Getting a better handle on drug-resistant bacteria
This undated photo provided by the U.S. Food and Drug Administration shows the tip of an endoscopic retrograde cholangiopancreatography (ERCP) duodenoscope, attached to a long tube, not shown. A 'superbug' outbreak is raising disturbing questions about the design of a hard-to-clean medical instrument used on more than half a million people in the U.S. every year. (US Food and Drug Administration/AP Photo)
A recent outbreak of carbapenem-resistant enterobacteriaceae, a drug resistant bacteria known as CRE, at a California hospital has prompted an FDA safety warning on a medical imaging device associated with the outbreak.
A similar outbreak hit a Philadelphia hospital last year, and experts view this as a reminder of the importance of being diligent in preventing infections.
CRE has been around for a while, according to Dr. Neil Fishman, chief of patient safety at the University of Pennsylvania Health System who has long studied “superbugs.”
In general, he said, the risk of contracting it is “extremely low,” as is the risk of getting an infection from procedures utilizing the imaging device.
Endoscopes linked to the outbreaks have a design problem that makes them especially difficult to clean, so hospitals need to take extra steps, he said.
“We knew a while back that this was a liability,” said Fishman. “Our gastroenterologists came to us and said, ‘We’re using a new piece of equipment, but we need to make sure it’s cleaned properly.'”
That’s led to more intensive cleaning. Beyond that, he said, basic techniques including hand washing and contact precautions are essential.
To combat the rise of antibiotic-resistant bacteria in general, Fishman said, it’s also important to prescribe antibiotics only when appropriate “and not overuse and abuse antibiotics. Because at the core, that’s what leads to the emergence of this very resistant bacteria.”
The Philadelphia health department reported one outbreak of CRE at an area hospital last year related to the scopes, but it did not disclose which hospital. It affected eight patients. Two died, but the department said the deaths were not clearly linked to the infection.
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