Two patients at Ronald Reagan UCLA Medical Center in Los Angeles have died after contracting carbapenem-resistant Enterobacteriaceae infections from improperly cleaned scopes, according to an LA Times report.
Here are five things to know about the outbreak, other similar CRE outbreaks and the bacteria itself.
1. After discovering the outbreak in late January, the hospital started notifying 179 patients who could have been exposed to the deadly bacteria from October to January, according to the LA Times. Seven patients have confirmed CRE infections.
2. The infections have been linked to a specific type of scope, a duodenoscope. UCLA officials traced the infections back to two scopes that have since been removed from use. While the hospital had been cleaning the scopes "according to the standards stipulated by the manufacturer," the hospital now cleans them in a way that "goes above and beyond the manufacturer and national standards," according to the Times.
3. UCLA is not the first hospital to have duodenoscopes lead to CRE infections. For instance, at least 35 patients at Seattle-based Virginia Mason Medical Center fell ill from CRE infections between 2012 and 2014. There as well, the hospital linked the infections to duodenoscopes and changed the way it cleans them to prevent further infections.
4. Duodenoscopes, used in a procedure called endoscopic retrograde cholangiopancreatography, have a complicated design that makes them difficult to fully disinfect. The Food and Drug Administration has said the agency is aware of infection risks the scopes present, but the nature of the procedure for which they are used makes it important that they remain available. At least one senator, Sen. Patty Murray (D-Wash.), is pushing for the FDA to update its best practices for sanitizing the scopes.
5. CRE is a family of germs with a high level of resistance to antibiotics. CRE bacteria can contribute to death in up to 50 percent of patients who become infected, according to the Centers for Disease Control and Prevention, and they are difficult and sometimes impossible to treat. The CDC offers a CRE toolkit, covering guidance for control of the bacteria. Find it here.