Tallaght Hospital is facing a €6 million bill to tackle an outbreak of a lethal superbug partially caused by cuts to its cleaning budget which left staff with seven minutes to clean a bed.
Because of financial cutbacks no routine cleaning was carried out on Sundays before the outbreak, a conference organised by the Royal College of Physicians of Ireland has heard.
More than 2,000 people at the hospital have come into contact with carbapenemase-producing enterobacteriaceae (CPE) since the bug was first identified in mid-2015. As a result the hospital has had to dramatically increase its cleaning budget, close wards, cancel 700 operations, restrict visiting and test hundreds of patients every week.
CPE are bacteria in the gut that are resistant to most, and sometime all, antibiotics. The bug is spread from person to person through contact with faecal matter. Where it enters the bloodstream up to half of patients die.
“CPE outbreak control measures are extremely laborious, time-consuming and expensive, and may not be successful ultimately,” warned Dr Jerome Fennell, a consultant microbiologist at Tallaght Hospital.
Overcrowding
Other factors contributing to the outbreak were too few staff, overcrowding with high numbers of patients on trolleys, an insufficient number of single rooms and inadequate IT systems.
Dr Fennell said those most affected by CPE outbreaks were vulnerable patients on too many antibiotics who were admitted from nursing home where infection was impossible to control into overcrowded hospitals.
One patient who recovered reported feeling like “a big leper”, and said she was afraid afterward to use the toilet at work or the public swimming pool.
Dr Fennell said even today the hospital was unable to get dedicated nursing staff on the outbreak ward, as required by best practice.
Bad toilets
Poorly designed toilets that were “impossible” to clean and where accumulated scum tested positive also contributed to the problem, public health doctor Ruth McDermott said.
Tallaght Hospital continues to test almost 500 patients a week, and an average of two or three test positive.
Prof Martin Cormican, newly appointed HSE lead for anti-microbial resistance, said testing has shown 700 people are colonised or infected with CPE in Ireland and “there may be another 700 out there”.
He described the problem as a “stealth pandemic” that was already causing death and making patients’ lives miserable. The problem was well advanced but could be contained with immediate action.
“CPE has done vastly more harm to human health in Ireland than Ebola, but the response is focused on traditional pandemics. This will never burn itself out. We have a choice: pay upfront now while we can still control it, or pay forever.”
