Pennsylvania's Perelman School of Medicine in Philadelphia.
However, he concedes, "We have limited short-term options to put in
place to protect our patients."
An outbreak goes public
Between October 3, 2014, and January 28 of this year, 2 patients
who'd undergone endoscopic retrograde cholangiopancreatography
(ERCP) at UCLA's Ronald Reagan Medical Center in Los Angeles died
as a result of carbapenem-resistant Enterobacteriaceae (CRE) infec-
tions they'd acquired from contaminated duodenoscopes. At least 7
other patients were infected, hospital officials announced on February
18, and 179 more were notified that they may have been exposed to
the bacteria.
What stunned UCLA and government epidemiologists was that the
outbreak wasn't caused by shoddy scope reprocessing. "UCLA fol-
lowed both national guidelines and the sterilization standards stipulat-
ed by Olympus Medical Systems Group, the instrument's manufactur-
er," hospital officials wrote in a public statement (tinyurl.com/lgtgnmn).
"After discussion with local and national public health officials, it
appears that the ERCP scopes will require additional cleaning tech-
niques beyond what is recommended by the manufacturer or signifi-
cant redesign of parts of the scope."
For its part, the hospital now touts "one of the most stringent scope
protocols in the United States," not only manually cleaning and high-
level disinfecting the scopes in an automated endoscope reprocessor,
but also shipping them off site for ethylene oxide (EtO) gas steriliza-
tion. It hasn't seen any new CRE cases since implementing this proto-
col, according to the Los Angeles Times.
Tip of the iceberg
Several other hospitals have reached this conclusion after suffering
outbreaks of their own. It was reported in January that properly
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