Saturday 17 August 2019

CPE superbug replaces MRSA as danger to hospital patients

Numbers infected by deadly disease up from 433 to 537 in two years

Disease: Some infections are now resistant to antibiotics
Disease: Some infections are now resistant to antibiotics
Eilish O'Regan

Eilish O'Regan

A lethal superbug that poses a particular risk to people with weakened immune systems is replacing MRSA as an infection scourge in hospitals.

The number of cases of the potentially deadly superbug CPE has risen from 433 in 2017 to 537 last year.

At the same time the MRSA threat has continued to fall with 147 cases diagnosed last year, a reduction of more than 80pc in the past decade.

CPE lives harmlessly in the gut but can be dangerous if it gets into the bloodstream. More than half of all patients who develop infections with CPE die directly or indirectly as a result.

It poses particular risk to people with weakened immune systems and the elderly.

The bug was declared a public health emergency in October 2017 and can be difficult treat because it is resistant to many antibiotics.

It comes amid growing concern at the high use of antibiotics in hospitals and in the community which is linked to the development of drug- resistant infections.

Over-use and misuse of antibiotics exacerbates the development of drug-resistant bacteria - or superbugs.

The rate of use in some smaller hospitals is higher than in hospitals which treat the most complex illnesses.

Smaller hospitals with a high rate of antibiotic use include Our Lady's Hospital, Navan, Naas General Hospital, Cavan General Hospital, South Tipperary Hospital and Portiuncula Hospital in Ballinasloe, according to the annual report of the National Healthcare Quality Reporting System.

Concerns have repeatedly been raised that medicine will be taken back to the dark ages if antibiotics are rendered ineffective in the coming years.

A spokeswoman for the HSE said its surveillance system does not capture information about why an antibiotic was prescribed.

There is no data available to explain the differences in prescribing between hospitals.

She said: "In general, variations in prescribing between hospitals are likely to be related to differences in case mix and complexity.

"For example, because the rate is calculated based on total bed days used and antibiotic use is generally less in maternity and paediatric patients, the rate may generally be higher in hospitals that have no maternity or paediatric beds."

She said acute hospitals have the greatest number of seriously ill and critical patients. One in three patients in an acute hospital is given an antibiotic.

"It is important to recognise that there are pressures that tend to increase antibiotic use," she said.

"An increase in use may be related to the incidence of some infections - for example, E. coli blood stream infection is becoming more common in our ageing population.

"Hospital consumption of antibiotics is measured in defined daily doses (DDD) not in terms of weight of drugs used.

"The reason for using DDD is because 100mg may be the daily dose for one antimicrobial whereas the daily dose may be as high as five or 10 grammes for another."

She added: "Smaller local hospitals that provide care mainly to older people requiring urgent care are likely to have a high proportion of admissions with pneumonia and urinary tract infection and may use more antibiotics."

Irish Independent

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