CHP investigates cluster of Carbapenemase-producing Enterobacteriaceae carrier cases
The Centre for Health Protection (CHP) of the Department of Health is today (June 12) investigating a cluster of Carbapenemase-producing Enterobacteriaceae (CPE) carrier cases involving five residents of a residential care home for the elderly (RCHE). This cluster has no epidemiological linkage to the previous cluster involving another RCHE. The CHP has notified the Social Welfare Department (SWD) and will monitor the implementation and enforcement of infectious disease prevention and control measures in the RCHEs.
In recent months, the CHP received notifications from the Hospital Authority that three residents (two males and one female, aged between 65 and 84) living on the same floor of an RCHE in Mong Kok District had been admitted to a public hospital for treatment due to their underlying illnesses. Their admission screening samples tested positive for CPE upon laboratory testing. All patients are carriers, with none of them having exhibited symptoms associated with CPE infection. They are in stable condition.
Upon notification, the CHP immediately conducted epidemiological investigations and inspected the RCHE. The CHP found that the hygiene conditions of the RCHE was substandard. Given that there had been previously at least two known carriers on the same floor of the RCHE, the CHP could not rule out that the RCHE management had not fully implemented the related infection prevention and control measures leading to the transmission of CPE to the three residents through contaminated environment or sharing of items within the facility. The CHP reminded the RCHE management to strictly adhere to the Guidelines on Prevention of Communicable Diseasein RCHEs(the Guidelines), thoroughly clean and disinfect the environment, and ensure good hand hygiene among staff and residents. The CHP also recommended that the RCHE cohort the carriers in the same area and provide adequate hand-washing facilities.
The CHP will continue to investigate the cluster of cases and conduct screening at the RCHE in question to determine whether there are other CPE-carriers. The CHP will also put the RCHE under medical surveillance.
For the sake of prudence, the CHP has also reminded all RCHEs in Hong Kong, through the SWD, to implement the infection prevention and control measures in accordance with to the Guidelines.
Enterobacteriaceae (such as Escherichia coli andKlebsiella) are common pathogens that can cause infections in various parts of the body, including urinary tract infections, intra-abdominal infections or blood infection. CPE are enterobacteriaceae that produce carbapenemase, an enzyme that can deactivate carbapenems and other beta-lactam antibiotics such as penicillins. These bacteria are commonly resistant to multiple antibiotics, limiting therapeutic options, and may render severe clinical infections difficult to treat. The range of diseases associated with CPE varies from asymptomatic carriage to potentially life-threatening or fatal infections. The level of risk depends on which part of the body is affected by the infection and the patient's general health.
The proper use of antibiotics and maintaining good personal and environmental hygiene, especially hand hygiene, are important for preventing the emergence and cross-transmission of multi-drug resistant organisms (MDROs), such as CPE. In addition, susceptible individuals such as the elderly, infants, young children, people with weakened immunity and pregnant women can reduce their risk of contracting MDROs by avoiding raw or undercooked foods.
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