Two Hutt Hospital patients have been identified as carriers of Carbapenamase-producing Enterobacteriaceae (CPE) – a rare superbug resistant to nearly all antibiotics.
Screening led to a further three people in the community being identified as carriers of the bacteria which produces the enzyme carbapenemase that deactivates the broad spectrum Carbapenem group of antibiotics. Only one of the five was ill due to the bacteria and had been successfully treated.
Hutt Valley DHB infectious diseases senior medical officer, Dr Matthew Kelly, says the community need not be alarmed, but should be aware.
“We are taking the presence of CPE in the community extremely seriously,” said Dr Kelly.
“CPE is extremely rare in New Zealand, but also concerning because of its resistance to antibiotics, which is why we are alerting our community.”
“The first line of defence against any bacteria is thorough and frequent handwashing, especially after going to the toilet, and before preparing and eating food.”
A New Zealand Medical Journal article in 2017 called for a national response plan to CPE which can cause serious infections in hospitalized patients and was steadily on the rise with five or less cases a year before 2012 and nearly 50 in 2016. While most cases were traceable to returned travelers or repatriated patients from other countries there had been several cases of probable secondary spread of CPE including once in a hospital and once in a long-term care facility.
Kelly said the cluster of Hutt Valley cases appear to have originated in the community but to date the DHB had not been able to confirm the source of infection.
He said the DHB was contacting people who may have been in contact with the two patients who were in hospital to provide them information about CPE.
“The bacteria can be in your gut for months to years and will usually cause no harm. There is no effective way to remove it from the gut and it may stay for longer if you take other
antibiotics. The bacteria can cause infection in vulnerable people if it gets into the wrong place such as in the urine or a wound from surgery.
“In the hospital – good infection control practices are an essential and everyday part of health care. The silver lining to this cloud is that we have identified these cases through our standard screening procedures and have been able to manage this situation.”
Actions to Date:
- checking contacts for the five patients with confirmed colonisations to understand if there are signs of spread – none has been found at present.
- getting in touch with contacts who have left hospital and their general practice teams to explain what is happening.
- Other DHBs, the Ministry of Health and the Health Quality and Safety Commission have been informed.
- informing other health care professionals in environments that deal with vulnerable people, such as hospitals, aged residential care facilities, community nursing and general practice.
- reminding staff to be extra vigilant in use of hand hygiene and infection control.
Information about CPE can be found at www.huttvalleydhb.org.nz