Jamaican-American neonatologist says neonatal baby deaths “heartbreaking”

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Sunday, November 1st, 2015. Aaron Humes Reporting: As Belize this week welcomed a new pediatric and neonatal intensive care unit built out of the tragedy of 13 babies killed in a month at the Karl Heusner Memorial Hospital (KHMH) two years ago, Jamaica is struggling with a heavier toll, spread across two hospitals.

Nineteen babies have died in two local hospitals in eastern and central JamaicKarl-Heusner-Memorial-Hospitala recently after bacteria identified as klebsiella and serratia, and their families have begun demanding compensation from the Jamaican government. The Belizean deaths were caused by Enterobacter cloacae but it was never determined how the bacteria got into the unit.

So far, two officers of the University Hospital of the West Indies (UHWI) – CEO Dr Cecil White and Medical Chief of Staff Professor Trevor McCartney – have resigned in the wake of the deaths of the babies at that hospital and the St James-based Cornwall Regional Hospital.

Questions have also been raised about the time taken by senior officials in the health ministry to respond after the first death linked to klebsiella and serratia was reported, The Gleaner says.

The Sunday Jamaica Gleaner quotes Jamaica-trained, United States-based neonatologist Winslade Brown as describing the deaths of the babies as heartbreaking, while arguing that “it is quite possible that without the bacteria, the doctors at the hospitals would have worked magic to keep the infants alive”.

Bowen, who works in Florida, explains that the University Hospital of the West Indies (UHWI) may only have the capabilities for level-three babies (on a four-level scale of neonatal problems), even though some would present with level-four needs.

He said three years ago, he was involved in the donation of some equipment to the neonatal unit at the UHWI and learnt of the “extreme challenges facing the medical professionals there”.

Bowen insisted that cleanliness was critical to handling the delicate infants residing in these units.

Bowen said it was possible that klebsiella was imported to the hospital, even as he questioned if any of the infants presented a condition known as necrotising enterocolitis – a breakdown of the gut tissue that could have caused klebsiella to invade and produce the infection.

He said the babies could also have been infected through the ventilation system: “Serratia is renowned for living in equipment. If the babies are on ventilators and the system is infected, they are going to be infected.’

According to Bowen, several years ago, there was a serratia outbreak involving babies in the hospital he works, and it was determined that it was spread though the vacuum-cleaning of the contaminated carpet in the nursery.

He urged local health officials to “cultivate cleanliness, excellence and safety”, and suggested “a regular review of morbidity and mortality among this group as trends may indicate the need for pre-emptive action”.

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