Bacteria in baby unit traced to sink taps
WATER TAPS in the neonatal unit of the Royal Jubilee Maternity hospital in Belfast were the source of the pseudomonas bacteria that claimed the lives of three babies in recent weeks, the North’s Minister for Health Edwin Poots has confirmed.
The sink taps are now being replaced, the Minister told the Northern Assembly yesterday. The infection has caused the deaths of three babies in the neonatal unit of the hospital while a fourth child, also diagnosed with pseudomonas, died from unrelated causes.
The three babies with fatal pseudomonas died on January 6th, January 13th and January 19th.
Two babies have recovered from the infection and are still in the neonatal unit. A seventh baby was diagnosed with suspected pseudomonas on Monday and is being treated for pneumonia at the Royal Jubilee Maternity hospital (RJMH).
The unit was given a “deep clean” at the weekend as tests were carried out to identify from where the virus emanated. The intensive care area of the neonatal section was closed while the rest of the unit remains open.
“I can report that investigations so far have shown that pseudomonas bacteria have been found in a number of taps in the intensive care area of the neonatal unit in the RJMH,” said Mr Poots yesterday evening.
“The Trust Health Estates team are in the process of removing and replacing all taps and related pipework in the affected area. There is no evidence of pseudomonas in the water system. This indicates that it is likely to be a localised problem,” he added.
“Specialist advice has been received from experts in England and action is based on current best available evidence. This work should be completed within the next couple of weeks. The unit will only be opened once all remedial work is completed and tests show that it is safe to nurse babies in this environment,” he said. New ultra-violet light taps which kill the bacteria at source are to be installed in the unit, he added.
Before Christmas a different strain of the infection caused the death of a baby in Altnagelvin hospital in Derry. But it also emerged yesterday that in total there were three such cases at Altnagelvin.
As Mr Poots explained yesterday, one baby recovered while the second child was transferred to the Royal Jubilee Maternity hospital. “It is important to note that the strain of pseudomonas bacteria in the two units is different,” he said.
Mr Poots, in answer to Assembly member Jim Allister, said the two strains would not mutate and “therefore the infection would not have come from Altnagelvin” to Belfast. “It is a standalone infection that happened in Belfast.” He added that in response to the situation in Altnagelvin all the North’s health trusts were issued with a letter on December 22nd “reminding them of the potential infection risks posed by water systems in healthcare facilities and reinforcing important messages regarding the use of sinks and general hygiene”.
Mr Allister also asked were the taps at the Royal Jubilee Maternity hospital therefore checked after the 22nd “and found to be bacteria free but after the deaths they were found to be bacteria infected?” If such were the case what did it say about the initial inspection, he further asked.
Mr Poots said the trusts had assured him that the advice given was followed. Nonetheless, “in due course” he felt that he would want to look further at this question raised by the Traditional Unionist Voice leader.
Michelle Gildernew, the Sinn Féin chairwoman of the Assembly health committee, said further action was necessary to ensure that sufficient action was taken in the wake of the death of the baby at Altnagelvin hospital.
The Minister also told the Assembly that there were six other babies who had the pseudomonas bacteria on their skin but were not infected. Three of these babies are being treated in the Royal, one was transferred to Antrim Area Hospital and one to Craigavon Area Hospital while the sixth was well and had been discharged home.
Pseudomonas infections rare in healthy people
The pseudomonas bacterium is an organism that can be found in many natural environments, including soil and water, as the North’s Minister for Health Edwin Poots informed the Northern Assembly yesterday. It can be found in sinks, taps and water systems and can be difficult to eradicate.
Pseudomonas bacteria can be present on the skin without causing infection. This is known as colonisation.
However, if the bacterium enters the bloodstream, lungs or urine it can cause infection, which can be treated by antibiotics.
Pseudomonas infections occur mainly in immuno-compromised and debilitated patients. The bacterium rarely causes infection in otherwise healthy individuals.
From 2008 to 2011 in Northern Ireland there were on average each year between 80 and 90 cases of pseudomonas across all age groups.
For children under one, the numbers are in single figures.
Babies in neonatal units are already vulnerable due to clinical conditions and varying degrees of prematurity.
Their immune systems are not fully developed, and this makes them less able to withstand infections, including those that would not cause problems in healthy babies.