The Health Service Executive (HSE) is facing the prospect of huge annual costs to fight a lethal superbug that has already taken hold in hospitals in Dublin and Limerick.
The Irish Times reports that more than 2,000 patients at Tallaght Hospital have come into contact with carbapenemase-producing enterobacteriaceae (CPE) since it was first identified at the facility in mid-2015.
In an effort to tackle the bug, the hospital has been forced to dramatically increase its cleaning budget, restrict visiting, cancel operations and test hundreds of patients every week.
It is believed the outbreak was partially caused by cuts to the facility's cleaning budget - which saw staff left with seven minutes to clean a bed before new patients were brought in, and routine cleaning timetables cancelled on Sundays.
Other issues contributing to the outbreak include hospital overcrowding, staff shortages, insufficient numbers of single rooms and a lack of proper IT systems to track and monitor the prevalence of the bug.
Almost endemic
On The Pat Kenny Show this morning, Irish Times journalist Paul Cullen said the superbug is “the latest big worry for health authorities all over the world" adding that it has "become almost endemic in Ireland now.”
He said the overuse of antibiotics has seen the bug adapt to produce enzymes that render the medicines useless.
Many people can pick up the bug without falling sick – although it can be very dangerous for more vulnerable people, and when it enters the bloodstream the mortality rate is up to 50%.
“In rough terms you actually need a wide variety of bugs in your gut, the flora there is essential for good health,” he said. “What happens when we overuse antibiotics is basically we nuke those defences that are in our gut and strange things start happening such as this,” he said.
Mr Cullen said that once the bug takes hold in a hospital it is "really, really hard to eradicate" with the use of peroxide, deep cleaning and patient isolation all contributing to a hefty bill for the health service.
"I have seen figures where the HSE are estimating now that fighting a number of outbreaks of this each year will cost at least €20m and probably another €20m and more in litigation costs as patient sue," he said.
Short term thinking
Responding to the story, Fianna Fáil spokesperson on health Billy Kelleher said the decision to reduce the cleaning budget at Tallaght Hospital suggests a "very worrying short-termism in our health system."
"This decision has led to the closure of wards, and the cancellation of 700 operations, and other capacity-draining implications," he said.
"More worryingly, 2,000 patients have been put at risk. Let’s get real here - these aren’t 2,000 fit and healthy people; but 2,000 people in hospital undergoing treatment due to being ill.
"At a time when the ability of our health system is being severely restricted by reduced capacity, this decision with its knock-on effects could not have come at a worse time."
He said there are serious questions to be answered at the HSE and the Department of Health - adding that he plans to call senior management representatives before the Oireachtas Health Committee to answer questions on the issue.
Using sledgehammers to crack nuts
Mr Cullen warned that Ireland has been shown to be very high internationally when it comes to overusing antibiotics, describing it as "the use of sledgehammers to crack nuts in many cases."
"One of the major changes we are going to have to make is we are going to have to ration antibiotics," he said.
"This bug only emerged in Ireland 10 years ago and it is now in a number of health care establishments.
"Antibiotics were only developed 60 or 70 years ago and one by one, their effectiveness is becoming less useful as we overuse them and resistance develops - because these bugs have been living in our gut for all of mankind’s history; they are well adapted to us and have learned a few tricks along the way."
You can listen back to the full conversation on the Pat Kenny Show here:
