Canterbury superbug patients a 'frightening sign'

30 people tested positive for CRE in NZ between 2009 and 2014.
KIRK HARGREAVES/FAIRFAX NZ

30 people tested positive for CRE in NZ between 2009 and 2014.

Confirmation three people have left Christchurch hospitals with a rare multi antibiotic-resistant bacteria was another sign of a growing world-wide problem, an antibiotics expert says. 

Three people tested positive as potential carriers of Carbapenem-resistant Enterobacteriaceae (CRE) Canterbury District Health Board (CDHB) said on Friday.

Thirty people tested positive for CRE in New Zealand between 2009 and 2014.

However, Auckland University Associate Professor Mark Thomas said news of three new cases in Christchurch was another indicator of a problem that would become more difficult for the health sector to manage in the future..

"For those who know about it, it is a very frightening sign of what is to come."

Thomas said although the three Canterbury patients may never have any problem with the germ, there was potential for CRE carriers to develop life-threatening infections and the numbers of CRE carriers would increase.

"...they are the beginning of what will inevitably be a lot more of these patients and at the moment we don't have safe, cheap, convenient antibiotics to treat those sorts of organisms with. So if a patient has an infection of the kidney or an abcess in the abdomen or an infection of their gall bladder or bile duct due to CRE, then doctors all around the world have great difficulty in treating these infections." 

Canterbury DHB Medical Officer of Health Nigel Millar said the presence of CRE was detected as part of routine screening while the patients were in hospital.

None of the patients were unwell as a result of CRE, and had been discharged from hospital.

For carriers of CRE who developed an infection, symptoms were complex and would depend on what part of the body was affected, Thomas said. 

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Millar said CDHB was well aware of the potential for antibiotic-resistant bacteria to spread and had robust prevention processes. 

Thorough hand-washing was key to control of the bacteria, Millar said. 

"Good infection prevention practices are an essential part of healthcare and perhaps the single most important thing we can do to keep patients and ourselves safer." 

In 2014 the CDHB struggled to meet the national target for hand hygiene compliance of 70 per cent, and achieved 62 per cent for the July-October period.

Measures to lift performance were implemented and the national target had been met since then. In the period April-June 2015 CDHB achieved 76.8 per cent compliance.

Thomas said there had been a huge improvement in hand hygiene in hospitals throughout New Zealand over the past 10 years.

Millar said the issue of antibiotic resistance was a worldwide concern.

"No new classes of antibiotics have been discovered in the past 20 years and unless that situation changes, we will encounter more bacteria that we can't treat effectively."

Actions taken to date by the CDHB :

• checking contacts of the three patients with confirmed colonisations to understand if there are signs of spread – none has been found at present
• following up with all health professionals who were or will be involved in the care of these three patients
• Other DHBs, the Ministry of Health and the Health Quality and Safety Commission have been informed.

CDHB was in the process of informing other health care professionals who work with vulnerable people, such as hospitals, Aged Residential Care facilities, community nursing and General Practice.

 

 - Stuff

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