CHP investigates cluster of Carbapenemase-producing Enterobacteriaceae carrier cases
The Centre for Health Protection (CHP) of the Department of Health is today (October 2) investigating a cluster of Carbapenemase-producing Enterobacteriaceae (CPE) carrier cases involving five residents of a residential care home for the elderly (RCHE). The CHP reminded all RCHEs to implement measures for the prevention and control of infectious diseases in accordance with theGuidelines on Prevention of Communicable Diseasein RCHEs(the Guidelines).
The CHP recently received a notification from the Hospital Authority (HA) that three residents living on the same floor of an RCHE in North Point 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 and they were suspected to have been infected in the RCHE. The CHP immediately conducted epidemiological investigations, contact tracing and screening. Subsequently, the CHP identified two additional carrier cases at the RCHE.All five patients (three males and two females, aged 77 to 92) are carriers. None of them exhibited symptoms associated with CPE infection. They are currently in stable condition.
The CHP's investigation found that the source of infection for the aforementioned five carrier cases may have been another previously identified CPE carrier case on the same floor of the same RCHE. After inspecting the facility, CHP staff discovered that the RCHE had not duly implemented relevant infection prevention and control measures. It cannot be ruled out that the bacteria were transmitted within the RCHE via staff, or contaminated environment and objects. The CHP reminded the staff of the RCHE to adhere to the Guidelines and take necessary measures, including the use of appropriate personal protective equipment, enhancing hand hygiene among staff and residents, and thoroughly cleaning and disinfecting the environment and objects. The CHP also recommended that the RCHE cohort the carriers in a single designated area.
The CHP will continue to investigate the cluster of cases and conduct screening at the RCHE concerned to determine whether there are any other CPE-carriers. The CHP will also continue to put the RCHE under medical surveillance.
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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