Hong Kong cases of ‘public enemy No 1’ superbug more than double in 2018, prompting Hospital Authority to unveil five-point plan to halt the spread

The number of Hong Kong patients diagnosed with a superbug that has been dubbed “public enemy No 1” more than doubled last year, with fears the increase in cases of the virus was driven by people eating bacteria-infected food or poor personal hygiene.

Hospital bosses have moved to quell worries among the public with a five-point plan to combat the spread of a range of superbugs, which includes more active screening for patients deemed high risk, issuing guidelines to local doctors to reduce the use of antibiotics where possible, and strengthening environmental hygiene.

On Monday, Dr Raymond Lai Wai-man, chief infection control officer at the Hospital Authority, which manages the city’s 43 public hospitals and institutions, said the number of inpatients diagnosed with carbapenemase-producing enterobacteriaceae (CPE) last year was 972, a dramatic rise from 473 in 2017.

Only 16 per cent of those 972 cases involved people who had stayed in hospitals outside Hong Kong in the previous year, down from 27 per cent in 2017, prompting fears the superbug was locally transmitted, in most cases through hospitals and homes.

“There is a risk of the superbug spreading in the community; it can be contracted when people eat meat that is not fully cooked,” Lai said. “It can also be spread when people don’t wash their hands properly after going to the toilet, and then touch food or other items.”

The bacteria are resistant to the carbapenem class of antibiotics, a powerful drug for such infections.

Most people who carry CPE show no symptoms, but it can cause urinary tract infections, pneumonia, bladder or kidney infections and inflammation of wounds.

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

Addressing the alarming spread of the superbug, the authority has increased the speed of detection and isolation by carrying out active screening for patients who have been hospitalised outside Hong Kong in the last 12 months, as well as those who have spent 14 days or more in hospital and those suffering from unexplained diarrhoea.

Test results are now available in minutes using an on-site device in hospitals, rather than in one to two days as was previously the case, when test samples had to be taken to Department of Health laboratories for analysis.

“This allows for quicker medical responses, such as single room isolation in hospitals, with the room wiped clean of bacteria, and nurses dressed in protective gowns and gloves when entering and leaving it,” said Lai.

Superbug cases on the rise at Hong Kong’s public hospitals

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

Lai said the authority has begun an antibiotic stewardship programme, which closely monitors the prescription of antibiotics by hospital doctors and gives advice on reducing and halting the use of powerful antibiotics when appropriate.

Lai added 87 per cent of public hospital doctors had been found to have used antibiotics appropriately in 2018, while 86 per cent had accepted advice to reduce or stop the use of antibiotics.