Hospital Upgrades Scope Cleaning After Outbreak

2013 outbreak of carbapenem-resistant Enterobacteriaceae -- or CRE -- affected dozens of patients

Friday, Jan 3, 2014  |  Updated 11:04 AM CDT
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An investigation into an outbreak of a superbug bacterial infection shows Illinois hospitals are learning to take preventive steps quickly in cooperation with health authorities, the state's top doctor said.

The 2013 outbreak of carbapenem-resistant Enterobacteriaceae -- or CRE -- affected dozens of patients, with some cases apparently linked to a tainted endoscope used at Advocate Lutheran General Hospital in Park Ridge.

Illinois Department of Public Health Director Dr. LaMar Hasbrouck said public health experts worked with the hospital to find the source of the outbreak of CRE. Carbapenems are a class of antibiotics considered among the last lines of defense against hard-to-treat bugs.

"It is this type of coordinated effort that is vital to stopping CRE infections from spreading," Hasbrouck said in a statement.

The hospital changed its sterilization procedures after the investigation to establish practices exceeding the manufacturer's recommendations.

The investigation was written up in the current Morbidity and Mortality Weekly Report published by the U.S. Centers for Disease Control and Prevention. The design of the specialty endoscopes "might pose a particular challenge for cleaning and disinfection," the report said.

The bacteria can cause infections of the bladder or lungs, causing coughing, fever or chills, and can be fatal, although there were no deaths in the most recent outbreak.

Dr. Tom Frieden, the head of the CDC, has called this class of bugs "nightmare bacteria" because they can spread their resistance to other bacteria and because of their high mortality rates. They kill up to half of people who get serious infections.

Dr. Leo Kelly, vice president of medical management for Advocate Lutheran General Hospital, noted the help from the CDC and the Illinois health agency in an email. He said the investigation found no deficiencies with the hospital's sterilization process.

"However, as a precaution, we have moved to gas sterilization for these particular scopes, which exceeds the manufacturer's recommended cleaning and disinfectant guidelines to ensure no other patients are at risk," Leo said.

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