Exclusive: Superbug now factor in seven University Hospital Limerick deaths

Chief clinical director Prof Paul Burke says superbug ‘did not kill anybody’

Chief clinical director Prof Paul Burke says superbug ‘did not kill anybody’

THE CPE superbug was an “associative factor” in seven deaths at University Hospital Limerick, this newspaper can exclusively reveal.

New findings, leaked to the Limerick Leader this week, follow an internal and external investigation launched by the UL Hospitals Group into possible association of CPE with patient deaths between February 2009 and May 2017.

Over the past year, the probes reviewed files of 36 patients named in a whistleblower’s letter, according to the official documents.

The external investigation was conducted by UK expert microbiologist Dr Robert C Spencer in October 2017, and was completed earlier this year.

The UL Hospitals Group has said it has accepted the conclusion of the review, “that no deaths were a direct result of CPE acquisition; however a small number of patients died where CPE may have been an associative factor in their deaths”.

In November 2016, the UL Hospitals Group said CPE was a “contributory factor” in three patient deaths. Chief clinical director Prof Paul Burke said there is no difference between “contributory” and “associative”.

In an interview with the Leader, Prof Burke said the bug “did not kill anybody”.

He also stressed that UHL is “safe as it ever was”.

“These people when they pick up these bugs, they are not infected with it. They are just carrying it. There is always a risk because it is multi-resistant. It’s not totally resistant because we do have antibiotics to treat it. When it is there, we isolate these people. We are in control. Lots of hospitals haven’t been monitoring it as closely as we have been monitoring it.”

He added: “These people died of lots of other things and in a very small number of people, [CPE] might have contributed, but it did not kill anybody.”

The age profile of patients, where CPE was an associative factor in their deaths, ranges from mid-50s to late-80s.

In a letter to coroner John McNamara on February 12 last, the office of chief clinical director said that no death arose as a direct consequence of CPE “but there were seven deaths identified in the whistleblower list in which CPE played an associative role.

The majority of these patients had serious comorbidities”.

The external review is expected to be published in early October, after next-of-kin of all patients involved in the review have been contacted.

CPE is a multi-drug resistant superbug that is resistant to the carbapenem antibiotic group. For those who carry the superbug, CPE rests harmlessly in the gut.

However, if the patient is infected with CPE, there is generally a 50% mortality rate.

According to the findings, CPE was an “associative factor” in seven deaths. CPE was “not associated” with 26 deaths.

The superbug was “never detected” in one patient, while CPE was “not detected” in another patient. The findings for another patient wrote: “No evidence of death”.

In a letter to members of staff on September 10, Prof Burke said that they will be publishing a report “into the deaths of known CPE positive patients shortly.

“There are some lessons for all of us to learn following on from the investigation and review of patient notes and open disclosure processes.

“We are required to inform the coroner of all health-care associated infections that may have contributed to the death of a patient being managed at ULHG,” he said.

Prof Burke wrote that the “next of kin should be informed of same in a timely manner and this also should be documented within patient notes.

“The cause of death and micro-organism (where applicable) should be listed on the death cert whether a direct or indirect factor in the death.”

Speaking on the leaked information, Prof Paul Burke said this Wednesday: “It is regrettable that sensitive and confidential information of this nature has been leaked to the press in advance of publication of the review.

“We will be happy to answer all queries from the media upon publication of the review but our current priority is the ongoing communications with next-of-kin.”

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