Record number of CPE superbug cases detected in Irish hospitals last month

Eight hospitals have outbreaks of antibiotic-resistant bacteria which is potentially lethal

A record number of hospital patients were diagnosed with the potentially lethal CPE superbug last month.

A total of 109 new CPE patients were identified in August, the highest level of detections since surveillance started in 2019, according to the Health Protection Surveillance Centre (HPSC). Carbapenemase-Producing Enterobacterales is regarded as the most dangerous superbug because it is resistant to almost all antibiotics.

So far this year, the number of cases detected is up 41 per cent on the same period in 2021. The HPSC says the increase is not likely to be explained by more samples being tested.

There are eight outbreaks in hospitals across the State: in St Vincent’s University Hospital in Dublin; St Luke’s Hospital, Kilkenny; Galway University Hospital; University Hospital Kerry; Mercy University Hospital; University Hospital Waterford; University Hospital Limerick; and Croom Orthopaedic Hospital, Co Limerick.

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The transmission and spread of CPE in hospitals is driving new detections but there have also been a number of significant outbreaks in nursing homes, according to the HPSC.

Hospitals are increasingly testing moist areas such as showers, sinks and toilets because these are now recognised as significant sources of infection, in addition to person-to-person spread.

CPE is spread person-to-person or through contact with contaminated surfaces and is very difficult to eliminate from a health setting once found there. 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.

About one in 20 patients who come in contact with carriers will themselves be colonised by CPE and one in 400 runs the risk of a serious, invasive infection.

The HPSC says 11 patients were diagnosed with the most serious bloodstream CPE infection last year, compared to nine in the previous, Covid-affected year.

In 2019, before the Covid-19 pandemic, HSE chief executive Paul Reid said antibiotic-resistant superbugs posed an “existential threat” to the health service and could become an irreversible problem.

With more than 1,000 people then carrying CPE, he warned a continued increase in cases would move hospitals to a “tipping point beyond which effective control is impossible”.

However, the HPSC says data to the end of 2019 suggest measures to control the spread of CPE have been generally effective. At that point, the number of invasive cases had fallen and the number of cases identified from diagnostic samples was close to plateauing.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times