New Sterilization Rules Will Prevent More “Superbug” Infections, Doctors Say

Doctors say improved techniques for cleaning the devices linked to spread of the bacteria will keep more people from being infected, doctors say.

Doctors and administrators at Ronald Reagan-UCLA Medical Center said Thursday that new procedures for cleaning a medical device used in some exams will prevent the "superbug" that led to two deaths and five other infections from spreading to anyone else.

Officials also faced tough questions as many wondered why it had taken them until yesterday to tell the public about an outbreak that began more than a month ago.

"It takes a little bit of time to identify the patients who are at risk for the procedure," said Dr. Zachary Rubin, the hospital’s medical director of infection prevention.

In mid-December, a UCLA patient received a gallbladder exam using a device called an endoscope.

The patient, whose identity was not disclosed, developed immediate symptoms of the "superbug" bacteria, doctors said. The patient had a fever, chills and then a massive infection.

Doctors tested the scope to make sure it was used and sterilized properly.

The devices are difficult to sterilize completely, and even feature warnings from the manufacturer. Doctors found two of the scopes may have transmitted the bacteria.

Researchers then found seven other cases of the infection stemming from the CRE bacteria, which is fatal in as many as half of those whose bloodstreams are exposed to it.

The bacteria exists naturally in many people’s intestines and will not affect them, but once it enters the bloodstream it can be deadly.

"We do do surveillance on a regular, routine basis for CRE, and we've actually done additional investigation over the past few years," Rubin said.

But the bacteria did not turn up when the first patient was admitted, the one who may have been a "carrier."

While researching any possible exposure, the hospital implemented new and stricter requirements for sterilizing the scopes.

Checking records to find out which endoscopies were performed on which patients with the two contaminated devices took time, said doctors.

They also didn't want to alarm all patients who'd had endoscopies if they weren't exposed to the same contaminated instruments.

Ultimately, they discovered 179 patients total who may have been exposed during procedures between October 2014 and Jan. 28.

Doctors are continuing to reach out to patients who may have been affected. Rubin said they have called and emailed patients out of an “abundance of caution.”

"What we're doing now is trying to identify any patients that have 'carrier state,'" Rubin said.

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