Tuesday 22 November 2011

a very premature baby who died after contracting ESBL E. coli at the city's Singleton Hospital.




Singleton Hospital, where a premature baby has died from suspected E.coli
Singleton Hospital, where a premature baby has died from suspected E.coli
A premature baby has died after contracting a form of E.coli while on the neonatal unit at Singleton Hospital, in Swansea.
Hope Erin Evans died aged just five days after being born "very premature" and contracting the the ESBL strain of E.coli.
Another baby has died and another three people are ill after an outbreak of the same antibiotic-resistant form of the infection.
Health officials were yesterday investigating the five cases which include baby Hope and a new mother in a maternity ward.
The second death happened "in the community" outside the hospital but health chiefs believe the cases were linked.
Doctors are investigating how the cross-infection happened between the two dead babies - the second child wasn't being named.
Admissions to the neonatal unit have now been restricted as a "precaution" to babies born at 36 weeks gestation or more.
Hope was born in the hospital on October 31 but was never taken home by her parents after contracting the illness.
An inquest has been opened. Her father Jonathan gave evidence that she died on November 4 in the hospital.
A hospital spokesman said: "ESBL E.coli is most often found in the gastrointestinal tract but may cause urinary tract infections.
"It is resistant to commonly used antibiotics such as penicillins, but can be treated."
Dr Bruce Ferguson, medical director of Abertawe Bro Morgannwg University Health Board, which runs Singleton Hospital, said: "ABM University Health Board, supported by Public Health Wales, is investigating two cases of ESBL E.coli cross infection in the maternity-neonatal unit at Singleton Hospital.
"Tests have confirmed that in one of these cases the ESBL E.coli infection was contracted in the hospital.
"Sadly, this was a very premature baby who, despite the best efforts of staff, later died. The cause of death of this baby is currently being investigated by the coroner.
"Everyone involved with the unit and in the care of this baby deeply regret this tragic loss."
The second case is understood to involve a mother who tested positive for ESBL E.coli but who has not shown any symptoms and has not required treatment.
It is thought the woman also contracted the infection while in hospital.
These two cases, which are being investigated, are linked to three other confirmed cases of ESBL E.coli where the infection was contracted outside hospital.
Another young baby who contracted the infection also died.
Dr Ferguson said: "These appear to be isolated incidents, which have been contained, and there is no evidence of the infection spreading further.
"Checks have been taken of patients, equipment and areas in the maternity-neonatal unit and no evidence of ESBL E.coli has been found.
"The unit has an excellent record for hand-hygiene and general infection control adherence. Reported infection levels in the unit have been below the national average in recent years.
"Nevertheless we have taken extra precautions. For example, the obstetric theatres have undergone a deep clean and cleaning has been increased in the neonatal and labour wards.
"As a precaution, we have temporarily restricted the neonatal unit to admissions for babies of 36-weeks and over gestation. This is under constant review and we anticipate lifting this restriction shortly.
"All routine full-term births are continuing at the Singleton maternity unit as normal.
"We would like to reassure expectant mothers due to give birth in Singleton Hospital that the maternity unit is open as usual for full-term births.
"However, any mothers-to-be who have concerns or questions should speak to their community midwife in the first place."
Extended-Spectrum Beta-Lactamases (ESBLs) are enzymes which can be produced by bacteria making them resistant to antibiotics widely-used in many hospitals.
A new class of ESBLs have emerged and been detected in E.coli bacteria. ESBL-producing E.coli are resistant to penicillin and cephalosporin antibiotics.
A helpline has been set up for women who are due to give birth at Singleton Hospital and are concerned. It can be contacted on 07747 615 627.


Read More http://www.walesonline.co.uk/news/wales-news/2011/11/22/two-babies-die-after-contracting-new-strain-of-e-coli-at-singleton-hospital-91466-29821677/#ixzz1eStLkH13

Two babies die, three other E. coli cases in Swansea


Singleton HospitalSingleton Hospital's maternity unit is still open for full-term births
Two babies have died after an E. coli infection, health officials in Swansea have confirmed.
One was a very premature baby who died after contracting ESBL E. coli at the city's Singleton Hospital.
The other baby died in the community but doctors say the cases were linked. How the cross-infection occurred is being investigated.
As a precaution the unit, which has undergone a deep clean, is only open for full-term births.
An inquest has been opened and adjourned into the death of one of the babies, Hope Erin Evans from Aberdare, south Wales, who was just five days old when she died at the hospital on 4 November.
'Tragic loss'
Three other non-fatal cases have been confirmed but Abertawe Bro Morgannwg (ABM) University Health Board said they appeared to be isolated incidents.
The board's medical director Dr Bruce Ferguson said: "Tests have confirmed that in one of these cases the ESBL E.coli infection was contracted in the hospital.

What is ESBL E. coli?

  • ESBL E. coli is not the same as the E.coli O157 which causes food poisoning
  • ESBL stands for Extended Spectrum Beta Lactamose
  • ESBL E. coli is most often found in the gastrointestinal tract but may cause urinary tract infections
  • ESBL E. coli is resistant to commonly-used antibiotics such as penicillin, but can be treated
  • In most people ESBL E. coli does not cause harm but in vulnerable individuals it can cause serious infections
  • Source: ABM health board
"Sadly, this was a very premature baby who, despite the best efforts of staff, later died.
"The cause of death of this baby is currently being investigated by the coroner. Everyone involved with the unit and in the care of this baby deeply regret this tragic loss."
The other baby contracted the infection outside the hospital.
Dr Ferguson reassured expectant mothers due to give birth in Singleton Hospital that the maternity unit is open as usual for full-term births.
As a precaution, the health board has temporarily restricted the neonatal unit to admissions for babies of 36 weeks gestation, or longer.
"These appear to be isolated incidents which have been contained, and there is no evidence of the infection spreading further," Dr Ferguson added.
"Checks have been taken of patients, equipment and areas in the maternity/neonatal unit and no evidence of ESBL E. coli has been found.
"Very saddened"
"The unit has an excellent record for hand-hygiene and general infection control adherence. Reported infection levels in the unit have been below the national average in recent years."

Analysis

The investigation into these cases will concentrate on the history of contact between all five people involved.
This means looking at any links they have in the community as well as what happened at Singleton Hospital.
It will be vital to establish whether any of the regular infection control measures used in neonatal units have been breached.
This was the suspicion in the last major outbreak of ESBL e.coli in 2008 at Luton and Dunstable Hospital.
An official report concluded that the bacteria there spread via the hands of staff or shared equipment, although no definitive evidence was found.
Managers in Swansea have already stressed their 'excellent record for hand-hygiene and general infection control'. They will need to be sure that every possible precaution was taken.
Microbiologist Prof Hugh Pennington told BBC Radio Wales ESBL E. coli caused problems for young babies because their immune systems were not well-developed.
"These bugs . . . are really quite good at getting about and once they get into something like a neonatal unit, history tells us with other related bugs they can be really quite difficult to eradicate.
"I'm sure that the people at Singleton are doing their utmost to make sure that there aren't any problems.
"They have restricted admission to the very young babies because they are the ones really at risk from this particular nasty bug. It's a very reasonable approach to take."
Health Minister Lesley Griffiths said she was "very saddened" to hear of the two deaths.
Conservative health spokesman Darren Millar AM expressed his condolences for the families involved, adding: "This is obviously an incredibly serious case and I urge the health minister to update us on the current situation and the next planned steps as soon as possible.
"While I recognise these infections appear to be isolated and contained, those using the hospital will expect regular reassurances from the Welsh government in the immediate future."
Anxious people
Welsh Liberal Democrat leader Kirsty Williams said the deaths were a "terrible tragedy".
"While the unit is temporarily closed for some patients, pregnant women in the area who are expected to deliver at the unit need to be reassured that there are alternatives set in place," she added.
"Guarantees are needed that other units that will have to take pre-term mothers have the resources to cope.

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