The following, about a hospital roughly 50 miles east of Edmonton, Alberta, is rather alarming.
Dr. Gerhard Benadé, the region's medical health officer, issued a public health order Friday requiring St. Joseph's General Hospital in Vegreville to halt all admissions and close its sterilization room. The order was not made public until Tuesday.
Benadé discovered the sterilization problem while investigating an outbreak among patients of methicillin resistant staphylococcus aureus, or MRSA.
Seven patients in the 25-bed hospital east of Edmonton contracted the antibiotic-resistant bacterial infection over a one-month period beginning in mid-January.
"These are minor infections, usually skin infections, if any symptoms at all," said Dr. Karen Grimsrud, deputy provincial health officer.
Dr. Grimsrud is having an Officer Barbrady moment...MRSA isn't called a superbug for nothing. It's resistant to a number of antibiotics, and few versions are really aggressive (previous blog here). Plus as this article notes...
Patients in intensive care units are particularly vulnerable. Hospital mortality associated with MRSA sterile-site infections is reported to be greater than 20 percent.
As one would expect, people with weakened immune systems are more vulnerable to MRSA. Back to the original article...
While investigating the outbreak, Benadé uncovered the unrelated problem of improper sterilization of medical equipment at the hospital.
Benadé said it was the first time he had been in the sterilization room since he started his job six years ago, and he made the decision to shut the room down as soon as he saw the problem.
...
Health officials are now checking records of patients back to April 2003, including those who had surgeries or emergency room procedures. They are sending letters to those exposed to equipment that was inadequately sterilized and advising them to get tested for HIV, as well as hepatitis B and C.
One certainly hopes that one of more of Benadé's staff has actually inspected that room in the last six years. Curious that the authorities are checking records back nearly four years.
Both Benadé and Alberta's health minister made comments about the risk to patients being low...
Grimsrud confirmed that for one biopsy procedure alone—cystoscopy—80 patients were being contacted. Scopes used during surgery need to be thoroughly sterilized, but that wasn't happening at St. Joseph's, she said.
"There's tissue and blood left from the previous patient in that scope if it was not cleaned thoroughly with a brush and scrubbed and then is put into a sterilizer, so the concern was then the scope used on the next patient may still have material in it that can then transmit either HIV, hep B or hep C."
Benadé said if blood tests show anyone contracted HIV or any other disease at the hospital, officials will search for patients from even earlier dates.
Cystoscopy...
Cystoscopy is a test that allows your doctor to look at the interior lining of the bladder and the urethra. The cystoscope is a thin, lighted viewing instrument that is inserted into the urethra and advanced into the bladder.
The cystoscope is inserted into your urethra and slowly advanced into the bladder while your doctor looks through the scope to examine the inside of the urethra. Your doctor then examines the inside of your bladder for stones, tumors, bleeding, and infection. Cystoscopy allows your doctor to look at areas of your bladder and urethra that usually do not show up well on X-rays. Tiny surgical instruments can be advanced through the cystoscope that allow your doctor to remove samples of tissue (biopsy) or samples of urine from each kidney.
Cystoscopy can also be used to treat some bladder problems. Small bladder stones and some small growths can be removed by using tiny surgical instruments that slide through the cystoscope. This may eliminate the need for more extensive surgery.
There are going to be some worried people in that region for awhile.
