In an abundance of caution, we notified everybody," UCLA spokesperson Dale Tate told the Associated Press.

Though the scopes in question had been sterilized according to the manufacturer's standards, as in the other recent CRE outbreaks, the superbug appears to have resisted sterilization, the L.A. Times reported. Thus the medical center is now cleaning scopes via a process that "goes above and beyond manufacturer and national standards," according to a UCLA statement.

But increased sterilization may not be enough, Andrew Ross, M.D., section chief of gastroenterology at Virginia Mason Medical Center in Seattle, where one of the recent CRE outbreaks occurred, told the L.A. Times, suggesting that the federal government should step in to address design and cleaning guideline issues with the scopes.

The Food and Drug Administration has thus far refused to ban the use of duodenoscopes, citing the "lifesaving nature" of ERCP procedures, FierceHealthcare reported.

Healthcare providers and device manufacturers can also play a role in prevention, Lawrence Muscarella, a hospital-safety consultant and expert on endoscopes, told the newspaper, saying "bringing patients into the loop and answering their questions is important for hospitals to prevent outbreaks."

To learn more:
- read the L.A. Times article
- here's the AP report
- read the UCLA statement