SINGAPORE General Hospital is taking major precautions to prevent the spread of a newly discovered superbug - not because the germ is deadly, but because the hospital does not want it to become entrenched here.
SGH said yesterday that this has happened to another superbug - methicillin-resistant staphylococcus aureus (MRSA) - which is found in all hospitals here.
The new bacterium, vancomycin-resistant enterococci (VRE), has been found in 15 SGH patients since March 9, making SGH cancel all elective surgery from Monday.
SGH's director of quality management, Dr Ling Moi Sin, said the hospital wants to stop the spread of a more difficult bug.
Vancomycin is the drug of choice to treat MRSA.
The hospital fears that through contact, VRE bugs could teach the MRSA bugs the genetic secrets of resisting vancomycin, one of the most powerful antibiotics available today. This antibiotic is one of the few guaranteed to kill all forms of the common, and sometimes lethal, pneumococcus bacteria, which cause pneumonia.
Eventually, doctors fear, VRE could transmit its vancomycin-resistant gene to more lethal bugs, making them untreatable too.
Meanwhile, washing hands often is the best way for ordinary folk to avoid catching VRE, a leading infectious disease specialist said.
The bug is usually spread through 'direct hand contact', said Dr Brenda Ang, chairman of the infection control committee at Tan Tock Seng Hospital.
A person in contact with infected stool or skin ulcers, in which VRE is commonly found, could spread it by shaking hands with another person.
Direct contact with an open wound could also spread it.
However, VRE is not spread through droplets or through the air, Dr Ang said.
Overcrowding in hospitals and 'inadequate isolation facilities' could spread the bug as well.
Dr Ang recommended that VRE patients be kept in strict isolation and be attended to by gowned and gloved medical staff.
Patients and relatives at SGH were not unduly worried by news of the superbug, though many were not told about it.
Ms Serene Tan, 19, warded for diarrhoea and fever for over a week, heard of the bug on the news. 'I am not too worried, I believe the hospital has the necessary precautions in place,' she said.
Visitor Shawn Maniam said he was 'a bit surprised' when told of the news. The civil servant, who was there to visit his father, said the hospital should have kept family members informed.
ADDITIONAL REPORTING BY BEN HO
WHAT is vancomycin-resistant enterococci (VRE)?
It is a special drug-resistant strain of the enterococci bacterium, which is commonly found in the stomach and bowels in 19 out of 20 healthy people. Enterococci can also be found in human stool, open wounds and skin ulcers.
It is resistant to vancomycin, a powerful antibiotic that doctors often regard as a last-resort drug to eliminate bacterial infections, since many bacteria have become resistant to many other drugs. VRE is usually known to spread in a hospital setting.
Yes it can, but mainly in people with weak immune systems, including seriously ill patients, the very young and the very old.
At present, it is not at all common here.
The most common way is by direct contact with an infected person, usually with the hands.
It can occasionally be spread by direct contact with surfaces like railings, faucets and handles that may have been contaminated by an infected person.
How can you prevent VRE infections?
There is no vaccine to protect you from it.
The most important thing you can do is be meticulous about personal hygiene - wash your hands before eating, drinking, smoking or applying personal care products, and after using the toilet.
Health-care workers should also wash their hands after contact with a patient.
They should scrub their hands well for about 10 seconds using warm water and regular soap, and use a disposable paper towel.
Routine cleaning of surfaces like railings, faucets and handles, with soap and water can also help reduce the spread of VRE and other micro-organisms.
What are your chances of getting VRE?
If you are healthy, and living in the community, your chances of becoming infected with it are low, even if you have been in contact with someone with it.
You may be more at risk if you have been treated with frequent doses of vancomycin before, or if you stayed for a long time in a hospital where previous VRE cases have been often reported.
Healthy people who carry VRE do not need treatment.
Serious VRE infections, while difficult to manage, may be treated with certain new antibiotics.
How long do VRE infections last?
Healthy people may carry VRE for weeks, or even years, and may become free of the bacteria without treatment.
However, if you have had a serious VRE infection, this infection can come back again.