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ESBL E. coli

Tuesday, 22 November 2011
Statement from Dr Bruce Ferguson, Medical Director, ABM University Health Board: 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. (23.11.2011 - further clarification added)
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 involved a mother who tested positive to ESBL E.coli but who has not shown any symptoms and has not required treatment. We suspect she also contracted ESBL E.coli within the hospital, but this can only be confirmed in test results which we expect later this week.
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. In addition a helpline has also been set up: 07747615627.
The two cases of ESBL E. coli transmissions currently under investigation are linked to three other confirmed cases of ESBL E. coli where the infection was contracted outside hospital. Sadly, one of these cases, also a very young baby, has died. Everyone associated with the unit also regrets the tragic loss of this baby.
It is important to note that ESBL E. coli is not the same as E.coli O157 which causes food poisoning. In most people ESBL E. coli does not cause harm but in vulnerable individuals it can cause serious infections.
This is a very complex ongoing investigation and we are unable to give any further details at this stage to safeguard patient confidentiality. We will, however, be providing appropriate updates as soon as possible.
We are unable to provide exact dates for these incidents because of the small number of patients involved and the likelihood that patient confidentiality would be breached. We can say, however, that they took place within the past month.
ESBL E. coli is not the same as the E.coli O157 which causes food poisoning.
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 penicillins, but can be treated.
In most people ESBL E. coli does not cause harm but in vulnerable individuals it can cause serious infections.
23rd November - clarification:
We would like to clarify that both deaths occurred within the hospital, but only with one of these deaths are there any concerns about a cross infection.
The other baby who sadly died contracted the infection outside hospital.
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