The Irish Times – Wednesday, March 16, 2011

EITHNE DONNELLAN, Health Correspondent

ATTEMPTS ARE being made to contain an outbreak of a highly drug-resistant and potentially lethal bug at the Mid-Western Regional Hospital in Limerick.

It is the first outbreak of KPC, or klebsiella pneumoniae carbapenemase, in an Irish hospital. to date seven patients in the hospital have been affected, and a further case has been identified at a long-stay facility in the midwest.

The cause of the outbreak, which doctors have described as of serious concern, is being investigated.

Symptoms include vomiting and diarrhoea.

Visiting restrictions have been put in place and a programme of intensive deep cleaning has been instituted in wards where transmission is suspected of occurring.

Dr Fidelma Fitzpatrick, clinical lead for healthcare-associated infections with the Health Service Executive and the Royal College of Physicians of Ireland, said the bug was serious because it was multi-drug resistant. it is resistant to a range of antibiotics, including penicillin and carbapenem antibiotics.

“it would be sensitive to only one or two antibiotics and, ironically, it is sensitive to some of the older antibiotics we haven’t used for years,” said Dr Fitzpatrick.

The bug was also of concern, she added, because it was in the bowel and was “almost impossible” to get rid of, unlike MRSA which was on the skin and could be treated with washes and creams.

She said that in patients with underlying conditions, the bug could be life-threatening.

“up to recently the only cases we noted in Ireland were sporadic and only associated with travel to other countries. that is what is unusual about this outbreak.”

There have been outbreaks in a number of hospitals abroad, including in the US and Greece.

Dr Kevin Kelleher, head of health protection with the HSE, said: “This is the first time that there have been a number of cases in an Irish hospital and unfortunately, it got to another hospital.”

He said there had been seven confirmed cases of the bug at the Mid-Western Regional Hospital in Limerick but only one patient had become ill as a result. The other patients were only colonised with the bug.

Studies suggest the bug kills about 40 per cent of people who become infected, according to Dr Arjun Srinivasan, a medical epidemiologist with the US Centers for Disease Control and Prevention.

Typically, these are older, frail patients with multiple medical problems and compromised immune systems.

Meanwhile, visitors are asked not to visit the Mid-Western Regional Hospital in Limerick, including its emergency department, unless it is absolutely essential.

Visiting is restricted to critically ill patients, with one visitor allowed for each critically ill patient and confined to visiting times (2pm-4pm, 6.30pm-8.30pm).

The hospital says the elderly, children, pregnant women or young adults, those with chronic illnesses or vulnerable others are also advised not to visit.

Outpatient and daycare services, as well as routine hospital admissions, are not affected.

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