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Contaminated Doctors’ Scopes May Have Spread a Superbug to Almost 180 Patients

A drug-resistant bacteria usually found in the gut has infected seven people and contributed to two deaths

A surgeon using an endoscope, similar to the device involved in the UCLA outbreak (Corbis)
smithsonian.com

Medical scopes called duodenoscopes—used to treat gallstones, cancers and other problems in the digestive system—can be difficult to disinfect, and these devices appear to have carried a drug-resistant strain of bacteria to almost 200 patients, reports the Los Angeles Times. Two people have died, and UCLA’s Ronald Reagan Medical Center has contacted 179 others who may have been exposed to the same infection. 

It’s called Carbapenem-resistant enterobacteriaceae, or CRE, and it typically infects the gut. The drug-resistant bugs have an enzyme that can break down common antibiotics such as penicillin and amoxicillin, reports ABC News.   

In healthy individuals, CRE likely wouldn’t cause infection in the gut, Frank Esper, of UH Case Medical Center in Cleveland, Ohio, told ABC News. The problem arises when people are already sick and have a weakened immune system or when the microbe enters from through a wound. ABC News again:

About half of the people who develop CRE in a hospital will die, according to the CDC, but it's important to note that these patients are already very sick. As a result, it's hard to say whether CRE caused or played a role in [the two] deaths.

Five others have confirmed infections at UCLA. The LA Times reports:

County officials said they conducted a site visit at the UCLA medical center "to observe duodenoscope reprocessing procedures. No infection control breaches were observed." Apparently, two scopes were involved in this outbreak.

A Centers for Disease Control and Prevention medical officer, Alex Kallen, notes that the scopes are "cleanable, but it’s very difficult to adhere 100 percent every time to what you need to do." UCLA is now using decontamination procedures that exceed the standards.

So-called superbugs—bacteria that have developed drug resistance—are a common source of infection. Unfortunately, our own practices using antibiotics over the last 70 years are to blame. Now each year, at least 2 million people in the U.S. are infected with a superbug, and 23,000 die, according to the CDC. MRSA, or methicillin-resistant Staphylococcus aureus, in particular has garnered a lot of attention.

So while the UCLA outbreak is grabbing headlines now, there will be more outbreaks in the future. How to combat this monster of our own making? Start spending money, writes Maryn McKenna, author of Superbug: The Fatal Menace of MRSA, at her Wired blog. A British project on antibiotic resistance reveals that agencies in the U.S. and Europe really aren’t spending much on the issue. She writes:

Possibly the most dismaying finding is that the corps of people who would treat and research resistance is underfunded and shrinking. In the US, the report says, HIV and infectious disease physicians are the lowest-paid among the top 25 medical specialties, and the highest-ranked specialty journals are not considered prestige platforms to publish on. This especially made my jaw drop: Medical students don’t aspire to be infectious disease physicians any longer. For every 100 residency slots in neurology, there are 250 applications; for every 100 plastic surgery slots, 200 applicants. For every 100 infectious-disease slots, there are only 84 students who want to train.

At least the White House’s proposed 2016 budget plan recognizes the need to combat antibiotic-resistant bacteria. According to a statement, the proposal includes $1.2 billion in funding toward the issue.

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