MPATT takes Rahael to task on outbreak

“Misguided and misinformed” was how the Medical Professionals Association of TT (MPATT) described Health Minister John Rahael’s announcement that the Mt Hope Women’s Hospital will be relocated to the Eric Williams Medical Sciences Complex, and all women admitted should be screened to prevent an outbreak of enterobacter bacteria. “The intervention of swabbing pregnant patients on admission to the hospital and moving the entire hospital indicates a misunderstanding of infections like enterobacter that is a nosocomial infection,” Dr Kerry Brahim said in a media release on behalf of MPATT on Saturday.

He questioned what action was taken after the enterobacter outbreak in August 2003. The North West Regional Health Authority has dismissed its Vice-President of Quality after an investigation into that incident. Dr Brahim said: “It is clear that creation of isolation units, the provision of individual instruments, staffing requirements were not addressed or put in place.” He said swabbing and moving the Women’s Hospital may not be prudent and needs further analysis. Nosocomial infections are hospital acquired ie a previously ill patient or staff member is infected by organisms that are encountered in the hospital environment. Since these infections at Intensive Care Units such as the neonatal unit are multi-factorial, Dr Brahim said the response must be multi-factorial.

He said two important general principles need to be re-emphasised — the patient is previously ill and the organism survives in the hospital setting. To control nosocomial infections, Dr Brahim advised: adherence to proper sterile techniques, the provision of adequate gloves, gowns and sterile equipment; isolation areas/cubicles; a nursing patient ratio of 1:1 or 1:2; no cross-cover of doctors between the General Pediatric and Neonatal Unit. Dr Brahim said if there is a breakdown in any of these factors the spread of nosocomial infections will continue to plague neonatal ICUs. He called for continual epidemiological assessment and vigilance to be implemented.

Meanwhile, at the neonatal unit, there is still no security presence although Permanent Secretary in the Health Ministry Hamid O’Brien had said a guard would be posted at the unit to ensure compliance with infection control measures by doctors and visitors. A sign on the door warns members of the public who have no business at the neonatal unit to not enter the area. The PS had said the Ministry had received reports that doctors were entering the unit with “cell phones and their street clothes.”