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Liver transplant unit ill-equipped to fight superbug,watchdog warns

Ireland’s national liver transplant unit is ill-equipped to fight a potentially deadly superbug, health watchdogs have warned.

The drug-resistant VRE infection has been on the increase at the unit in St Vincent’s Hospital in Dublin, says the Health Information and Quality Authority (Hiqa).

Inspectors who carried out an unannounced visit to the 21-bed ward in March this year have reported a raft of shortcomings in stemming its spread.

The watchdog said “high risks” to patients were identified during the recent inspection, despite an apparent ramping up of measures in the wake of an outbreak in 2014.

These included poor facilities and infrastructure in the ward “which does not facilitate effective infection prevention and control”.

There is also a lack of isolation rooms and toilets, while patients who had picked up the bacteria have to share shower facilities with those who have not, the report found.

Furthermore, Hiqa criticised the lack of precautions being taken to stem the spread of infection.

Tests to detect VRE in patients were stepped up over the past two years after the unit reported Ireland’s first outbreak of the superbug in 2014.

They have confirmed an increase in cases among patients after being admitted to the hospital.

Hiqa said the increase was “particularly notable in patients undergoing gastrointestinal surgery”.

While the majority of patients who pick up the bacteria do not develop an infection, more vulnerable patients are at risk from its spread, it added.

“Such patients may include those undergoing solid organ transplantation, or abdominal surgery,” the watchdog said.

“For that reason, effective infection prevention and control measures need to be prioritised in higher risk clinical areas.”

Hiqa said there is “significant scope for improvement” at the unit for fighting the spread of VRE infection.

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St Vincent’s told Hiqa it recognised significant issues in infection prevention and control, and that it had stepped up screening, isolation and cleaning.

The hospital was also considering relocating the unit.

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