Replies to LegCo questions
LCQ12: Antibiotic-resistant bacteria in public hospitals
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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LCQ 12 Annex