An illustration of the CRE bacteria. Photo: US Centers for Disease Control and Prevention
An emerging superbug that kills about half of those it infects has been found in dozens of patients in Victorian hospitals and may have caused two deaths at St Vincent’s Hospital in Melbourne last year.
On Tuesday, Victorian hospitals were put on high alert for Klebsiella pneumoniae carbapenemase-producing bacteria (KPC), a relatively new superbug that has been detected in 57 people in Victoria over the past three years and has been found to be spreading between patients at St Vincent’s Hospital.
The deadly bacteria kills half of those that it infects. Photo: Gabrielle Charlotte
A spokesman for the Department of Health said while 18 of the 57 people had died with the bacteria in them, it was unclear if the bug had caused their demise.
The bacteria can can colonise a person’s bowel without making them sick.
However, infectious disease specialist Kumar Visvanathan said the superbug may have led to the death of two patients at St Vincent’s Hospital hospital last year.
He said 28 cases had been diagnosed at St Vincent’s since 2012, including 10 people who had fallen ill with an infection because of it. Those cases were found in both the Fitzroy campus and in the Ellerslie aged care unit of its St George’s campus in Kew.
The hospital has stepped up its infection control procedures with more screening of vulnerable patients, faster testing systems, steam cleaning of rooms, hand hygiene education and isolation of people found to be carrying the bug.
It has had five cases this year, with the last one occurring at its Ellerslie unit in March.
“We are committed to doing everything we can to eradicate KPC. While it’s early days yet we believe we are having some success,” said Associate Professor Visvanathan.
“We think we have it under control now.”
While the first cases of KPC in Victoria were thought to be unrelated diagnoses in people likely to have picked it up overseas where it is more prevalent, health authorities were alarmed to see that it appeared to be spreading between patients this year.
The evidence of local transmission prompted the Department of Health to order hospitals to use maximum infection control procedures and to screen new patients who had travelled overseas in the last year.
A department spokesman said the superbug had been detected in patients at other hospitals, but he would not name them.
Associate Professor Visvanathan said KPC – a type of antibiotic-resistant bacteria known as Carbapenem resistant Enterobacteriaceae (CRE) – did not respond to modern antibiotics, forcing doctors to use drugs from the 1940s, which carry more side effects.
While this approach can be successful, Associate Professor Visvanathan fears the bacteria will stop responding to the old drugs at some stage and that no other options will be available for patients who fall ill with KPC. He said patients whose immune systems were compromised were most vulnerable to infections.
KPC can be present in the bowels of a patient without causing clinical disease. This is known as colonisation. Some of these patients may develop infection such as urinary tract or blood stream infections that can become difficult to treat. Depending on how weak the patient is and how well they respond to antibiotics, this can be fatal.
Associate Professor Visvanathan said KPC had become more prevalent overseas in recent years, particularly in Greece, Italy and parts of Asia. People generally pick it up in hospitals where it is spread through contact with people’s faeces, which can be transmitted to other surfaces.
“It stays on surfaces for about four hours, so it’s possible to get it from a surface…such as a sink tap,” he said. “Someone could touch that and then put it in their mouth.”
Internationally, the increasing prevalence of KPC has been associated with death rates of up to 50 per cent in infected patients.
Victoria’s acting chief health officer Dr Finn Romanes said Victorian health services had been briefed about the need for heightened infection control measures in response to the cases.
A statewide review of the problem continues, he said.
“All Victorian health services have been provided with information from the Department of Health & Human Services emphasising the need to ensure all current national standards are in place and being strictly followed,” Dr Romanes said.