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Why The 'Nightmare Superbug' Isn't As Scary As It Sounds


There have been some scary news reports coming out of California this week about a deadly outbreak at a UCLA teaching hospital. It's been linked to bacteria described as a nightmare superbug. But NPR's Jon Hamilton reports that the risk from this particular bacteria doesn't live up to the headlines.

JON HAMILTON, BYLINE: The UCLA Health system says at least seven people have been infected by a drug-resistant bacteria known as CRE. Two of the patients have died. But David Perlin, an expert on infectious disease at Rutgers University, says CRE isn't a threat to most people.

DAVID PERLIN: This is something that affects people with underlying immune problems, but it's not something that is likely to spread around the community or is really a cause for alarm.

HAMILTON: One reason is that CRE doesn't usually jump from person to person. At UCLA, it appears to have been transmitted by two contaminated endoscopes, fiber optic tubes used to inspect the digestive. UCLA says those endoscopes are no longer in use, and it has begun notifying 179 endoscopy patients who may have been exposed. Perlin says that's the right approach.

PERLIN: Those particular patients - you know, they're at somewhat of a risk, but probably not a very high risk. But they need to be watched.

HAMILTON: The contaminated endoscopes are a special type used to diagnose and treat problems in the pancreas and bile ducts. Perlin says their design makes them especially hard to disinfect.

PERLIN: Any time you place something in the body, there's always the opportunity to collect bacteria. Bacteria are inherently difficult to eradicate, and so transferring it then from patient to patient is not terribly surprising.

HAMILTON: Perlin says the special endoscopes have been implicated in a number of other CRE outbreaks that were eventually brought under control. Deverick Anderson, codirector of the Duke Infection Control Outreach Network, says there's a good chance the UCLA outbreak is already contained.

DEVERICK ANDERSON: Now that the source has been identified and essentially eliminated, I don't think that we would expect further uptick or an explosion of CRE infections in that community.

HAMILTON: Anderson says the larger issue is the rise of CRE bacteria. They're hard to kill, even with a class of powerful antibiotics known as carbapenums.

ANDERSON: These are bacteria that are resistant to that big gun - that last line of defense.

HAMILTON: Anderson says a study of CRE infections in hospital patients showed a sixfold increase from 2008 to 2012. The study also found that lots of patients harbored CRE bacteria in their bodies even though they had no active infection. Perlin says this means CRE outbreaks can start when a healthy person carrying the bacteria has an endoscopy.

ANDERSON: As a fraction of the population that has a CRE organism in their gut undergoes these kinds of procedures, well, then, lo and behold we find ourselves in this situation where these increasing numbers of outbreaks are happening as a result.

HAMILTON: Anderson says one solution is to develop better ways of disinfecting the special endoscopes involved in the UCLA outbreak.

ANDERSON: The way that we perform the disinfection on these different scopes is probably not sufficient, but there unfortunately is not a very quick fix to that very issue.

HAMILTON: Because it's hard to kill all the bacteria without damaging the instrument. And even with imperfect disinfection techniques, the risk of CRE infection is low. About 500,000 people a year are treated with the special endoscopes. Studies suggest fewer than 100 are infected. So why so much ado about a relatively small outbreak of CRE at one hospital? David Ropeik, a risk communications consultant, says our fears don't have much to do with actual risk.

DAVID ROPEIK: Ebola wasn't a threat to most people. Plane crashes aren't a threat to most people, but it has characteristics that make it feel scary.

HAMILTON: Like making people feel powerless to protect themselves. Also, Ropeik says, these events are out of the ordinary.

ROPEIK: Out of the ordinariness gets news coverage. News coverage feeds the brain, saying, woah, that's out there. I better pay attention and worry...

HAMILTON: ...About the immediate threat, even if it's minor. Ropeik says the challenge is to get people to focus on the long-term implications of something like a disease outbreak. In this case, he says, that means recognizing the very real threat posed by a wide range of drug-resistant germs, many of which spread more easily than CRE. Jon Hamilton, NPR News. Transcript provided by NPR, Copyright NPR.

Jon Hamilton is a correspondent for NPR's Science Desk. Currently he focuses on neuroscience and health risks.

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