Superbug: Cork hospital staff warned about dress code

Infection control practices at Cork’s main hospital have been strongly criticised followed two outbreaks of a potentially deadly superbug on its wards last year.

Cork University Hospital needs to significantly improve measures to prevent the CPE superbug for the safety of patients, according to the State’s health watchdog.

The Health Information and Quality Authority says an inspection raised significant concerns around the hospital’s approach to managing risk, after 17 patients were colonised by the superbug in two outbreaks last year.

The watchdog criticised the accommodation of patients with the superbug in the same multi-bed room with no toilet, shower or hand washing facilities. It also said cleaning and monitoring did not meet the required standards to deal with an outbreak, and pointed out that patients coming from other hospitals or nursing homes were not routinely screened in accordance with guidelines.

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CPE (Carbapenemase Producing Enterobacteriaceae) is highly antibiotic-resistant and can be lethal when it enters the bloodstream. The newest in a long line of bacteria that are extremely difficult to kill with antibiotics, it lives harmlessly in the gut in healthy people but can be lethal if it gets into the bloodstream or urine. It poses a particular risk to older people and those with reduced immune system function.

Inspectors also criticised a decision to reopen the outbreak ward while one of the outbreaks was continuing. The hospital justified its decision by saying the ward was less than half full and the decision was made “on the balance of clinical priorities”.

“Observations during the inspection, combined with discussions in meetings with hospital staff, suggested that staff compliance with and oversight of the hospital’s dress code policy continued to be an issue,” the inspection report states.

The measures taken were not effective and were not in accordance with national guidelines, it points out.

On the day of inspection, Hiqa staff were initially told all affected patients were confined to the same ward, but it later turned out they were spread among four different wards.

Subsequent to the inspection, Hiqa wrote to the hospital’s chief executive Tony McNamara seeking assurances on the management of CPE at CUH.

He replied outlining the measures taken to combat the outbreaks and the additional infection control staffing sought from the HSE. It said the number of more serious bloodstream cases of CPE remained “low” during 2018.