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Victor Ting

Overcrowding in Hong Kong’s public hospitals was largely to blame for a surge in the number of infections of a dangerous superbug and the city’s elderly were the worst hit, a top microbiologist said on Tuesday.
Dr Ho Pak-leung said the elderly were among the most likely to be infected as crowded wards were fertile ground for the spread of carbapenemase-producing enterobacteriaceae (CPE).
The Hospital Authority revealed on Monday an alarming rise in the number of patients detected with the bacterial infection. There were 972 cases last year, more than double the 473 cases in 2017.
Most people who carry CPE show no symptoms, but the bacteria can infect vital organs such as the bladder or kidney, with potentially fatal results.

Ho said the situation was so serious that one patient was getting infected with some kind of superbug every three hours, adding that 60 per cent of infected inpatients were elderly.
And overcrowding was to blame, he said.
“The greatest challenge is the crowded environment in public hospitals, where during peak hours there can be zero distance between beds,” said Ho, HKU’s associate microbiology professor, who sits on the Centre for Health Protection’s committee on antimicrobial resistance.
He urged the government to increase the number of hospital beds, and said the target of 14,000 extra beds by 2036, announced on Saturday by authority chief executive Leung Pak-yin, was not enough.
Superbug resistant to all known antibiotics spreading among hospitals
Ho suggested a more integrated approach to health care, with more elderly people getting residential care, relieving the pressure on hospitals.
The superbug is resistant to the carbapenem class of antibiotics, a powerful drug for such infections.
The overuse of antibiotics has long concerned doctors locally and globally, as it contributes to the rise of superbugs, which are resistant to common antibiotics.
Asked about the effectiveness of the authority’s antibiotic stewardship programme, which started in 2017 and found 87 per cent of hospital doctors had prescribed antibiotics appropriately, Ho said that figure was acceptable and in line with international standards.
The greatest challenge is the crowded environment in public hospitals, where during peak hours there can be zero distance between beds
Dr Ho Pak-leung, HKU
“I would actually be worried if the figure went above 90 per cent or even hit 100 per cent, because that would mean doctors were too hesitant in prescribing antibiotics, which could make it harder to tackle illness in patients,” Ho said.
Superbugs were branded a “global emergency” by the World Health Organisation in April.
Scientists believe the overuse of antibiotics has contributed to the bugs’ rise, because the medication kills non-resistant bacteria that might otherwise keep the superbugs in check. The superbug could also spread the drug resistance to other bacteria.
While some superbugs can be treated with one or two types of antibiotic, others are untreatable.


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Hong Kong healthcare and hospitals

Crowded hospitals to blame for surge in cases of superbug CPE, says top Hong Kong doctor

Overcrowded public hospitals have contributed to the rise in CPE infections, Dr Ho Pak-leung said. Photo: Sam Tsang

Dr Ho Pak-leung is HKU’s associate microbiology professor and who sits on the Centre for Health Protection’s committee on antimicrobial resistance. Photo: Edward Wong

Crowded hospitals to blame for surge in cases of superbug CPE, says top Hong Kong doctor

Dr Ho Pak-leung says elderly worst affected by antibiotic-resistant bacteria