WIKIMEDIA, ZOL87Nearly 50 people in the Chicago area have turned up with infections involving a relatively new and virulent bacterium, and a suburban hospital appears to be a major contributor to the outbreak. The US Centers for Disease Control and Prevention (CDC) reported last week (January 3) that 44 people in northeastern Illinois were infected with carbapenem-resistant Enterobacteriaceae (CRE), a bacterium that is highly resistant to treatment, and one the agency last year deemed an urgent threat to public health. Of the 44 affected, 38 were patients who underwent endoscopic procedures involving the pancreas or bile ducts at Advocate Lutheran General Hospital in Park Ridge, IL, between January and September 2013.
“It’s the largest outbreak that we’ve seen in the U.S. of this bacteri[um] ever,” Alex Kallen, a CDC infectious disease doctor involved with the investigation of the outbreak, told CBS Chicago.
In total, 243 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at Advocate Lutheran were exposed to the bacterium, but most people were only “colonized,” not infected with the pathogen. According to the hospital, 28 patients tested positive for the microbe, but did not show signs of an infection, and 10 others did exhibit symptoms of infection. “The design of the ERCP endoscopes might pose a particular challenge for cleaning and disinfection,” according to the CDC report.
In the U.S., CRE was first reported in 2009, and through 2012, only 27 infected patients have been confirmed. Since January 2013, the CDC has confirmed that 69 patients were infected with CRE, including the 44 from northeastern Illinois.
CRE typically causes a urinary tract infection, but if the bacterium gets into the bloodstream, the infection can be fatal.
Administrators at Advocate Lutheran have switched to a more intensive sterilization process for their endoscopes, even though the CDC investigation found no flaws in their previous disinfection protocols. “To ensure no other patients are at risk, we have moved to gas sterilization for these particular scopes, which exceeds the manufacturer’s recommended cleaning and disinfectant guidelines,” Leo Kelly, vice president of medical management at Advocate Lutheran General Hospital, told CBS Chicago.