Harney: Superbug-linked deaths serious

THE MINISTER for Health has described as “serious” the death of 15 patients at a Co Clare hospital following a superbug infection.

In the first half of last year, 46 mostly elderly patients — 39 women and seven men — at Mid-Western Regional Hospital Ennis were affected by clostridium difficle (C Diff). The number of cases peaked at 18 in April 2007, falling to two in June of that year. From May 4, the superbug is to become a notifiable disease.

Ennis hospital says that clostridium difficile was not the primary cause of their death, but a significant issue in their demise.

The HSE initiated a review at Ennis Hospital after questionable levels of the infection became apparent during scheduled infection audits in the region.

Yesterday a spokeswoman said: “Once the Hospital became aware of this increase in late April 2007, immediate measures were implemented to address the issue. This included a deep clean of hospital wards, the replacement of existing curtains on wards with disposable curtains, a deep clean of hospital equipment and the immediate implementation of mandatory weekly hand hygiene and infection control training for staff.

“Advice was sought on antibiotic prescribing and that advice implemented”.

The HSE spent Wednesday and yesterday contacting patients and their families by phone and letter and providing them with a copy of the review prior to its publication yesterday.

Patients and their families have been offered appointments either at the hospital or in their own homes to meet with their clinician.

A HSE review of the outbreak said the bacteria identified at Ennis Hospital were of a particularly virulent and highly transmissible strain.

It was recommended in the review that hand washing, patient isolation facilities and staff education be improved at the hospital and more detailed death certification be introduced.

Consultant physician and cardiologist, Dr Terry Hennessey said that clostridium difficile is no longer an issue at present at Ennis General.

“The most important message for the people of Clare is that the hospital now has the one of the lowest number of C Diff cases in the country.

“Unfortunately there will always be a background incidence of C Diff because one in 20 of us carry the bug in our bowel naturally. If you are particularly ill or receive broad spectrum antibiotics this can cause the bug to breathe itself out and cause a problem,” he said.

Ms Harney also expressed her sympathy to all those patients and families affected.

“This increased rate of infection in Ennis General Hospital was happening in stark contrast to other hospitals in the region which were showing a downward trend in clostridium difficile associated diarrhoea (CDAD),” she said.

There are more cases of clostridium difficile in Irish hospitals than cases of MRSA.

What is C diff?

Clostridium difficile is the most common cause of diarrhoea following antibiotic therapy. A small proportion (less than one-in- 20) of the healthy adult population carry a small amount of C diff in their bowel but it is kept in check by the “good” bacterial population of the intestine. Most infections happen in hospitals and nursing homes but it can also occur in the community. In most cases it causes relatively mild illness. Occasionally it may result in serious illness and even death in elderly patients or those with underlying illnesses, like cancer.