A superbug outbreak at a Lower Mainland hospital has been brought under control.
Fraser Health Authority declared an outbreak of carbapenemase-producing enterobacteriaceae, or CPE, at its Royal Columbian Hospital in New Westminster on Feb. 3, marking the first officially declared outbreak in the province since it launched a surveillance program for the bacteria in 2010.
CPE are drug-resistant bacteria that can make infections difficult to treat and can spread rapidly in hospitals.
“The outbreak was initially declared because we continued to see sustained transmission of the bacteria in spite of aggressive infection control measures that were in place on the affected unit,” Elizabeth Brodkin, Fraser Health Authority’s executive medical director for infection prevention and control, said Thursday in an e-mail. “As CPE is a slow-moving bacteria, it took several weeks before we could be certain that the increased infection control measures were, in fact, successful in stopping the spread of it.”
By March 10, five weeks after the outbreak was declared, no further transmission was taking place and the outbreak was declared over. The outbreak involved fewer than a dozen people and did not result in any deaths, Fraser Health said.
The health authority had previously stepped up screening measures after detecting an increasing number of CPE cases at its facilities in 2013. Patients who received medical treatment outside of Canada within six months of being admitted to the hospital are now tested for CPE.
The outbreak is part of a global problem of drug-resistant bacteria that are making diseases and infections more challenging to treat. Enterobacteriaceae are a family of bacteria that live – usually without causing any harm – in the guts of humans and animals. CPE are bacteria that have become resistant by producing an enzyme that breaks down carbapenems – antibiotics often referred to as the drugs of last resort.
If CPE move from the intestine to another part of the body, such as the bloodstream or urinary tract, infections can result. Those infections can be deadly, with mortality rates as high as 50 per cent for people who develop an infection in their bloodstream.
CPE can also transfer their resistant qualities to other bacteria. Relatively uncommon until a few years ago, CPE are now considered a global threat and are endemic in countries such as China, India and the United States. Infection control experts were not surprised to see the bacteria – which has also resulted in outbreaks in Ontario and Quebec in the past few years – emerge in B.C., especially in the Lower Mainland, which has a sizable South Asian population.
“These bacteria are most likely brought back to Fraser Health by travellers to endemic areas, such as South Asia, some parts of the United States and Greece, where they are regularly found in health care settings,” Fraser Health said last month. B.C. is working on provincewide guidelines for reporting and tracking CPE outbreaks. Fraser Health decided to publicly announce it because it was the first of its kind for the health authority, Dr. Brodkin said.
On another front, Fraser Health said Thursday that measles cases appear to have moved outside previous school and religious groups to the general communities of Chilliwack and Agassiz. The health authority announced a measles outbreak on March 8, linking cases to a school in Chilliwack in a community with “traditionally low immunization rates.” Special vaccination clinics are being organized for early next week.