An antiseptic commonly used by renal patients is suspected to have caused a bacterial infection in 53 people in Hong Kong over the past two years.
The Department of Health has urged the public to stop using Pro-Medi Prosept, a chlorhexidine antiseptic solution used for wound care, as it might be contaminated with a bacteria called Burkholderia cepacia.
Medical experts said this strain of bacteria was resistant to some antibiotics and diluted disinfectants, and while it posed little threat to healthy individuals, it could cause infections in those with weak immune systems.
The infection cluster was identified by Queen Mary Hospital, in Pok Fu Lam, after specimens collected from the catheter exit site of four peritoneal dialysis patients earlier this month were found to contain the bacteria, according to a news release issued by the Hospital Authority on Wednesday.
Peritoneal dialysis is a treatment to remove waste products from a patient’s blood when kidneys are not functioning properly. In the procedure, cleansing fluid flows through a catheter into parts of a patient’s abdomen, the lining of the abdomen, or peritoneum, acting as a filter and removing waste product from blood.
While the two brands of chlorhexidine antiseptic used by public hospitals and clinics tested negative for the bacteria, a type of pre-packed chlorhexidine product available in community pharmacies and some hospitals’ health care product shops was found to contain that bacteria.
The pre-packed antiseptic product, which comes in sachets, is commonly used by peritoneal dialysis patients for skin disinfection and care for catheter exit site at home.
A retrospective review by the hospital found that 53 patients who had peritoneal dialysis had been infected over the past two years, and five of them had more serious conditions.
“There is currently no evidence that any of the patients died of the infection,” a spokesman for the authority said.
Officers of the health department on Wednesday conducted an inspection at Sources (USA) Medicines Limited, which distributed the antiseptic, and collected samples of the product for analytical tests. The company also initiated a recall from the market and set up a hotline for enquiries.
All renal units of public hospitals have been alerted, and the authority said it would also review laboratory results of kidney-disease patients with the bacterial infection in all public hospitals.
An investigation by health authorities is continuing.
Dr Ho Pak-leung, a microbiologist from the University of Hong Kong, said the bacteria of concern was commonly found in the environment.
“One feature of this bacteria is it has a certain level of resistance against many antibiotics and diluted disinfectants. That means diluted disinfectants cannot kill the bacteria,” Ho said.
“This type of bacteria has a rather low level of invasion. But cleansing with the bacteria-loaded disinfectant daily, it is possible to cause infection at the [cleansing] site.”
William Chui Chun-ming, president of the Society of Hospital Pharmacists of Hong Kong, said he suspected contamination of the antiseptic product was a result of improper sterilisation during manufacturing, or very tiny cracks on the packaging which allowed the bacteria to get in.
Chui said patients could purchase other brands of chlorhexidine antiseptics from the market, or use iodine for the same purpose.
He said that similar cases involving the same types of bacteria and disinfectant had been reported in South Korea in 2014 and 2015, affecting 21 babies in a neonatal intensive care unit there.
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