Contaminated medical tool suspected in 'superbug' outbreak

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Contaminated medical tool suspected in 'superbug' outbreak
The manufacturer of the endoscope involved in two superbug deaths at UCLA never received permission from the Food and Drug Administration.
This illustration released by the Centers for Disease Control depicts a three-dimensional (3D) computer-generated image of a group of carbapenem-resistant Enterobacteriaceae bacteria. The artistic recreation was based upon scanning electron micrographic imagery. A potentially deadly "superbug" resistant to antibiotics infected seven patients, including two who died, and more than 100 others were exposed at a Southern California hospital through contaminated medical instruments, UCLA reported Wednesday Feb. 18, 2015. (AP Photo/Centers for Disease Control)
FILE - This undated file 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 patient has sued the maker of the medical scope linked to the outbreak of a superbug at Ronald Reagan UCLA Medical Center in Los Angeles. (AP Photo/U.S. Food and Drug Administration, File)
A pedestrain approaches an entrance to Cedars-Sinai Medical Center in Los Angeles on September 7, 2012 in California, where veteran French rocker Johnny Hallyday underwent examinations this week following a health scare in the Caribbean. Hallyday's manager Sebastien Farran said the “general” tests on the 69-year-old singer were due to be finished Friday” with Hallyday released from hospital. AFP PHOTO / Frederic J. BROWN (Photo credit should read FREDERIC J. BROWN/AFP/GettyImages)
LOS ANGELES, CA - JUNE 15: General view of the Cedars-Sinai Medical Center where Kim Kardashian and Kanye West welcomed a baby girl on June 15, 2013 in Los Angeles, California. (Photo by JB Lacroix/WireImage)
A pedestrain crosses a street at Cedars-Sinai Medical Center in Los Angeles on September 7, 2012 in California, where veteran French rocker Johnny Hallyday underwent examinations this week following a health scare in the Caribbean. Hallyday's manager Sebastien Farran said the “general” tests on the 69-year-old singer were due to be finished Friday” with Hallyday released from hospital. AFP PHOTO / Frederic J. BROWN (Photo credit should read FREDERIC J. BROWN/AFP/GettyImages)
WESTWOOD, CA - FEBRUARY 18: The exterior of the Ronald Reagan UCLA Medical Center is shown February 18, 2015 in Westwood California. (Photo by Francine Orr/Los Angeles Times via Getty Images)
WESTWOOD, CA - FEBRUARY 18: The exterior of the Ronald Reagan UCLA Medical Center is shown February 18, 2015 in Westwood California. (Photo by Francine Orr/Los Angeles Times via Getty Images)
7 Infected, More Than 100 Exposed To Potentially Fatal "Superbug" At UCLA Hospital: http://t.co/1hscksipJk http://t.co/mCQ3lsx3TG
'Superbug' may have caused two deaths at UCLA hospital http://t.co/gFElaAgUrI #sanfrancisco http://t.co/RLRkLuY3gQ
More than 100 patients might have been exposed to a deadly bacteria known as CRE at UCLA Ronald Reagan Medical Center.
Dr. Zachary Rubin, medical director of clinical epidemiology and infection prevention at the Ronald Reagan UCLA Medical Center, right, takes questions from the media in Los Angeles Thursday, Feb. 19, 2015. Los Angeles County health officials say a "superbug" bacterial outbreak at a local hospital doesn't pose any threat to public health. At left, Dr. Robert Cherry, chief medical and quality officer, UCLA Health System, and Dr. Benjamin Schwartz, deputy chief of the Acute Communicable Disease Control Program at the county Department of Public Health, middle. (AP Photo/Damian Dovarganes)
Dr. Zachary Rubin, medical director of clinical epidemiology and infection prevention at the Ronald Reagan UCLA Medical Center, left, takes questions from the media in Los Angeles Thursday, Feb. 19, 2015. Los Angeles County health officials say a "superbug" bacterial outbreak at a local hospital doesn't pose any threat to public health. A day earlier, UCLA officials said nearly 180 patients at Ronald Reagan UCLA Medical Center had been exposed to antibiotic-resistant bacteria called CRE. Seven of them got the infection and two of those people have died. (AP Photo/Damian Dovarganes)
UCLA medical officials take questions from the media outside the Ronald Reagan UCLA Medical Center in Los Angeles Thursday, Feb. 19, 2015. A day earlier, UCLA officials said nearly 180 patients at Ronald Reagan UCLA Medical Center had been exposed to antibiotic-resistant bacteria called CRE. Seven of them got the infection and two of those people have died. (AP Photo/Damian Dovarganes)
LOS ANGELES, CA - JUNE 15: General view of the Cedars-Sinai Medical Center where Kim Kardashian and Kanye West welcomed a baby girl on June 15, 2013 in Los Angeles, California. (Photo by JB Lacroix/WireImage)
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LOS ANGELES (AP) -- A "superbug" outbreak suspected in the deaths of two patients at a Los Angeles hospital has raised questions about the adequacy of the procedures for disinfecting a medical instrument used on more than a half-million people in the U.S. every year.

At least seven people - two of whom died - have been infected by a potentially lethal, antibiotic-resistant strain of bacteria after undergoing endoscopic procedures at Ronald Reagan UCLA Medical Center between October and January, and more than 170 other patients may have been exposed as well, UCLA said.

UCLA said Wednesday that the infections may have been transmitted through at least two contaminated endoscopes that were used to diagnose and treat pancreatic and bile-duct problems.

An endoscope - or more specifically in this case, a duodenoscope - is a thin, flexible fiber-optic tube that is inserted down the throat to enable a doctor to examine an organ. The device typically has a light and a miniature camera.

"We notified all patients who had this type of procedure, and we were using seven different scopes. Only two of them were found to be infected. In an abundance of caution, we notified everybody," UCLA spokeswoman Dale Tate said.

The two medical devices carried the bacteria even though they had been sterilized according to the manufacturer's specifications, UCLA said.

"We removed the infected instruments, and we have heightened the sterilization process," Tate said.

On Thursday, the U.S. Food and Drug Administration issued an advisory warning doctors that even when a manufacturer's cleaning instructions are followed, infectious germs may linger in the devices. Their complex design and tiny parts make complete disinfection extremely difficult, the advisory said.

More than 500,000 patients undergo procedures using duodenoscopes in the U.S. every year, according to the FDA.

The germ is known as Carbapenem-resistant Enterobacteriaceae, or CRE, and similar outbreaks have been reported around the nation. They are difficult to treat because some varieties are resistant to most known antibiotics.

By one estimate, CRE can contribute to death in up to half of seriously infected patients, according to the U.S. Centers for Disease Control and Prevention.

CRE can cause infections of the bladder or lungs. Symptoms can include coughing, fever and chills.

The bacteria may have been a "contributing factor" in the deaths of two UCLA patients, the university said in a statement. Those who may have been exposed are being sent free home-testing kits that the university will analyze.

National figures on the bacteria are not kept, but 47 states have seen cases, the CDC said.

One outbreak occurred in Illinois in 2013. Dozens of patients were exposed to CRE, with some cases apparently linked to a tainted endoscope used at a hospital.

A Seattle hospital, Virginia Mason Medical Center, reported in January that CRE linked to an endoscope sickened at least 35 patients, and 11 died, though it was unclear whether the infection played a role in those deaths.

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