In a follow-up on the outbreak of CPE (Carbapenemase Producing Enterobacteriaceae) at University Hospital Limerick, health officials are reminding the public that strict visitor restrictions remain in place at University Hospital Limerick as staff continue to manage an outbreak of the antibiotic resistant bug CPE (Carbapenemase Producing Enterobacterales).

Image/Robert Herriman

All necessary infection prevention and control measures are in place to manage this outbreak.

The most recent detection of CPE at UHL concerns a type of bacteria not typically found in the MidWest. This type of CPE produces the OXA-48 enzyme and not the KPC enzyme more common in the MidWest. This type of CPE (OXA 48) is more easily spread and therefore ongoing vigilance is required to manage the situation and strict visitor restrictions are being enforced.

There have been 24 new positive cases detected since June linked to this current outbreak. There are currently four CPE-positive inpatients at University Hospital Limerick. The vast majority of cases detected since June relate to patients colonized with and not infected with CPE. CPE contacts are being isolated/cohorted as appropriate.

Until further notice only one visitor per patient is allowed and during visiting hours (2pm to 4pm and 6pm to 9pm) only. Members of the public are reminded not to bring children on visits anywhere in the hospital. Parents of children in Pediatrics and relatives of those in critical care are the only exceptions to this restriction.

With high volumes continuing to present to UHL, these restrictions, while regrettable for patients and their loved ones, have been deemed necessary in the interests of patient care.

These restrictions are necessary to reduce visitor traffic to wards to allow clinical teams to concentrate more time to deliver patient care and to facilitate good infection prevention and control practice, including additional cleaning.

Please note that there is no significant risk to visitors from the presence in the hospital of isolated CPE-colonised patients or isolated/cohorted CPE contacts. Any risk is overwhelmingly to other vulnerable patients and the visiting restrictions are in place to allow staff to manage this risk.

A number of beds are closed to admissions this Friday as part of ongoing control measures and this has contributed to longer waits in the Emergency Department for some admitted patients. Members of the public must consider all their care options at this time and reminded not to attend the Emergency Department unless necessary.

Injury Units in St John’s, Ennis and Nenagh hospitals are open for appropriate injuries. Injury Units are open in Ennis and Nenagh Hospitals from 8am to 8pm, Monday to Sunday and 8am to 6pm Monday to Friday at St. John’s Hospital.  Others with a less serious illness can be treated by their GP or out of hours GP service where their GP can refer them to an Assessment Unit the following day if required.

However, if you are seriously injured or ill or are worried your life is at risk the ED will assess and treat you as a priority.

A number of measures have been taken to deal with the current CPE outbreak. These include:

  • twice weekly incident meetings convened for all affected areas
  • isolation of all positive patients with strict high level contact precautions
  • All CPE inpatient contacts  are screened for a period of 28 days with 4 negative swabs.  These inpatients are isolated/cohorted with contact precautions
  • Extensive environmental cleaning and hydrogen peroxide decontamination is ongoing

CPE is recognized as being endemic in the MidWest Region and UL Hospitals Group has developed comprehensive control measures to deal with Multi-Drug Resistant Organisms.