THE CHIEF executive of the Belfast Health Trust has pledged a full investigation after a third baby died of infection in a hospital in Northern Ireland.
The baby died on Thursday night and followed two previous deaths of babies in the neonatal unit of the Royal Jubilee Maternity hospital – one on January 6th and one on January 13th.
A fourth baby was being treated at the hospital last night following an outbreak infection caused by the bacteria pseudomonas.
A spokeswoman for the Department of Health, Social Services and Public Safety said that a total of seven babies were found to have the infection at the neo-natal unit.
Three have died, one is currently undergoing treatment, two have been treated and have already recovered, while another made a recovery from psuedomonas but subsequently died of unrelated causes.
Meanwhile health officials in Northern Ireland also revealed that a different - and apparently unlinked - strain of the infection claimed the life of another baby in Altnagelvin hospital in Derry last month.
Parents of other children being treated at the unit are awaiting results of tests for the infection, while the unit is undergoing a deep clean to remove all traces of the bacteria.
A helpline has been set up for worried parents, with admissions to the hospital being restricted to all but the most seriously ill babies.
Colm Donaghy from the Belfast trust said it was the “first priority” of the organisation to ensure the safety of other babies.
“I have absolute confidence in the measures being taken by our staff,” he said.
“We are continuing to thoroughly investigate these deaths and the potential causes of this infection.
“Sadly three ill babies have died whose deaths may be linked to this outbreak. We are supporting these families at this very difficult time. We are in the process of investigating the outbreak and taking all steps to identify the source. The situation will be kept under constant review.”
Consultant neonatologist at the hospital Dr Clifford Mayes said staff first became aware there was a “major problem” on Monday night following tests on the second child that died.
“The bacteria in itself is not infectious, but because it exists in water or where things are moist, what we are having to do is investigate very thoroughly the unit itself in efforts to try and identify a source.
“It’s a bacteria that can survive in moist conditions. Patients can carry it on their skin and not be affected, or they can develop problems with chest infections or bloodstream infections.
“The population of the unit are often extremely premature, very small babies and therefore they are very vulnerable.” Expectant mothers who need the unit after the birth of their children may be sent to different hospitals, although the hospital’s delivery suite is operating as normal.
Expectant mothers who need the unit after the birth of their children may be sent to different hospitals, although the hospital’s delivery suite is operating as normal. Two pregnant women have already travelled to Dublin to have their babies because of the outbreak.
Northern Minister for Health Edwin Poots said the situation was “desperately sad”. “Infection control teams are now in the process of trying to identify the source of the infection and minimise the risk of spread to other babies in the unit.
“Babies in neonatal units are already vulnerable due to clinical conditions and varying degrees of prematurity. This makes them less able to withstand infections, including those that would not cause problems in healthy babies.
“I have asked the trust to work with the Public Health Agency to ensure all necessary steps are swiftly taken to identify the source of the infection so that we contain it and reduce further risk of spreading.”
The neonatal unit contains 31 cots for premature babies and takes in about 550 patients each year.
In regard to the death in Derry in December, officials said the strain of the infection, which has been eradicated, was different to that which has hit the Royal’s maternity unit and there was no evidence the outbreaks were linked. - (Additional reporting PA)
‘Opportunistic’ organism that preys on the weak
THE OUTBREAK of Pseudomonas aeruginosa infection at the Royal Jubilee Maternity hospital in Belfast and the subsequent death of three young babies in its neonatal intensive care unit will be a huge source of concern for parents of children being treated there, writes
DR MUIRIS HOUSTON
These babies are some of the sickest children in Northern Ireland; all will have been admitted following delivery because of their prematurity or other significant disease requiring intense treatment. The unit has about 550 admissions a year, and even without the threat of this infection, some 30 babies die in the unit annually.
Pseudomonas is a relatively uncommon source of infection; the bacterium tends to lie dormant in soil and stagnant water. It is an extremely tough and durable microbe and can survive for days on surfaces. Although the hospital is still trying to identify the source of the infection, contaminated water in pipes and sinks may well emerge as the culprit over coming days.
Classified as an “opportunistic” organism, pseudomonas rarely causes problems in healthy people. But when our defences are weakened because of other illness the microbe takes the opportunity of a weakened immune system and begins to multiply. It poses a particular risk to cancer patients, people with severe burns and patients of all ages undergoing treatment in an intensive care unit.
The type and severity of disease it causes depends on its route into the body. By entering lung tissue it can cause pneumonia; infected skin wounds can cause extensive tissue damage; and the bacterium is also responsible for urinary tract and bloodstream infections.
In premature babies, pseudomonas is known to invade the gut causing the lining of the bowel to slough away. And the microbe is increasingly the cause of healthcare-associated infections and chronic lung infections in people with cystic fibrosis. A notifiable infectious disease in the Republic, the number of cases here actually dropped by 10 per cent in 2010.
Of the 222 people affected, most were in their 70s.
Although resistant to a number of antibiotics, pseudomonas can be successfully treated using a combination of agents such as gentamycin and a third generation cephalosporin antibiotic.
Spread by contaminated hands or via contaminated moist reservoirs in hospital equipment such as catheters and respiratory aids, the best defence is by regular hand-washing and the regular and thorough decontamination of medical equipment. The Belfast unit will likely be closed to allow a “deep clean” process to rid it of the infection source.