Hong Kong health care and hospitals

Full screening for superbug begins as Hong Kong hospitals battle rising number of cases

Number of CPE cases increased by 40 per cent last year, but city hospitals can now test for the bacteria on site

PUBLISHED : Friday, 04 May, 2018, 11:04pm
UPDATED : Sunday, 06 May, 2018, 1:02pm

Hong Kong hospital bosses have started providing full screenings for a type of superbug – dubbed “enemy No 1” – to increase the speed of detection and isolation, after the number of cases increased by 40 per cent last year.

Anyone already in hospital and deemed high-risk will be checked for carbapenemase-producing enterobacteriaceae (CPE), with the tests carried out on site. 

On Friday Dr Dominic Tsang Ngai-chong, chief infection control officer at the Hospital Authority, which manages the city’s 43 public hospitals and institutions, noted that the number of patients detected with CPE last year was 473, up from 340 in 2016.

The benefit is that you can know [about the detected cases] quickly and can immediately isolate the patients, so they will not spread it to neighbouring patients
Dr Dominic Tsang

The bacteria are resistant to the carbapenem class of antibiotics, considered the drug of last resort for such infections.

Most people who carry CPE have no symptoms, but it can cause urinary tract infections, pneumonia, bladder or kidney infections, bloodstream infections and can be life-threatening. 

While CPE can still be treated by colistin, another type of antibiotic, doctors say the decades-old drug is not very effective and has negative side effects. 

But Tsang noted that more than 90 per cent of those detected with the bug were just carriers, with fewer than 10 people having infected with the bacteria. 

He attributed the high number of cases detected to stringent screening, adding that 473 was a small number compared with the 118,442 cases tested.

Tsang also noted a trend in the last few years of more cases of CPE in patients who have no hospitalisation history outside Hong Kong, which he said prompts a need to evolve a strategy to tackle the bacteria.

He said that, to better manage the spread of the superbug, the authority last month began providing CPE screening with polymerase chain reaction (PCR) confirmation in the hospitals themselves. 

In the past, the authority has had to depend on the Department of Health’s laboratories to complete the screening process, it can now do so itself.

“The benefit is that you can know [about the detected cases] quickly and can immediately isolate the patients, so they will not spread it to neighbouring patients,” he said.

Tsang said high-risk patients would be screened, including those who were hospitalised outside Hong Kong during the past 12 months and those who had contact with CPE carriers from being in the same cubicle or ward.

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The authority also began providing procalcitonin tests last month to guide antibiotic use and to prevent abuse.

The overuse of antibiotics has long been a concern for the local and international health community, as it contributes to the rise of superbugs, which are resistant to common antibiotics.

Other measures recently deployed by the authority in its war on superbugs included bringing in an online platform to standardise infection monitoring and changing bedside curtains more often.