Neonatal Unit closed for a month while upgrades being installed

Doctor Coye said that the bug could have come from another section of the hospital or from an incoming patient. There were questions regarding whether or not air condition problems in clinics one through four were a part of the problem, but he said it was not. Inside the special care nursery, terminal cleanings were carried out three weeks ago. Now, the K.H.M.H. has specialized areas that are Hepa-filtered, a specialized air filtering system and the water is tested every month for bacteria. So there are factors in place to keep the hospital sterile. But that didn’t help within the Neonatal Intensive Care Unit. The hospital says it has to carry out specific procedures to find out what is causing the deaths and that includes lab tests. The question was also asked if someone had flagged that the twelve infants had died in twenty days?

Dr. Adrian Coye, Director of Medical Services, K.H.M.H.

“It can be anywhere, but the susceptible population is the premature babies who are in the intensive care unit as they are. Whether it was brought from other parts of the hospital, I cannot say, but I know from an epidemiological point of view, when you look for an outbreak, you try to identify an index case. An index case was identified in February; the first infection of this nature. However, that baby was treated and went home. It could be then from that original infection, colonization had happened and that’s how when you talk about how things could spread and so that may be one source. But like you rightly suggest, there may be an environmental aspect to it. This number of twelve is unusually high for us. We are more used to seeing rates of five or six neonatal deaths per month. So this rate of twelve and as we’ve explained, it was in a very short period of time that it went above what we recognized as a baseline because we receive babies from everywhere in this country—all the way down south, P.G. and from private hospitals as well that have operated on them and send them here for ventilation and those babies go home alive. But other babies have come to us very septic and in a position where we cannot recover them.”

Jose Sanchez

Adrian Coye

“When the infant dies of sepsis, is it normal procedure then to have that body tested for a particular bacteria?”

Dr. Adrian Coye

“Well that is a very good question because you don’t want to diagnosing when they have died; you want to be able to know. And so from when the baby is not well, we will be sending samples. However, if that opportunity didn’t happen for whatever reason and sepsis is something that we have been very sensitized to. In CMEs we have done here, Dr. Grinage has presented a global picture on continuous medical education. And so we have been talking about pediatric sepsis and all of these things already. It is not that there is not the awareness but yes, for some babies that died from sepsis, we don’t know why they die, we take samples to confirm and that is how we confirmed some of the cases as having this same organism. Adjustments were being made when recognition that some septic events were happening. We do have a log when we were able to confirm. And the log is confirmed positive cultures because we rely on the central pathology services by sending specimens there for them to incubate it over two three days, analyze it and then do testing of the bug or the organism that they grow to see what antibiotics they are sensitive too. And so that is a process. But then what do you do in the meantime? You adjust.”

Chandra Nisbet-Cansino

Chandra Nisbet-Cansino, Chairlady, Board of Governors, K.H.M.H.

“The definitive information that we got today were the epidemiological reports and the reports from the infection control. We still have a lot of information that we are gathering regarding that specific question that Jose and Miss Amaya are asking. What was the process of communication? That is important to us. We do not have that answer today, but we are definitely working on getting hat answer because we know that that is one of the biggest questions that the public has. And we feel an obligation to answer the public on that question.”