Bacteria outbreak confirmed; 52 patients at Arkansas Cancer Institute infected, over 100 at risk

Fifty-two people who were treated recently at Arkansas Cancer Institute have tested positive for a previously unknown bacteria, the Arkansas Department of Health confirmed Monday.

Three people who tested positive for the infection have died, though it's unknown whether their deaths were caused by the bacteria or other illness, such as the cancer for which they were originally being treated. More than 100 others identified as being at risk have been screened and results are pending, Arkansas state epidemiologist Dr. Dirk Haselow said.

"We expect these numbers to rise above 52, but how much more, we don't know," Haselow said.

The outbreak connected to the Pine Bluff treatment center was discovered among people who have ports, which are implanted devices that allow access to the bloodstream to administer medication and help with blood draws. The infections had thrived in the ports, which are typically implanted in a vein in the chest, according to the Memorial Sloan Kettering Cancer Center website.

Early tests of the bacteria -- nicknamed FVL-2018-32 -- have not shown it to be easily passed from person to person, and currently researchers do not believe that it is dangerous for people with healthy immune systems.

"I think it's really important for the public to understand that this is not a general public risk," Haselow said. "Further, we do not believe that this risk continues among those who are newly seen at [Arkansas Cancer Institute]."

In a phone interview Monday, Arkansas Cancer Institute administrator Michael Legate said that the treatment center had notified health authorities, including Jefferson Regional Medical Center, the state health department and the Centers for Disease Control and Prevention, after observing that some patients were getting sick.

The problem was traced to a saline flush process for ports that had been used for 27 years without incident, Legate said. Though he said the specific source of the contamination is being investigated, the process has been discontinued.

Haselow said that in investigating the outbreak the Arkansas Department of Health had noted areas where the treatment center was "vulnerable to infection," using an analogy to explain why this may have happened now.

"You can speed all your life and never be in an accident, but then the first time you get in an accident, you recognize that speeding might not have been a great idea. ... It went wrong at least once," he said.

The list of potentially affected people comprises those who had their port accessed at the facility between March 22 and Sept. 11 of this year. The treatment center has reached everyone identified as having been at risk for infection, Legate said, and most have been treated.

"The main takeaway is that this is not communicable, and there's no new cases, no new exposure," he said.

Haselow said although he had not seen a situation exactly like this one in Arkansas, it's not unheard of for there to be clusters of infections associated with surgeries or procedures, and that similar infections sometimes happen in patient ports.

Many of the patients have had their ports removed, and people who tested positive for the bacteria will undergo a two-week course of antibiotics, Haselow said. They'll then be observed for two weeks and re-tested to make sure the infection has not returned.

No one has been fully cleared, but five people have undergone their second round of testing and are waiting for those results.

Arkansas Cancer Institute opened in 1991 and treats several types of cancer. In a news release, it said this is the first time there has been an outbreak of this kind at the facility.

"We are thankful for the sake of our patients and our Pine Bluff community that this infection does not spread from person to person and will not cause infection to the public. ... Nevertheless, we are dismayed and saddened by the turn of events," the release said. "This has been a moment of reflection and introspection for all of us at the clinic."

Metro on 10/30/2018

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