Posted on 03/10/2015 10:36:35 AM PDT by Oldpuppymax
on this topic generated plenty of interest (despite the small number of posted comments), so we continue our coverage…
Yet another prestigious hospital joins the ranks of those reporting Carbapenem resistant enterobacteriaceae (CRE) infections, linked to endoscopic retrograde cholangiopancreatography (ERCP) endoscopes. On March 4th, Cedars-Sinai Medical Center in Los Angeles discovered that four patients were infected with CRE, and 67 others may have been exposed.
Lisa McGiffert, director of the Safe Patient Project at Consumers Union, and a longtime activist regarding hospital-acquired infections, said that “It’s highly likely many hospitals around the country have had outbreaks, and they haven’t been able to connect the dots until this problem was disclosed at UCLA. It’s just a little late—especially for those who got infections and maybe died as a consequence.”
As discussed in last week’s piece, the magic bullet to end this horror seems to be true sterilization of the scopes with ethylene oxide (EtO). This finding was published on October 8, 2014 in JAMA, in an article entitled “New Delhi Metallo-ß-Lactamase–Producing Carbapenem-Resistant Escherichia coli Associated With Exposure to Duodenoscopes.”
Notably, EtO is hardly new technology, introduced 70-odd years ago. So why, people asked me, are these ERCP scopes not being sterilized with EtO? Good question. In fact, this was one of two questions repeatedly posed to me, via e-mails, phone calls, and from a Boston-based talk show host.
Regarding the non-use of EtO, the answer is cost. EtO sterilization is not expensive per se, but its 10-12 hour cycle time means that more scopes (at nearly $40,000 each) would need to be placed in inventory, to maintain the production flow of the ERCP procedures. Other reprocessing methods are quicker, but have proven to be less effective. However, in light of the CRE outbreaks...
(Excerpt) Read more at coachisright.com ...
Insufficiently sterilized objects inserted there can lead to life threatening infections.
Who knew?
< / gay lifestyle >
I have been working in this area for years. It has always been about money. Hospitals don’t want to pay the costs to have sufficient instruments sets so that they can be processed and don’t want to pay for personnel who are technically proficient (about the equivalent skill set of a lab tech) to perform the processing. So they do short cuts and skip steps. And this is NOT limited to endoscopes.
The FDA could also require endoscope manufacturers to design their scopes to make reprocessing better and they are really trying to do this. There are standards out there that, if followed would eliminate this problem. Unfortunately, the FDA is politically and legally constrained at demanding that new devices be better than existing approved devices. Plus the FDA is a bureaucratic nightmare.
A lot of us are working to solve these problems and it will happen. But it should happen sooner.
Manufacturers of OR equipment use ethylene O for mass production sterilizations. Why don’t the hospitals just outsource the endo ethylene sterile`s to OR/med equip. manufacturers? - After all, that ethylene is going 24/7 there -no problem to throw some endo`s in there at low cost- well??? Is it a well duhhh?
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.