Winnipeg Free Press - PRINT EDITION

Antibiotic-resistant infection hits 100 at HSC

No patient ill from outbreak, officials report

MORE than 100 patients have tested positive for an antibiotic-resistant infection from an ongoing outbreak at Health Sciences Centre that has spanned more than six months.

Winnipeg Regional Health Authority officials first detected an outbreak of vancomycin-resistant enterococci (VRE) on Feb. 3. VRE are antibiotic-resistant germs that live in people's bowels and can cause urinary tract infections and abscesses.

What are vancomycin-resistant enterococci?

Enterococci are bacteria that live in the stomach and the bowel. They can be present in the body without causing illness. Vancomycin-resistant enterococci (VRE) don't respond to the antibiotic vancomycin, are hard to treat and can cause urinary tract or wound infections.

How do VRE spread?

The bacteria are usually transmitted through hand-to-hand contact or by touching a contaminated surface.

Who is at risk of VRE infection?

Healthy people are unlikely to get VRE, and if they are "colonized," or carrying the bacteria, they rarely fall ill. Hospitalized patients with underlying health conditions are most at risk, as their immune system may be more susceptible to infection. Serious infections caused by VRE are hard to treat because they are resistant to antibiotics.

Can VRE be prevented?

Routine handwashing and cleaning of surfaces can help reduce the spread of bacteria.

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The superbug infection is typically spread through contact with unwashed hands or surfaces contaminated with the bacteria.

WRHA officials said in a statement that the VRE outbreak at HSC has not compromised patient care, and there has been a ward-by-ward review of routine infection-control practices such as handwashing.

Infection-control officials refused an interview with the Free Press, but sent a prepared email statement saying they have not determined how VRE are spreading and that "the exact location of where (the outbreak) started is unknown." The statement said outbreaks of VRE are difficult to contain, and there is no "typical time frame" for containing the spread of infections.

The statement said the outbreak has affected patients from wards in HSC's general hospital, but that no patient has fallen ill from the infection.

Of the 1,100 patients screened for VRE, 129 tested positive. Most patients were "colonized," or carrying the bacteria, and officials said only 10 patients were infected, but they did not have symptoms. Their infections were detected through urinary or other types of screening, the statement said. Test results are still pending for 62 patients.

The statement said all patients who tested positive were placed in isolation to prevent VRE from spreading to other patients.

The outbreak at HSC is one of three current outbreaks in Winnipeg healthcare facilities. A VRE outbreak at Grace Hospital has been ongoing since March 15, and a respiratory outbreak at The Convalescent Home of Winnipeg was reported on Aug. 2.

"Outbreaks with VRE and other communicable agents are often very difficult to contain due to the many varying factors involved," WRHA officials said in an email.

A 2009 WRHA accreditation report found some hospital officials were not adequately analyzing infection data to identify clusters and outbreaks, and were not sufficiently monitoring whether staff complied with infection- control procedures.

Officials have since said the region now meets some of the required standards flagged as "unmet" in the report, and any other unmet "high priority" standards will likely change to "met" when they hear back from Accreditation Canada this fall.

jen.skerritt@freepress.mb.ca

Republished from the Winnipeg Free Press print edition August 13, 2010 A6

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