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Monday, January 26, 2015

Can't prevent everything..PO Day 225

Even if we are attentive and proactive, we can't prevent everything.

In 2012 there was a "superbug outbreak" that infected dozens of people in Pittsburgh, Seattle and Chicago. If everyone involved had washed their hands a hundred times it would have made no difference. The dangerous infection, Carbapenem-resistant Enterobacteriaceae (CRE) is one of the superbugs that have developed because of the overuse of antibiotics.

The infection was spread through the use of duodenoscopes used in gastrointestinal scopes of patients with gallstones, cancers and other digestive system problems. It was spread from patient to patient because the. CRE can survive traditional cleaning methods.

A Seattle investigation revealed 35 infected patients and eleven deaths, although it is difficult to rule out death from other problems as many of the patients were critically ill already.

In spite of this this, the FDA has not issued a recall for the devices saying it remains important to have the procedure available for use. One approach has been to culture and isolate the equipment for forty eight hours after use to be sure it is safe to use again. Hospitals and clinicians are having to think outside the box in designing protocols for infection control. Studies have shown, for instance, that wiping equipment down with chlorhexidine every day is not as effective as doing it every other day. Now how does that make sense?

All you can do is express concern and hope your doctor and hospital are tuned in to the problem. Sometimes merely asking a question is enough to ensure people do the right thing. Now if we just knew what that is!

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