Reuters Health Information: Second Los Angeles hospital identifies 'superbug' infections
Second Los Angeles hospital identifies 'superbug' infections
Last Updated: 2015-03-05
By Steve Gorman
LOS ANGELES (Reuters) - A second top Los Angeles hospital
has reported an outbreak of drug-resistant superbug infections,
and dozens more potential exposures, from procedures performed
with a duodenoscope.
The notice from Cedars-Sinai Medical Center of four such
infections and 67 more patients who were at risk coincided with
a hospital in Hartford, Connecticut, reporting a similar
outbreak involving at least five infections and more than 280
The Cedars-Sinai cases, like the larger number of infections
and potential exposures reported last month at the UCLA Ronald
Reagan Medical Center in Los Angeles, involved
carbapenem-resistant Enterobacteriaceae, or CRE.
The bacteria identified on Wednesday in the Hartford
Hospital outbreak was a drug-resistant strain of E.coli.
But the procedure and instrument implicated at all three
hospitals were the same - endoscopic retrograde
cholangiopancreatography, or ERCP, performed with a
The Food and Drug Administration, meanwhile, issued an
updated safety alert for duodenoscopes, urging medical providers
to inform patients of the risks, including possible transmission
of infection, associated with the use of such instruments.
The alert also puts providers on notice to report any
infections they suspect were caused by problems with the scopes
to the manufacturer and the FDA.
The latest flurry of infections has raised new questions
about whether manufacturers' recommendations for disinfecting
duodenoscopes are sufficient to protect patients.
The complex design of the instrument may hinder proper
cleaning, the FDA has warned.
A senior FDA official said this week that manufacturers' own
tests of disinfection measures they recommend contained flaws
that rendered those cleaning procedures unreliable.
Makers of the devices include Olympus Corp, Fujifilm
Holdings Corp and Pentax.
Olympus was the maker of the single duodenoscope linked to
all 71 patients of concern at Cedars-Sinai, from August 2014 to
February 2015, and of two suspect scopes tied to 179 potential
exposures dating back to October at UCLA.
Seven of UCLA patients were confirmed to have been infected,
and two of them had died.
One of the four infected Cedars-Sinai patients died from "an
underlying disease," not from the bacteria, as the infection had
by then been cleared, the hospital said in its statement.
Hartford Hospital said it found five or six of its patients
had contracted drug-resistant E.coli last year from two
duodenoscopes used in 281 more procedures, leading doctors to
conclude that those additional patients may have been exposed.
Both privately run Cedars-Sinai and UCLA, a public hospital,
say they were offering potentially exposed patients free
home-testing kits. The two facilities also said they have begun
using enhanced disinfection procedures, above and beyond the
Duodenoscopes have been associated with episodic infections
for more than a decade. But an increasing number of germs have
developed a resistance to antibiotics, making them potentially
more dangerous and difficult to treat.