Thursday 8 December 2016

Patients at liver unit left at risk from deadly superbug

Published 29/07/2016 | 02:30

St Vincent’s Hospital in Dublin, which is relocating its liver unit following the Health Information and Quality Authority report. Photo: Damien Eagers
St Vincent’s Hospital in Dublin, which is relocating its liver unit following the Health Information and Quality Authority report. Photo: Damien Eagers

A superbug, which inspectors found lurking in a ward at the national liver transplant unit in St Vincent's Hospital left vulnerable patients at risk of a potentially life-threatening infection.

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The hospital was criticised by inspectors from the Health Information and Quality Authority (Hiqa) during an unannounced visit in March for failing to properly control the bug, vancomycin-resistant enterococci (VRE).

Ireland has been shown to have the highest instance of the bug in Europe. If the bacteria gets into the urinary tract or seeps into a wound, it can become life threatening.

The report said the hospital had not fully learned from an outbreak of VRE in 2014.

The poor infrastructure in the St Brigid's ward also added to the risk as there were not enough isolation ensuite showers and toilets.

Patients who had the bacteria on their skin - which is not dangerous - were sharing shower facilities with people who were clear of it. Access to a hand wash sink in one room with several patients was blocked whenever curtains were drawn around a nearby bed.

Read more: Liver transplant unit ill-equipped to fight superbug,watchdog warns

The transplant unit in the hospital reported the first outbreak in Ireland in 2014 of VRE infection which proved resistant to the antibiotic Linezolid.

In response to the report, a spokesman for the hospital said yesterday that "it is our policy to maintain the highest possible standards of hygiene in all our clinical activities at all times, and in that spirit we accept all the findings of the report which we will use to further improve the delivery of our services for our patients".

He said it was gratifying that the Hiqa inspectors had found that "overall the patient environment and patient equipment was generally clean".

He added: "We share the inspectors concerns regarding an increased incidence of hospital-acquired VRE. St Vincent's had identified an increase in the incidence of hospital-acquired VRE colonisation in the period 2014-2015, but it is important to emphasise the majority of these newly colonise patients do not go on to develop an actual infection.

"Infection and prevention control measures taken in response to the 2014-2015 finding resulted in a 43pc reduction in the overall rate in 2015 compared to 2014.

"Nonetheless, St Vincent's fully recognises that additional work needs to be done as we wish to continually reduce any residual risk to our patients."

Solution

He said a detailed quality improvement plan has been completed and will be overseen by a dedicated steering group, the details of which will be made available in the coming weeks on the hospital's website.

"St Brigid's Ward has been home to the liver transplant programme since its inception in 1993 and has served the programme well over the years. It is no longer of an appropriate standard for the national liver unit. The solution is the relocation of the unit to another part of the hospital campus. This needs to be done in a manner that will not disrupt existing services, or inadvertently create other risks to patients.

"A detailed business case has been prepared for this," he said.

Irish Independent

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