Lutheran General finds, stops bacteria source

Advocate Lutheran General Hospital in Park Ridge is asking patients who had a specific procedure performed earlier this year to be screened for a potential infection that's highly resistant to antibiotics. Hospital officials also are assuring the public that the procedure has now been made completely safe.

It's believed 243 patients who underwent an Endoscopic Retrograde Cholangiopancreatography, or ERCP, procedure between January and September this year may have been exposed to the bacteria known as carbapenum-resistant enterobacteriaceae, or CRE.

Of the patients contacted, 105 have already responded to letters requesting they come in for a screening, said Dr. Leo Kelly, vice president of medical management at Lutheran General. The hospital still wants the remaining 138 to get in touch as soon as possible.

Those found to be infected can be treated with a specialized cocktail of antibiotics.

The procedure these patients underwent is a very specific one looking at the bile ducts and pancreas, Kelly said. It's a relatively rare procedure that patients come from all around the Chicago area to have done at Lutheran General.

The type of bacteria involved is one most people have in their digestive systems, but a strain has developed that is highly resistant to antibiotics through the misuse of antibiotics in some Third World countries, Kelly said.

While still relatively rare in the United States, this strain of bacteria is becoming an emerging problem here as it's resistant to industry-standard methods of cleaning some types of medical equipment.

"We feel this story is important to other patients and other institutions going forward," Kelly said.

It's possible that one patient unknowingly carrying the drug-resistant bacteria was the source of the contamination at Lutheran General, Kelly said.

It wasn't easy to figure out the cause of the infection, Kelly said. The earliest clue came when five or six patients were found to have contracted it.

Working with Lutheran General on the investigation were the Centers for Disease Control and Prevention, the Federal Drug Administration, the Illinois Department of Public Health and the Cook County Department of Public Health.

While the manufacturer's recommendation for cleaning the equipment for ERCPs involves a process of high-grade disinfectants and brushes, Lutheran General has permanently moved to the use of gas sterilization -- the same as is used for operating room equipment. With that change, patients should have no concerns about undergoing the procedure, Kelly said.

But as most hospitals still follow the industry standard, the probable reason cases of infection from medical equipment remain rare in the United States is that the bacteria itself is still rare, Kelly said.

While many people exposed to the bacteria may be without symptoms, people who are weaker or have compromised immune systems -- like cancer patients -- may be more at risk of serious problems.

Spread of the bacteria from one person to another is unlikely in normal daily contact. But as the bacteria can be carried by fecal material, caregivers of bedridden seniors and the like should pay particular care to basic hand hygiene, Kelly said.