Insufficient infection control and poor infrastructure have been blamed for a superbug outbreak in a Cork hospital which has infected 16 patients.
Poor performance demonstrated in a recent infection prevention and control audit of patient equipment may also have contributed to the outbreak at Mercy University Hospital, according to the State’s health watchdog.
Of the 16 cases of CPE infection recorded in the hospital between January and October this year, 12 were acquired in the hospital, a report by the Health Information and Quality Authority says.
The hospital has told Hiqa inspectors 110 patients who came into contact with CPE cases had been identified since December 2017. All of these had been informed either verbally or by letter and a dedicated clinic was run to screen patient contacts.
The hospital has not succeeded in eliminating the superbug but its efforts have contained the number of new CPE cases and in maintaining CPE-related bloodstream infections at very low levels, according to an inspection report.
“The hospital has also identified background rates of CPE in the community which may indicate it may not be possible to fully eradicate CPE in the hospital.”
Carbapenemase Producing Enterobacteriaceae (CPE) is the newest in a long line of bacteria that are extremely difficult to kill with antibiotics.
Of all the superbugs, CPE is the most resistant to antibiotics. It lives harmlessly in the gut in healthy people but can be lethal if it gets into the bloodstream or urine. It poses a particular risk to older people and those with reduced immune system function.
The Hiqa report says insufficient infection prevention and control resources had impeded the ability of staff to perform in the face of an increased workload caused by the CPE outbreak.
In addition, dated hospital infrastructure, including a lack of single rooms with en-suite facilities, an ongoing challenge at the hospital for many years had the potential to increase the risk of transmission of healthcare-associated infection to inpatients.
The hospital had since increased screening and surveillance of CPE “which is commendable”, the report states.
Mercy hospital said it wished to assure the public the problem was being addressed and monitored on a continuous basis. An application for a new hospital ward including 12 single rooms, as recommended for infection control, has been submitted.
Meanwhile, Connolly Hospital in Blanchardstown is not in compliance with Health Service Executive guidelines for screening patients for CPE, a separate Hiqa report has found.
The hospital must continue to work towards a centralised model of endoscope decontamination, the report recommends.
The first case of CPE in Ireland was isolated in University Hospital Limerick (UHL) in 2009 and the first outbreak in an Irish hospital occurred in UHL in 2011.
The bug has since been found in many other hospitals, and is a growing cause of concern within the health system.
