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Superbug outbreaks

Filthy endoscopes linked to superbug outbreaks at hospitals

Friday, January 17, 2014 by: Jonathan Benson, staff writer
Tags: superbug outbreaks, endoscopes, hospitals

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(NaturalNews) A common procedure used by doctors to evaluate the health of their patients' internal organs has been identified as the cause of multiple "superbug" outbreaks at several U.S. hospitals. A new report published in Morbidity and Mortality Weekly Report has found that filthy endoscopes, which are inserted into the body during an endoscopy, were responsible for infecting dozens of patients with a rare superbug known as carbapenem-resistant Enterobacteriaceae (CRE), which produces an enzyme known as New Delhi metallo-beta-lactamase, or NDM, that renders antibiotics useless.

The report, which was led by researchers from the U.S. Centers for Disease Control and Prevention (CDC), looked at a specific cluster of NDM-producing CRE infections that occurred at a single hospital in northeastern Illinois in 2013. Nine patients at this one particular hospital were among 69 total cases of NDM-producing CRE infections that occurred throughout the year, a figure that is 250 percent higher than the number of patients who came down with the infection during the four years between 2009 and 2012.

To identify the cause of this sudden outbreak, the research team looked at where each of the patients were treated, as well as what he or she was treated for. After identifying one hospital in particular where many of the infections occurred, the team collected samples from various equipment at the hospital to look for contamination, which led them to endoscopic retrograde cholangiopancreatography (ERCP) endoscopes that apparently were not being properly sanitized.

Even though the machines had undergone an intense disinfection process that should have eliminated any and all bacteria that may have been lurking, NDM-producing CRE was still found to be present. The reason for this, experts say, is that NDM, an enzyme produced by the superbug, renders most antibiotics useless, the likely result of persistent antibiotic overuse at hospitals and on factory farms.

"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," writes JoNel Aleccia for NBCNews.com.

Hundreds of patients at Illinois hospitals exposed to deadly NDM-producing E. coli

According to Medscape.com, 91 patients were initially identified as having been exposed to the culture-positive endoscope, which was being used at Advocate Lutheran Hospital in Park Ridge, Illinois. Each of these patients were notified about his or her exposure and asked to return for surveillance cultures -- and among the 50 who returned, nearly half tested positive for the deadly bacteria.

But according to the CDC's Melissa Dankel, who works for the agency's National Center for Emerging and Zoonotic Infectious Diseases, the number of exposed patients was actually far higher. As many as 243 patients at the hospital are said to have been exposed to the contaminated endoscope since January 1, 2013, a figure that hospital officials refused to discuss with the media.

"At this time, CDC recommends facilities reprocess endoscopes as directed by the manufacturer," stated Dankel to the media. "[F]acilities should review their endoscope reprocessing practices to ensure all manufacturers' reprocessing recommendations are followed exactly."

Endoscope-linked superbug outbreaks could be more widespread than we even know, say experts

While somewhat isolated in nature, these recent outbreaks could be the tip of the iceberg, infection control specialist Lawrence F. Muscarella, Ph.D., stated to Medscape Medical News. Many other types of infectious agents are likely being spread by dirty endoscopes, he says, but they are probably being overlooked in patients who have healthy immune systems or who are already being treated with antibiotics.

"This bacterium's resistance apparently caused a 'perfect storm' to present itself and to reveal the problem," he is quoted as saying.

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