ICU killer bug under control

One of the five babies who contracted the Enterobacter bacteria has been discharged while the others remain warded at Mt Hope Women’s Hospital. They have been warded at the maternity ward since Tuesday after being evacuated from the neo-natal unit. Last week, neo-natal consultant, Dr Jennifer Delamore raised concerns about an increased incidence in the bacteria after tests showed 100 percent of babies that is, ten of them, displaying various stages of Enterobacter. The Health Ministry and North West Regional Health Authority were informed last Monday and the following day a massive sanitsation exercise of the neo-natal unit and surrounding areas started. The roof of the unit was also removed. Dr Delamore said cleaning is expected to be completed by tomorrow night. When the area is ready the babies along with other newborns will be transferred back to the unit. They will be placed in one of four rooms away from the other babies. Dr Delamore yesterday described their condition as “quite stable.” Dr Delamore has been explaining to parents about the bacteria and where it may have come from, informing them that while it does not affect adults (and is present in the gut and female genital tract), it can be lethal to babies.

She has told parents that there can be complications from the fact that the baby is in a neo-natal unit. Their undeveloped immune system makes them vulnerable. “Complications arise with being premature and this overlaps with being Enterobacter positive.” When complications happen the baby’s platelet count falls and bleeding occurs. “Most important is that it is picked up early, most times when we get back results the baby is already on antibiotics,” Dr Delamore said.  Enterobacter are important nosocomial (hospital acquired) pathogens responsible for a variety of infections including: lower respiratory tract infections, skin and soft tissue infection, lower urinary tract infection, endocarditis, intra abdominal infection.

Enterobacter are referred to as an “ICU bug,”. Among the predisposing factors for acquiring it are prolonged hospitalisation in particular at an Intensive Care Unit (ICU), prior treatment with antibiotics, general debilitation and immunosuppression. ICU bugs cause significant morbidity and mortality and infection management is complicated by multiple antibiotic resistance. The US National Nosocomial Infection Surveillance found that between January 1990 and May 1999, the enterobacter species caused 11.2 percent of pneumonia cases in all types of ICUs.