Two babies die, three other E. coli cases in Swansea

Prof Hugh Pennington said something had clearly gone wrong at the hospital's neonatal unit following the deaths of two babies.

Two babies have died after an E. coli infection, health officials in Swansea have confirmed.

One was a very premature baby who died after contracting ESBL E. coli at the city's Singleton Hospital.

The other baby contracted the bug in the community but doctors say the cases were linked. How the cross-infection occurred is being investigated.

As a precaution the unit, which has undergone a deep clean, is only open for full-term births.

An inquest has been opened and adjourned into the death of one of the babies, Hope Erin Evans from Aberdare, south Wales, who was just five days old when she died at the hospital on 4 November.

'Tragic loss'

Three other non-fatal cases have been confirmed but Abertawe Bro Morgannwg (ABM) University Health Board said they appeared to be isolated incidents.

The board's medical director Dr Bruce Ferguson said: "Tests have confirmed that in one of these cases the ESBL E.coli infection was contracted in the hospital.

What is ESBL E. coli?

  • ESBL E. coli is not the same as the E.coli O157 which causes food poisoning
  • ESBL stands for Extended Spectrum Beta Lactamase
  • ESBL E. coli is most often found in the gastrointestinal tract but may cause urinary tract infections
  • ESBL E. coli is resistant to commonly-used antibiotics such as penicillin, but can be treated
  • In most people ESBL E. coli does not cause harm but in vulnerable individuals it can cause serious infections
  • Source: ABM health board

"Sadly, this was a very premature baby who, despite the best efforts of staff, later died.

"The cause of death of this baby is currently being investigated by the coroner. Everyone involved with the unit and in the care of this baby deeply regret this tragic loss."

The other baby contracted the infection outside the hospital.

Dr Ferguson reassured expectant mothers due to give birth in Singleton Hospital that the maternity unit is open as usual for full-term births.

As a precaution, the health board has temporarily restricted the neonatal unit to admissions for babies of 36 weeks gestation, or longer.

"These appear to be isolated incidents which have been contained, and there is no evidence of the infection spreading further," Dr Ferguson added.

"Checks have been taken of patients, equipment and areas in the maternity/neonatal unit and no evidence of ESBL E. coli has been found.

"Very saddened"

"The unit has an excellent record for hand-hygiene and general infection control adherence. Reported infection levels in the unit have been below the national average in recent years."

Analysis

The investigation into these cases will concentrate on the history of contact between all five people involved.

This means looking at any links they have in the community as well as what happened at Singleton Hospital.

It will be vital to establish whether any of the regular infection control measures used in neonatal units have been breached.

This was the suspicion in the last major outbreak of ESBL e.coli in 2008 at Luton and Dunstable Hospital.

An official report concluded that the bacteria there spread via the hands of staff or shared equipment, although no definitive evidence was found.

Managers in Swansea have already stressed their 'excellent record for hand-hygiene and general infection control'. They will need to be sure that every possible precaution was taken.

Microbiologist Prof Hugh Pennington told BBC Radio Wales ESBL E. coli caused problems for young babies because their immune systems were not well-developed.

"These bugs . . . are really quite good at getting about and once they get into something like a neonatal unit, history tells us with other related bugs they can be really quite difficult to eradicate.

"I'm sure that the people at Singleton are doing their utmost to make sure that there aren't any problems.

"They have restricted admission to the very young babies because they are the ones really at risk from this particular nasty bug. It's a very reasonable approach to take."

Health Minister Lesley Griffiths said she was "very saddened" to hear of the two deaths.

Conservative health spokesman Darren Millar AM expressed his condolences for the families involved, adding: "This is obviously an incredibly serious case and I urge the health minister to update us on the current situation and the next planned steps as soon as possible.

"While I recognise these infections appear to be isolated and contained, those using the hospital will expect regular reassurances from the Welsh government in the immediate future."

Anxious people

Welsh Liberal Democrat leader Kirsty Williams said the deaths were a "terrible tragedy".

"While the unit is temporarily closed for some patients, pregnant women in the area who are expected to deliver at the unit need to be reassured that there are alternatives set in place," she added.

"Guarantees are needed that other units that will have to take pre-term mothers have the resources to cope.

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