A new strain of a deadly antibiotic-resistant superbug has gripped Royal Perth Hospital. Picture: Kerris Berrington Source: PerthNow
A NEW strain of a deadly antibiotic-resistant superbug is causing panic among staff at Royal Perth Hospital.
The WA Government has confirmed that 98 patients have been detected with the T90 variety of Vancomycin-resistant Enterococci at RPH since May.
But the real number of VRE cases could be higher because the Government would provide figures only for the latest strain of the bug.
Internal emails obtained by The Sunday Times reveal dozens of suspected cases, likely different strains, have also been investigated in recent weeks. In the past, smaller outbreaks have resulted in drastic action, with one ward emptied and "gassed" at Fremantle Hospital in February because of the possibility that it had up to eight VRE-positive patients. Insiders at RPH said it had been thrown into "panic" by the multiple VRE detections, especially the new strain. Rooms in about 12 wards had been specially cleaned three times daily, with cleaning done around patients because there was nowhere to put them in the already cramped hospital.
The hospital emails revealed at least four wards had been classified "contact/positive" with "no transfers out" allowed.
RPH executive director Frank Daly said "since May 2013, there have been 98 confirmed cases of colonised VRE T90", and that as of Friday, there were still "18 patients at RPH with VRE T90".
But he refused to say how many cases of other types of VRE were in the hospital, though RPH emails revealed dozens of suspected cases had been investigated in recent weeks.
He confirmed RPH had started "an intensive cleaning program . . . three times per day, across four wards" after finding the VRE T90, which he said was detected in WA for the first time last year. "Royal Perth Hospital is placing VRE T90 patients together in ward 6G and this ward is closed to new general admissions," he said.
The emails also revealed RPH was trying to lower VRE numbers through a strategy of "early discharge of positive cases".
Dr Daly confirmed that five patients with VRE T90 were discharged in the past week.
RPH was unable to determine if the 98 cases were community or hospital acquired.
Clinicians said RPH authorities were panicking because it was not known how to control the bug which was spread often from hands and medical equipment, and which could survive in the environment for a long time "short of gutting the place". They said RPH was "so run down" it was full of bacteria havens such as cracked vinyl floors.
Dr Daly said the RPH cases were "colonised", meaning the patients carried VRE, but had not developed the infection, and that VRE was prevalent in the community.
But he conceded that "in people with a weakened immune system, such as patients who have undergone surgery", VRE "can find its way into other parts of the body and cause an infection.
"Once infected, the bacterium is resistant to Vancomycin, the antibiotic used to treat Enterococci," he said.
Enterococci normally lives in the gastrointestinal tract, but antibiotic-resistant strains can kill vulnerable people such as very ill patients, causing infections such as meningitis.
United Voice secretary Carolyn Smith said the RPH cases were "directly due to the WA Government's mismanagement of the hospital system", including failing to provide adequate cleaning staff and patient beds at RPH.
Health Minister Kim Hames said RPH had "some of the most stringent testing practices in the world" and he had "every confidence that the hospital is managing those patients with VRE to ensure the risk of spreading the bacteria to other patients is minimised".
He said the number of RPH cleaning staff had not been cut and health spending increased in this year's budget.
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