Three babies dead within one week at Madrid Hospital

Sunday, March 4, 2007 

Babies in neonatal intensive care units are sensitive to hospital infections. The causative bacterium in these cases in Spain, Klebsiella pneumoniae, does not usually cause problems in healthy individuals. It's an opportunistic pathogen, which means it usually only causes disease in the weakened and sick.

A Spanish hospital reported today that three premature babies have died within one week from the same infection. The babies, who were being cared for in the neonatal intensive care unit of Madrid's 12 de Octubre Hospital, all died after being infected with Klebsiella pneumoniae bacterium. Authorities also suspect that a fourth baby has become infected with the bacterium. The Spanish patients' association ADEPA has asked the public prosecutor of the Madrid Region, Manuel Moix, to open an investigation into the matter.

This morning, hospital authorities stated that the first death occurred on 26 February. A baby born eight weeks prematurely and weighing just under one kilo died due to septic shock arising from the infection, which was unconnected with the symptoms of his premature birth, according to hospital reports.

Shortly afterwards, two babies in the same unit died on 2 March. They appear to have died from the same infection; however the hospital stated that they are still waiting for confirmation of the cause of death. A fourth baby has been found to have the bacteria on his skin, but as yet there is no confirmation of whether he has been infected. The hospital states that although the baby is in a serious condition, this is to be expected when a baby is born so premature, and that his condition is also due to other factors, unrelated to the bacterium, which have arisen since his birth.

The hospital authorities have asserted that all of the babies in its care are under close supervision, and are being periodically monitored by the Preventive Medicine Centre, in order that the most up-to-date information may be had on the state of any and all patients in the hospital.

To prevent further infections, the hospital has taken several measures. The first is of course rigorous medical hygiene. High-risk patients are referred to other hospitals. The hospital has been divided into two separate zones, one for those already infected and the other for those who have not yet been affected. As a consequence, 25 children who were staying in the hospital while the 3 premature babies died, remain separate from the others, to make sure newly admitted children are not exposed. The nursing staff has also been restricted to one or other of these two areas. Visits from specialists of other hospital services, and from families, has been restricted. Furthermore, an epidemiological study is being undertaken to determine the origin of the situation.

The newspaper El País reports that the bacterium Klebsiella pneumoniae is to be found in hospitals as a matter of course and is often contracted by those who have been in hospital for prolonged periods (termed a nosocomial infection). The mortality rate from the bacterium is extremely high in those cases where it's contracted by people with serious illnesses, as is often to be expected in the case of a premature birth, which can result in newborn babies weighing less than 500 grammes.

According to the Spanish daily, this type of bacterium is prevalent in hospitals throughout the world, but the incidence of infection in Madrid hospitals is lower than the Spanish average. The head of the Neonatal Unit at 12 de Octubre Hospital, Carmen Payás, explained that the bacterium is very adaptable "and keeps on learning". The father of the dead baby, an Ecuadorian named Angel Marcelo, was quoted as saying that the progress of the baby had at first been "tremendous", and that he had even been taken off the respirator, but that a few days later he began to cough up blood, dying soon afterwards.

The chair of ADEPA, Carmen Flores, has appealed to the Madrid public prosecutor to open an investigation into the situation and to find those responsible. ADEPA have suggested that the investigation centre on the number of casualties among infants in the hospital, and on the question of whether conditions in the neonatal unit were a direct contributor to the incidence of the infection.

José Quero, head of the Neonatology Department of the La Paz hospital in Madrid said that, "sadly enough", this situation was "not something exceptional," but rather something neonatologists have to watch out for.

Sources

• "El Doce de Octubre aísla a 25 bebés prematuros, uno de ellos grave, tras la muerte de tres" — El País, March 4, 2007 (Spanish)
• "Fallecen en una semana tres bebés prematuros infectados por una bacteria en el Hospital 12 de Octubre" — El País, March 4, 2007 (Spanish)
• "El Hospital 12 de Octubre confirma la gravedad de un cuarto bebé prematuro" — elmundo.es, March 4, 2007 (Spanish)
• "El 12 de Octubre confirma que un cuarto bebé prematuro se encuentra grave" — ABC.es, March 4, 2007 (Spanish)