Superbug outbreak at UCLA hospital highlights importance of sterilising medical equipment


Could help drive growth in US$3.1bn sterilisation business, says Kalorama

A device-related superbug outbreak at a University of California, Los Angeles hospital, has revived concerns over device and facility sterilisation, said Kalorama Information, and is expected to help drive growth in the US$3.1bn market for such services.

In its new report on Healthcare Associated Infections Control Markets, which covers device and facility sterilisation, Kalorama notes that the effectiveness of many antibiotics is waning dramatically, as more types of bacteria become resistant to them. This is forcing the industry to re-evaluate prevention, diagnosis, and treatment plans for patients in hospitals and other health facilities.

Nearly 180 patients at UCLA's Ronald Reagan Medical Center may have been exposed to potentially deadly bacteria from infected duodenoscopes, and two deaths are linked to the outbreak. The recent exposure to carbapenem-resistant enterobacteriaceae (CRE) is thought to be a result of a mostly routine endoscopic procedure.

The US FDA issued a safety communication focusing on proper cleaning of the specific type of endoscope used, the duodenoscope, and the design complexity which may impede effective reprocessing of the device.

The US regulator has announced that from January 2013 to December 2014 a total of 75 reports were made to the administration, involving 135 patients in the US, for possible microbial transmission from reprocessed duodenoscopes. The most recent event in California involves an additional 100+ patients.

Kalorama says the healthcare facility sterilisation portion of the infection control business is a $3.1bn business worldwide.

The recent CRE cases discovered in California once again highlight the importance of sterilisation of medical equipment and facilities

‘In contrast, the market to diagnose and treat these infections is a $10bn market,’ said Melissa Elder, Kalorama Information analyst and the author of the report.

‘The recent CRE cases discovered in California once again highlight the importance of sterilisation of medical equipment and facilities.’

A growing list of treatment-resistant bacteria has emerged in the medical community. CRE is a highly drug resistant family of germs which has recently caused concern around the world. Some reports suggest that CRE is resistant to most antibiotics and may cause death in up to 50% of infected patients.

Effective reprocessing of reusable medical devices requires diligent cleaning and processing procedures which include recommendations from the FDA, US Centers for Disease Control (CDC) and the manufactures of these devices. In the case of duodenoscopes, Fujifilm, Olympus and Pentax are the three largest manufacturers.

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Additional precautions can be implemented to ensure patients are at the lowest risk for coming into contact with pathogens. Sterilising and disinfecting the reprocessing equipment, instruments in the health facility, the equipment, furniture, and all areas of patient and healthcare worker contact provide the best approach to preventing the spread of infection. This in combination with proper hand washing techniques and procedures, screening and diagnosing, using low-risk equipment all play a vital role in this fight, said the Kalorama report.