Superbug at Kilkenny hospital forces closure of 17 beds

Four patients in hospital’s surgical ward have been infected with the CRE superbug

St Luke’s Hospital in Kilkenny. The CRE outbreak was reported in late January, and full infection-control precautions were put in place

An outbreak of a highly resistant superbug at St Luke's Hospital in Kilkenny has forced the closure of two wards and up to 17 beds. Four patients in the hospital's surgical ward have been infected with the CRE superbug, which has a mortality rate of up to 50 per cent among vulnerable patients.

The outbreak will cause concern among HSE infection-control staff nationally, who are currently battling two significant outbreaks at Tallaght Hospital and the Mid-Western Regional Hospital in Limerick.

The outbreak at St Luke’s occurred after a patient who had contracted the disease in Tallaght and was later sent home was admitted to the hospital.

The Ireland East hospital group, which includes Kilkenny and Tallaght, confirmed there was currently a “small, contained” outbreak of CRE at St Luke’s. The outbreak was reported in late January, and full infection-control precautions were put in place.

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Last month, the first case of "pan-resistant" CRE was reported in the US involving a female patient whose infection was resistant to all 26 antibiotics approved by the Federal Drug Administration.

Carbapenem-resistant enterobacteriaceae (CRE) are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics. Beds that are found to have been occupied by carriers have to be left empty while the ward is deep-cleaned with hydrogen-peroxide.

National data shows the number of cases has grown from 48 in 2013 to 81 in 2014 and 140 in 2015. There were 132 cases in the first eight months of last year.

More than 2,000 people at Tallaght Hospital have come into contact with CRE since an outbreak there began 18 months ago. Some 142 patients were found to be carriers. In Limerick, CRE has been associated with 27 deaths over a six-year period.

Because of the growing problem posed by CRE, new rules for the recording of cases were introduced this year. All microbiology laboratories have to report to the HSE’s health protection surveillance centre the number of patients infected with the bug, and the first quarterly report on CRE will be published later this year.

CRE bacteria do not usually pose a risk for healthy people but can be problematic for people with compromised immune systems.

CRE germs are usually spread person-to-person through contact with infected people, particularly contact with wounds or stools. They can cause infections when they enter the body, often through medical devices, such as ventilators and catheters, or wounds caused by injury or surgery.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.