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'Superbug' infections sicken four patients at Cedars-Sinai

Infections come two weeks after two patients at UCLA's Ronald Reagan Medical Center who used the same kind of scope died from CRE.

Photo of Cedars-Sinai Medical Center from Wikipedia.

More “superbug” cases have been confirmed in California after Cedars-Sinai Medical Center on Thursday said four patients contracted carbapenem-resistant enterobacteriaceae infections, also known as CRE, from complex organ scopes.

One patient has died, though Cedars-Sinai said the death came from the underlying medical condition, not the infection.

Cedars-Sinai said it is notifying 71 patients who had a duodenoscope procedure between August 2014 and February 2015 with the scope linked to the four infections and offering them a free at-home testing kit.

Most people who are exposed to CRE do not develop an infection and “there is no evidence at this point that anyone other than the four patients acquired CRE from a duodenoscope,” the hospital said.

The infections come two weeks after UCLA’s Ronald Reagan Medical Center announced that two patients who used the same kind of duodenoscope died after CRE infection and that more than 100 may have been exposed.

[Also: Two dead from superbugs at Ronald Reagan Medical Center]

After that incident, Cedars-Sinai said infectious diseases specialists decided to do their own molecular analysis of their own hospital’s instruments.

They found that, despite “meticulously” following the disinfection procedure recommended by manufacturer Olympus Corporation and the U.S. Food and Drug Administration, a total of four patients contracted a CRE transmission after an endoscopic retrograde cholangio-pancreatography examining the liver, bile ducts or pancreas.  

Cedars-Sinai said it removed the particular duodenoscope from use — no others were linked to a CRE infection — and is continuing “to use enhanced disinfection procedures” that go “above and beyond the manufacturer's recommendations.”

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Olympus Corporation’s “disinfection recommendations may not be sufficient to protect patients,” the hospital said.

Olympus has not commented on the incidents.

Of all the antibiotic-resistant infections plaguing American healthcare, CRE is one of less worrisome. People often carry the bug in their guts with  ill-effect until it spreads, such as through endoscopies, and is transmitted to people with compromised immune systems.

The Centers for Disease Control and Prevention is suggesting that hospitals screen all new patients for CRE. Anthony Harris, MD, president of the Society for Healthcare Epidemiology of America told Kaiser Health News that CRE is “still a fairly rare event, but this is the time to intervene” to prevent CRE from becoming a problem on the scale of methicillin-resistant staphylococcus aureus or Clostridium difficile.

Twitter: @AnthonyBrino