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Following is a question by the Hon Albert Ho Chun-yan and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (May 21):
Question:
It is reported that there has been an upward trend in the number of cases of patients being infected in public hospitals with antibiotic-resistant bacteria (including extended-spectrum beta-lactamase-producing organisms, carbapenem-resistant Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus) in recent years. In this connection, will the Government inform this Council if it knows:
(1) a breakdown by hospital cluster of the number of cases of patients being infected in public hospitals with any of the aforesaid three bacteria in the past three years;
(2) whether the Hospital Authority (HA) has studied the reasons for the increase in the number of the aforesaid infection cases; if it has, of the results; if not, the reasons for that; and
(3) whether HA has formulated new measures to prevent bacterial infection of patients in public hospitals; if it has, of the details; if not, the reasons for that?
Reply:
President,
(1) Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), Methicillin-resistant Staphylococcus aureus (MRSA) and Carbapenem-resistant Acinetobacter species (CRA) are the more common antibiotic-resistant bacteria causing epidemic diseases in Hong Kong. The table in Annex sets out the preliminary yearly figures in respect of the situation of patients detected with these bacteria in public hospitals in the past three years.
(2) and (3) Public hospitals are facing challenges in controlling infection caused by antibiotic-resistant bacteria. Apart from the risks of cases imported from outside Hong Kong and the local community which will have a bearing on the number of infected cases, hospitals also face the problem of high occupancy rate and congested hospital wards. All these situations pose difficulties in the control of antibiotic-resistant bacteria.
Nevertheless, HA has all along been adopting the strategy of "early detection, early isolation" in controlling the bacteria and it endeavours to enhance hand hygiene and patients' personal hygiene as well as environmental hygiene. Specific measures include the implementation of a plan to screen patients upon admission to hospitals. If the patient has been hospitalised outside Hong Kong within the past six months, the hospital will conduct Vancomycin-Resistant Enterococcus (VRE) and CRA screening upon hospital admission. To further strengthen the control of bacteria, HA has put in place the following measures in 2013 and 2014:
(a) Introducing the Matrix-Assisted Laser Desorption/ Ionization Time of Flight Mass Spectrometry (MALDITOF-MS) as a new method of bacteria identification to shorten the testing time from three to four days to one to two days and enable segregation of carriers as early as possible. At the same time, Polymerized Chain Reaction (PCR) is used as a rapid test for high-risk groups to allow the issue of test reports on the same day;
(b) Enhancing the compliance of hand hygiene of healthcare staff and advocating personal hygiene of patients, for example, cleaning hands before taking drugs and meal and after using the toilet. Hospitals provide patients with 2% Chlorhexidine Gluconate (CHG) shower gels to reduce the amount of bacteria on patients' skin with a view to lowering the risk of bacteraemia (infection of the blood) caused by antibiotic-resistant bacteria as well as the risk of cross-transmission; and
(c) Implementing measures to prevent the environment from becoming a reservoir for transmission of antibiotic-resistant bacteria by, for example, enhancing the cleaning and disinfection of VRE patients' immediate environment to at least twice a day and using Hydrogen Peroxide Vapour (HPV) for terminal disinfection of room or disinfection of non-critical medical equipment so as to reduce the risk of cross-transmission.
HA will stay vigilant to review the effectiveness of various measures in controlling bacteria and introduce measures as appropriate in order to ensure the safety of patients.
Ends/Wednesday, May 21, 2014
Issued at HKT 17:30
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