Hospital patients and residents of aged care facilities should start checking that nurses and doctors have washed their hands before they touch them to prevent the transmission of a potentially deadly superbug that has been spreading in Melbourne, experts say.
As doctors start screening more Victorian patients for a new superbug that can kill up to half the people it infects, infectious diseases specialists said patients should cross-check their carer’s hand hygiene because it will help prevent infection.
The advice came as the Victorian department of health confirmed there may be people carrying Klebsiella pneumoniae carbapenemase-producing bacteria (KPC) in Victorian hospitals. The superbug can colonise the bowel without causing sickness, but if it does lead to an infection, particularly in lungs or blood, it carries a death rate of about 50 per cent.
On Tuesday, health services were put on high alert for the superbug after tests showed it had contributed to the deaths of at least two people at St Vincent’s Hospital last year. It continued to spread between patients this year.
While the hospital believes it has got the superbug under control and says the last detected case was in March, the department of health has asked all Victorian hospitals to step up their infection control procedures and screening of high-risk patients to prevent further transmission.
Director of infectious diseases at Royal Melbourne Hospital Michael Richards said his staff were already wearing badges encouraging patients to ask carers if they had washed their hands to minimise the spread of infections, including antibiotic-resistant “superbugs” like KPC.
“If we get a lot of these infections … it can sometimes close down hospital units,” he said. “That’s something that we don’t want to happen.”
Professor Richards said health authorities were concerned about KPC because it appeared to be one of the more transmissible bugs belonging to the larger group of Carbapenem-Resistant Enterobacteriaceae (CRE) superbugs. CRE infections are worrying because they have become resistant to Carbapenems – antibiotics traditionally viewed as “last resort” drugs.
This meant doctors had to use other potentially toxic antibiotics which can damage people’s kidneys, for example, and even then, the bacteria may still become resistant to those drugs. This has occurred overseas and can render the bacteria untreatable.
“Even with the antibiotics that we have available to us now, the treatment is often unsuccessful … it’s a real worry,” said Professor Richards.
To date, most cases of KPC have been diagnosed in people who have had medical treatment overseas where it is more prevalent in hospitals, particularly in Greece, Italy and south-east Asia.
The recent cases at St Vincent’s were the first example of it spreading locally between people in Australia.
Professor Richards said although some new antibiotics were being developed, there were not as many in the pipeline as doctors would like.
In the meantime, he said patients should insist that their carers wash their hands before touching them because KPC is usually spread from people’s faeces in toilets and bathrooms. It can remain on surfaces, such as sink taps, for about four hours.
Another infectious diseases specialist at Canberra Hospital, Sanjaya Senanayake, said patients should not be afraid to ask their doctors and nurses if they have washed their hands when they are caring for them.
“I’d be grateful if someone reminded me,” said the Associate Professor of Medicine at Australian National University.