Outbreak of CPE superbug causes unprecedented levels of overcrowding in Limerick hospital 1 year ago

Outbreak of CPE superbug causes unprecedented levels of overcrowding in Limerick hospital

Ireland has seen an increase in the number of CPE cases year on year.

University Hospital Limerick (UHL) has exceeded previous overcrowding limits as the notoriously difficult-to-treat CPE virus ravages the city's population.

Carbapenemase-Producing Enterobacteriaceae (CPE) is the newest in a long line of 'superbugs', a group of antibiotic-resistant bacteria that are becoming more common all over the world, especially in hospitals.

The CPE has seen its patient numbers in Ireland double in recent years; with the first case in Ireland detected in UHL back in February 2009.

According to the HSE, CPE is the most difficult of all superbugs to kill with antibiotics.

The bacteria is shed in the faeces and transmitted by both direct and indirect contact. A period of a month may elapse between the contact which results in the contraction of the organism. At this time, CPE then becomes detectable in the faeces.

Should CPE stay present in the gut or stomach, it is mostly harmless. However, if the bacteria spreads to the urine or blood, it can be fatal.

According to the Department of Health, more than half of all patients who develop bloodstream infections with CPE die as a result of their infection.

CPE has been on the radar in Ireland since October 2017 when the National Public Health Emergency Team and the Minister for Health activated the Public Health Emergency Plan to address CPE in our health system.

A surveillance report detailing the plan constructed at a series of meetings was published to the Department of Health's website and can be read here.

Speaking to JOE, a representative for UL Hospitals Group (the umbrella group for all hospitals in Limerick) confirmed that the hospital is currently managing an outbreak and that strict visitor restrictions are in place.

"There have been 21 new positive cases detected since June linked to this current outbreak," a statement read.

"There are currently three CPE-positive inpatients at University Hospital Limerick and all necessary infection prevention and control measures are in place to manage this current outbreak.

"Until further notice, only one visitor per patient is allowed and during visiting hours (2pm to 4pm and 6pm to 9pm) only."

A UL Hospitals Group spokesperson has also confirmed that all 21 cases currently being treated in UHL are colonised, meaning that the infection shows no risk of harming them.

Members of the public are reminded not to bring children on visits anywhere in the hospital. Parents visiting children are unaffected by the restrictions but are advised not to bring siblings.

All infection control measures are in place and every effort is being made to manage the situation, the UL Hospitals Group spokesperson confirmed.

"A number of measures have been taken to deal with the current outbreak. These include:

  • Twice-weekly incident meetings convened for all affected areas
  • Isolation of all positive patients with strict high-level contact precautions
  • All CPE contacts are screened for a period of 28 days with 4 negative swabs. These patients are then isolated with contact precautions
  • Extensive environmental cleaning and hydrogen peroxide decontamination are underway."

With CPE being recognised as endemic in the Midwest Region, high volumes of patients are continuing to present themselves at UHL, with the issue of overcrowding becoming a problem.

According to figures updated daily by the Irish Nurses and Midwives Organisation, 46 patients are currently being treated on emergency department trolleys and/or additional trolleys or beds in the wards in UHL as of Monday morning.

To provide context – The Mater Hospital has only 10.

21 new positive cases of the superbug have been detected in UHL since June linked to this current outbreak.