On 21 June 2017, the Ministry of Health and Medical Services (Ministry) alerted the public of four (4) deaths within the Neonatal Intensive Care Unit (NICU) at Suva’s Colonial War Memorial Hospital (CWMH). As of 11 July, a further two (2) deaths have occurred within the NICU.
The NICU is a specialist unit which provides intensive care to ill or premature infants born at CWMH, the national referral hospital of Fiji. Many of the infants who are cared for in this unit suffer significant pre-existing illnesses such as compromised immune systems.
The presence of the multidrug resistant bacteria, Acinetobacter baumannii, was detected by CWMH laboratory services in samples obtained from NICU patients. This bacterium is commonly found in hospital settings and hospital patients around the world. Whilst the bacterium poses very little risk to healthy people, it can be a significant health risk to those with compromised immune systems.
A similar outbreak of this bacterium occurred within the NICU at CWMH between December 2016 and March 2017.
The Ministry and WHO are working together closely with CWMH’s clinicians and Infection Prevention and Control team to respond to this current outbreak and ensure the safety of the hospital’s most vulnerable patients.
As part of the immediate response, CWMH has increased surveillance in the hospital to support early response to new cases of infection; enhanced screening and infection precautions of all new admissions to the hospital and the NICU; and intensified its infection prevention and control measures.
A specialist team has also been deployed by WHO to Fiji to work with CWMH to try and identify a source of the bacteria, in addition to reviewing current infection prevention and control practices within CWMH and, as a further preventive measure, also examine practices in Lautoka and Lambasa hospitals. Based upon their findings, this team will be providing recommendations for ensuring that the hospitals’ current processes are appropriate, and adequate systems are in place to ensure the delivery of quality clinical care and patient safety.
Whilst a common source of the bacteria has not been found, this is not unusual as sources are only identified in 50% of all outbreaks reported globally. As sustained elimination of multidrug resistant bacteria in hospitals is extremely difficult, enhanced prevention, surveillance and early intervention measures are critical to preventing the infection of individual patients and consequent outbreaks.
The Ministry and WHO will continue to provide updates to the public on this issue.