KINGSTON –– The Ministry of Health yesterday made a shocking revelation that since June, 18 babies out of 42 had died from health care-associated infections while in intensive care at the Cornwall Regional Hospital (CRH) and the University Hospital of the West Indies (UHWI).
The disclosure came after days of widespread reports of an infection outbreak at the neonatal intensive care unit (NICU) at the UHWI.
Minister of Health Dr Fenton Ferguson and his team appeared on the defensive at a Press conference, packed with ministry representatives and other stakeholders in the health sector, at Jamaica House, where journalists were told that outbreaks “happen from time to time” in special-care nurseries.
Statistics presented by the ministry at the Press briefing, where reporters were informed that they had five minutes to ask questions following presentations from the minister and members of his technical team, showed that as of August, 13 babies had been infected with klebsiella at the UHWI, and that seven had died.
Before that, between June and September, eight babies were infected with another strain of health care-associated infections known as serratia at the facility, resulting in one fatality.
Meanwhile, at the CRH, 14 babies were infected, resulting in six deaths since September. Additionally, there were seven cases of klebsiella among newborns at that institution between June and July, and four of those babies died.
The ministry has not yet identified the source of the pathogen for the current outbreak. “We have to swab everything, everybody who passes through, all the staff, every piece of equipment and try to find out where it has lodged, and try to remove it,” Permanent Secretary Dr Kevin Harvey stated, while stressing that the deaths had occurred in greater numbers among those who were born
at seven months’ gestation and who had had low birth rates.
Of the 14 babies infected at CRH since September, all of those who were born at seven months or less died, while the eight who died at the UHWI had been born before seven months.
The ministry says it has now taken action to address the outbreak. This includes isolation of infected babies; placing infected babies in separate rooms; placing new admissions in different locations; engaging additional staff; monitoring handwashing practices; re-educating and training hospital staff; training for parents; and restricting movement of patients, staff and parents.
Head of the Department of Child Health at the UHWI, Minerva Thame, sought to assure that strict sanitation methods were used in the NICU, when asked about specific instances of what appeared to be dirty rags and mops being used by cleaning staff inside the ward.
“Before there is even an outbreak, there are strict guidelines that we use. We have special staff who are employed to do the cleaning [and] clean equipment is used. In the case of an outbreak, we immediately contact our microbiologist and they beef up what we are doing to ensure,” she explained.
A caller to the Jamaica Observer, who identified himself as Sam Nicholls, claimed his child was admitted to a NICU at one of the facilities earlier this year, and described the infection control procedures there as “woefully inadequate”.
Nicholls complained that at the time no soap was provided in the bathroom of the parents’ room at the facility. He further alleged that “student nurses failed to wash their hands when moving between patients, student nurses failed to sterilize thermometers that were used on more than one baby . . .
and incubators were cleaned with dirty rags”.
“The same mop was used day after day to mop the floor with filthy water,” Nicholls told the Observer.
He said complaints were made to consultants and the nurses in charge, but nothing was done.
Klebsiella is a normal part of the flora in the gastrointestinal tract and can also be found in the genital tract and passed on through the environment. According to health authorities, it can lead to a range of diseases that are dangerous to newborns whose immune systems are not yet developed. These include pneumonia, urinary tract infections, septicaemia, meningitis, diarrhoea, and soft tissue infections.
According to Chief Medical Officer Dr Marion Bullock Ducasse, all the antibiotics that are needed to fight the bacteria are available in adequate quantities.