Via The Los Angeles Times, a real-life medical thriller: A Killer on the Loose: Patients at UCLA were becoming deathly ill. A superbug was spreading. Could doctors stop it? Read the excerpt and then go read the complete story:
Doctors at UCLA’s flagship hospital were baffled: A healthy 40-year-old woman had fallen deathly ill after a routine procedure.
A long black scope had been threaded down her throat to treat troublesome gallstones. Now antibiotics were powerless to stop a raging infection.
Her physicians called in Dr. Zachary Rubin, the hospital’s director of clinical epidemiology and infection prevention, and its top disease detective.
He immediately suspected the scope itself — a dirty one could cause this kind of infection.
So Rubin inspected the hospital’s cleaning rooms, where workers scrub dozens of reusable medical instruments and load them in washing machines packed with powerful disinfectants. He saw no evidence to support his theory.
He considered taking the devices, known as duodenoscopes, out of service. But if his hunch was wrong, he knew there could be serious consequences.
The scopes, used several times a day at the hospital, save the lives of some critically ill patients and spare them complications from surgery. He held off to keep investigating.
But he didn’t realize that the woman wasn’t an isolated case. A superbug outbreak was already spreading inside UCLA on that day in mid-December.
A killer was on the loose.
The bacteria arrived at UCLA unnoticed in September, hitching a ride on a patient.
Unbeknownst to doctors, that patient — a woman being evaluated for a liver transplant — was carrying an unusually potent version of CRE, or carbapenem-resistant enterobacteriaceae.
Some Americans carry these bacteria with no ill effects, but years of antibiotic overuse have created virulent strains immune to most treatments. By some estimates, CRE kills up to half of infected patients.
The source patient at UCLA underwent a procedure Oct. 3 known as ERCP, or endoscopic retrograde cholangiopancreatography. During the procedure, a flexible scope is used to diagnose and treat problems in the digestive tract such as cancers and blockages in the bile duct. Nearly 700,000 such procedures are performed annually in the U.S. More than 800 are done each year at UCLA, among the most at any hospital nationwide.
The medical scope had picked up the bacteria from the woman’s intestinal tract, and the standard cleaning didn’t remove it.