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Waikato Hospital moves to contain an outbreak of a multi-drug resistant organism CRE

Waikato Hospital has closed one of the Older Persons and Rehabilitation wards to new admissions after four patients tested positive for a multi-drug resistant organism, carbapenem-resistant enterobacteriaceae – CRE, sometimes called a ‘superbug’ in media reports.

Waikato Hospital infectious disease physician and infection control committee chairperson Dr Erana Gray said that these controls are in place to protect other patients and so that CRE does not spread.

“We always take these situations very seriously, especially with an organism that has proven so difficult to manage overseas and yet remains uncommon in New Zealand,” said Dr Gray

“There have been cases before in New Zealand, including in the Waikato and they have always been brought back from overseas.”

“Most people who catch this bug do not become unwell with it, as it lives harmlessly in the gut,”  she said.  “It is more likely to cause a problem in people who are sick for some other reason.”

Of the four patients with the bug currently, only one is unwell with it and is responding to an alternative antibiotic treatment, which the bug is still sensitive to.

The bug came into the ward from a patient who had a stroke while holidaying in Australia. This person was hospitalised in Australia and picked up the bug just before being transferred to Waikato Hospital.

Having CRE present does not mean a patient will go on to get a CRE infection, but it does mean that antibiotic choices become a lot more difficult.

Other antibiotic resistant bacteria are prevalent throughout the community and tend not to cause problems for healthy individuals. They are of particular concern when found in hospitals where patients are more vulnerable due to age, poor health or recovering from surgery.

If a patient in hospital is carrying CRE it can get into the ward environment and can also be passed from person to person via the hands of health care workers or contaminated medical equipment. Effective infection control procedures including environmental cleaning and good hand hygiene by staff and patients can reduce the risk of spread significantly.

The range of measures put in place to control CRE outbreaks include isolation of patients with CRE, screening of other patients in a ward, education for staff, patients and families and monitoring of laboratory specimens. Occasionally additional measures such as ward closure and “spring cleaning” of wards is implemented. Hand washing or use of alcohol gel to clean hands remains the most important infection control measure.

Waikato Hospital is advising all GPs and rest homes of the outbreak.

For more information about CRE visit our Waikato DHB website Public Health Advice A-Z pages

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