Charité No hygiene deficiencies due to germ contamination

Baby died of germ burden at Berlin Charité - prosecutor's office determined

24/10/2012

After a newborn had died on October 5 in the Berlin Charité because of infection with Serratien germs, the prosecutor investigates for negligent homicide. So far, it is still unclear how it came to the infection of the now 22 affected babies. The premature birth ward of the Charité should remain closed until full education. The clinic rejects the accusation of poor hygiene.

Another child infected with germs at the Berlin Heart Center
The deceased child was born with a heart defect and was therefore transferred from the preemie ward to the German Heart Center. There, a second child infected with the germ. The boy was referred from a clinic in Potsdam to the heart center and, like the later-deceased baby, was operated on October 2, according to the director of the Clinic for Congenital Heart Defects and Pediatric Cardiology, Felix Berger. The boy was lying next to the sick child and was probably infected there. The doctors assume that the Serratien germs arrived with the later deceased child in the heart center.

The antibiotic therapy had been successful in the boy, so that the child could be released this Wednesday, so Berger. An infection with Serratien germs is life-threatening only for humans with strongly weakened immune system like preemies. Although the boy had not been born too soon, he had a severe heart defect, so he was initially treated at one of the Charité prematures. From there he was transferred to the cardiac center as an emergency.

Stop recording on premature births of the Charité because of bacterial load
At the heart center and Charité press conference last Tuesday, it was said that the baby's infection was most likely due to his mother's birth in July. Thereafter, the child has infected another baby. By September, there had been no new infections.

The Charité preterm infant wards remain closed until they have been completely cleared up, according to Ulrich Frei, Medical Director, due to the infestation with Serratia germs. Overall, 22 of the 40 premature babies had been detected in the germs. Seven babies are sick. However, the condition of all affected children is stable, as the head of the premature infants ward, Christoph Bührer, said at the press conference. After a child died of an infection on October 5 and a second child was found to be contaminated on October 8, the Charité decided to screen all premature babies, and the other cases were confirmed, the clinic said. Subsequently, an immediate stop of admission for the affected preterm infant wards was initiated.

According to Karl Schenkel, Head of Hygiene and Environmental Medicine in the district of Mitte, three stations in the maternity clinic and two at the cardiac center are affected, whereby a maternity ward is now germ-free. „The exact number of germ colonies can change every minute.“ Since it would be unthinkable to stop the highly specialized cardiac center, emergencies would still be there. However, parents are advised to avoid planning their children's surgery to another clinic.

Has Charité neglected to register for germ contamination?
Accusations of possible hygiene deficiencies are now getting louder. However, the medical director rejected all allegations decidedly. The neonatal intensive care unit is characterized by highly qualified and highly motivated employees. He excludes inadequate hygiene measures and, in the context of critics, dismissals of employees. Although the staffing of the preemie wards is just below the three nurses required by the Robert Koch Institute (RKI) per bed, with overtime at least 2.85 to 2.91 employees are responsible for each bed. That is justifiable.

As Schenkel explained, they are working hard to find the source of the infection. More than a hundred samples had already been examined, including soaps or disinfectants. Nevertheless, have so far „nothing indicative of direction“. The director of hygiene and environmental medicine in the district of Mitte considers it possible that the exact cause is not found. But the hygiene is meticulously checked in the hospital.

As reported by Schenkel, from July - the presumed time of infection of the first child - there had been further germ outbreaks by October. In the Virchow Hospital of the Charité, there were a total of 20 to 30 people affected. However, since these were isolated cases and the stations were partly germ-free for a long time, there was no report. An official notification must be made when at least two patients are affected. Schenkel then pointed out that the Charité „the context of the cases not recognized“ Has. In retrospect, however, the responsible authorities had taken the necessary measures just in time. The health department has yet started its investigation and is currently examining whether the Charité have neglected their reporting since July, said Anke Elvers-Schreiber, medical officer in Mitte.

Allegations of crisis management of the Charité are getting louder
„We do not yet know what are the causes of the germ attack“, explained Ulrich Fegeler, speaker of the Berlin paediatricians. „It is dubious and unfair to blame the doctors or nurses for speculation. I know what they are doing at the preterm station.“ Nevertheless, the allegations against the crisis management of the Charité are getting louder.

As Petra Gastmeier, head of the Charité Hygiene Institute, reported, the Virchow-Klinikum has not been noticed negatively so far. It even outperformed the use of hand sanitizer above average. It would also be examined evidence, according to which a baby bath could be the germ source that was taken by the company Rossmann already out of commerce. In a press release of the Charité states: „The convened team of experts continues the search for the source of infection with high pressure. The recording stop for the two stations concerned will continue.“

As the prosecutor announced, should be clarified in a preliminary investigation, the cause of the germ burden and the resulting criminal charges. Health Senator Mario Czaja (CDU) and Science Senator Sandra Scheeres (SPD) have not yet commented on the allegations. The Uni-Klinikum belongs to the area of ​​responsibility of Scheeres.

Expert report makes staff shortage responsible for germ contamination in Bremer Klinik
In May this year and at the end of last year, multiresistant pathogens were detected in the Bremen-Mitte hospital center, leading to the death of three preemies at the end of 2011. Recently, Bremer Health Senator Renate Jürgens-Pieper (SPD) in the Committee of Inquiry of the Citizenship criticized the expert Professor Walter Popp. The hygienist did not receive all the files of the prosecutor and therefore did „incorrect conclusions“ drawn. Popp had pointed out in his report that the death of premature babies was due to the bacterial contamination due to various maladies. According to him, the senator and the hospital management are responsible for the hygiene scandal, as they did not provide enough staff at the pre-hospital. (Ag)

Picture: Karl-Heinz Liebisch