Another MRSA cluster was reported in Rotunda NICU

A cluster of methicillin-resistant Staphylococcus aureus (MRSA) cases in the Rotunda Hospital’s neonatal intensive care unit (NICU) was highlighted at its board meeting in March, the Medical Independent (MI) has learned.

A hospital spokesperson informed MI that four babies were colonised and there were no adverse outcomes associated with the cluster. The spokesperson also confirmed there had been no instances of Covid-19 in NICU patients to date.

A number of dangerous infectious outbreaks have occurred in the NICU in recent years, which the Rotunda has attributed to constrained infrastructure. The hospital confirmed that incubators were still less than one metre apart due to lack of space. Minutes of its board meeting in March underlined that the “prevention of serious infection and spread is extremely difficult to control and contain when there is high occupancy in the NICU”.

The same meeting heard that two of the Rotunda’s top five risks involved NICU capacity, namely “risk to business continuity due to age of building and capacity constraints in labour ward and neonatal intensive care unit” and “risk of injury due to infection outbreaks in the NICU due to space constraints”.

A proposal for a “critical care wing” was discussed at the March board meeting, with formal support reported from the RCSI Hospitals Group and HSE Director of Acute Operations Mr Liam Woods.

According to the Rotunda’s spokesperson: “Design proposals and business rationale for the critical care wing were submitted to HSE Estates national capital steering committee for consideration in March 2020. Submission was approved subject to capital funding. Funding has been allocated to complete a CBA [cost-benefit analysis] (2020).”

Last November, MI reported that NICU admissions were capped to mitigate the risk of further outbreaks.

Earlier in 2019, an outbreak in the NICU of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella led to the unit closing to external admissions and to the transfer of babies to the two other Dublin maternity hospitals, in what was a “major operational crisis” for the Rotunda.

In 2018, MI reported that an MRSA outbreak in the NICU contributed to the severity of illness in two babies who died due to the complications of prematurity.