Thursday, January 9, 2014

An Endoscopy related antibiotic resistant Super Bug.

You don’t have to be a medical tourist to acquire the New Delhi metallo-β-lactamase (NDM), an enzyme that breaks down carbapenems which are considered a “ last resort” remedy for infections like Escherichia coli.

Image Courtesy of Yuya Tamai
The NDM enzyme gives immunity to antibiotic resistant bacteria and has been traced to a hospital in Illinois. That is what patients who had endoscopies to examine their bile and pancreatic ducts, Endoscopic retrograde cholangiopancreatography ( ERCP), at the hospital found when they were called back for re-examination. Fifty of the 91 patients tested positive for the bacteria even though routine cleaning procedure of manual cleaning and high-level disinfection in automated endoscope reprocessors were followed for disinfection.

Endoscopy has to be one of the most unpleasant procedures in medicine today and it is possible many people shun this intrusive and painful examination but given this new development it puts this type of test under a new light. Attributing the failure of infected endoscopes to be cleaned properly as a possible design flaw, the CDC thinks the NDM might be giving rise to a new superbug, given the level of immunity it gives to bacteria which, could kill 50% of the people who may be unfortunate enough to get it in their bloodstream.

According to the CDC “Healthy people usually do not get CRE infections. In healthcare settings, CRE infections most commonly occur among patients who are receiving treatment for other conditions. Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics
are most at risk for CRE infections.”

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