Potentially fatal superbug sparks 30% rise in cases

There was a 30 per cent increase in the number of patients diagnosed with potentially fatal superbug CPE last year when compared to 2021.

According to provisional data from the Health Protection Surveillance Centre (HPSC), there were 927 patients who were detected for CPE in 2022, compared with 712 in the corresponding period in 2021.

Carbapenemase-producing Enterobacterales, referred to as CPE, is generally regarded as the most dangerous superbug because it is resistant to almost all antibiotics. The HPSC said the increase is not likely to be explained by an increase in testing.

There were 11 hospitals in the State with CPE outbreaks in December: Naas General Hospital, Tallaght University Hospital, St Luke’s University Hospital Kilkenny, St Vincent’s University Hospital, Beaumont Hospital, Galway University Hospital, Letterkenny University Hospital, Sligo University Hospital, Cork University Hospital, University Hospital Waterford and University Hospital Limerick.

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Dr Susie Frost, consultant microbiologist at the HPSC, said anecdotally a lot of cases have been travel-related, with a proportion of refugees testing positive for the bug, as well as a “large number” of the detections being associated with cosmetic tourism in Turkey.

[ Staff and bed shortages compound the ‘superbug’ threat to patients in hospital ]

Dr Frost said it was difficult to ascertain the extent to which cosmetic tourism plays a part, as there is no Irish surveillance data for cosmetic infections to make a direct comparison.

“All we know is that we are all seeing these horrible resistances post-cosmetic tourism with a huge cost to the patients and the Irish healthcare system,” she said.

According to the HPSC, the transmission and spread of CPE in the acute hospital setting remains the “key driver” of new CPE detections.

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“However there have now also been a number of significant outbreaks in nursing homes,” the body said.

Since late 2018, there has been an increasing recognition that, in addition to direct and indirect person-to-person spread, environmental reservoirs of these organisms in acute hospitals represent a “significant source”.

“Increasing numbers of hospitals are undertaking environmental testing in wards that are deemed potential high-risk areas. Moist areas, for example showers, sinks and toilets are the most common locations from which CPE have been detected,” the HPSC said.

The HPSC says 11 patients were diagnosed with the most serious bloodstream CPE infection in 2021, compared to nine in the previous, Covid-affected year. The total number of bloodstream infections in 2022 is not yet available.

[ Thousands tested positive for ‘superbugs’ in Irish hospitals last year ]

CPE are bacteria that live in the gut of healthy people, but can be lethal if they get into the bloodstream or urine. It poses a particular risk to older people and those with reduced immune system function.

A national public health emergency team was established to tackle CPE in 2017. It was unofficially stood down a number of years ago, having had its last meeting in 2019, just before the threat of Covid-19 took priority.

However, the prevalence of CPE is beginning to increase again following the reopening of society and resumption of non-Covid healthcare in hospitals.

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