SA: Superbug closes hospital unit: one dead

AAP General News (Australia)
12-13-2001
SA: Superbug closes hospital unit: one dead

By Tim Dornin

ADELAIDE, Dec 13 AAP - An antibiotic-resistant superbug has closed down the intensive
care unit of an Adelaide hospital after possibly claiming at least one life.

Queen Elizabeth Hospital (QEH) officials said today the pseudomonas bacteria was found
in routine screening of a patient transferred from a NSW hospital to Adelaide on November
29.

They said testing had discovered the infection in two other patients, one of whom died
on November 4, although the precise cause of death was yet to be determined and was expected
to be the subject of a coroner's investigation.

Another two patients in the intensive care unit (ICU) had also been found to have the
bacteria but a less severe variety that was expected to respond to one or more antibiotics.

QEH director of infectious diseases, David Grove, said the patients with the most severe
cases had been found to have a strain of pseudomonas which was resistant to all nine antibiotics
usually reserved for such infections.

He said should their condition deteriorate their fate might ultimately rely on a 10th
relatively untried antibiotic.

"We have a patient who has an infection with an organism that was untreatable with
all the nine antibiotics that we have tested," said Professor Grove.

"There is a 10th antibiotic that we are currently testing that may or may not be effective.

"It's not an antibiotic I've ever used because it's very toxic and the other problem
with it is there is no laboratory test to say for sure whether it will work or not.

"Whether this particular organism is susceptible to that or not we don't yet know."

The worst case scenario for both patients would be if the infection advanced to their
bloodstream which could then lead to death from septicaemia.

"If a patient has a severe infection such as septicaemia and you have no antibiotics
to treat it with well then it is a nightmare because there is nothing you can do about
it," Professor Grove said.

He said pseudomonas was a smart bug, capable of mutating to increase its resistance
to treatment and was commonly found in wet areas such as laundries or bathrooms.

Professor Grove said when a person's bodily defences were impaired the bug could strike.

Patients in intensive care units were particularly vulnerable because they often had
tubes in their throat, catheters in their bladder or wounds which provided places of entry
for the bug, he said.

Professor Grove said to his knowledge the current outbreak of the resistant pseudomonas
strain was the first in South Australia.

He said there had probably been similar incidents in other hospitals in Australia but
they were not always reported.

The QEH said the closure of the intensive care unit would result in some patients being
transferred to other areas and the instigation of a decontamination process that was expected
to take several days.

The Human Services Department said a critical incident review would be undertaken to
investigate the circumstances of the transfer of the original patient from NSW and the
subsequent spread of the infection within the QEH.

That investigation was expected to take two weeks.

Human Services executive director Brendon Kearney declined to reveal the hospital the
person came from but said the patient was originally from Adelaide and had been in intensive
care in NSW for five to six months prior to returning to SA.

The hospital involved had been contacted by SA health authorities as had the families
of those people who had contracted the infection.

QEH chief executive Peter Campos said the reaction of relatives had been quite balanced.

"No doubt they're anxious but so far the reports I've received is that they are satisfied
that we are communicating with them," he said.

Mr Campos said while legal ramifications were an issue for the hospital his main concern
was isolating the current outbreak to the ICU and ensuring the safety of patients and
staff.

AAP tjd/ldj/de

KEYWORD: SUPERBUG NIGHTLEAD

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