'Nightmare' superbug alarm Dandenong Hospital. A widely feared superbug has contaminated hand-washing sinks in Dandenong Hospital's intensive care unit, causing 10 patients to fall ill with the "nightmare bacteria" that have killed many people worldwide. A report published in the Medical Journal of Australia on Monday says the 440-bed hospital in Melbourne's south-east has been struggling to contain the multi-drug-resistant bacteria since 2009. Ten patients have been infected since then, but none died from the infection. An infectious disease physician at the hospital, Rhonda Stuart, said doctors had been concerned about a string of cases in the intensive care unit between 2009 and last year, but only acquired the technology last August to test surfaces for the bacteria known as CRE. Associate Professor Stuart said the tests revealed the bacteria were in the sinks where healthcare workers washed their hands. While it could not be proved, she said, this might have spread the infection to patients because the sinks' poor design caused water to splash back off the drain. Despite this being discovered seven months ago, Associate Professor Stuart said the hospital was only now preparing to replace the sinks. When asked if cost had delayed this, she said "there were always difficulties with trying to do things in budget-restrained times." However, she said doctors were satisfied the intensive care unit was safe. The sinks were being cleaned regularly with 170-degree pressurised steam, which removes the bacteria for about three days before they grow back. Staff were also being careful with infection control procedures to prevent further patient infections, she said. "No patients have tested positive for the bacteria since we've undertaken this process, so we're happy things have been controlled with the new steam technology ... There is no risk to anybody," said Associate Professor Stuart, who is also medical director of infection control for Monash Health. CRE (Carbapenem-resistant enterobacteriaceae) is a new class of multi-resistant bacteria alarming doctors worldwide because of their ability to spread drug resistance to other bacteria. Two weeks ago the director of the US Centres for Disease Control, Tom Frieden, labelled CRE "nightmare bacteria" because of their resistance to nearly all antibiotics and their high mortality rate. Some types are estimated to kill up to half of the people they infect. Associate Professor Stuart said Dandenong Hospital had found various types of the bacteria. All carried genetic material making them resistant to carbapenems - a broad-spectrum antibiotic used as a last resort for the most resistant bacteria. She said that although 10 patients had tested positive for CRE, none had died from it. Some of the patients had cleared the bacteria themselves and some had been treated with antibiotics that still worked. Eight patients were discharged from hospital and two died of other causes. Associate Professor Stuart said although it was difficult to know how the bacteria got into the hospital, staff had previously breached guidelines by pouring clinical waste with antibiotic residues down the contaminated sinks. This could have caused CRE to emerge. It was also possible the superbug emerged because the patients had spent a long time in the intensive care unit on antibiotics. Patients who had travelled overseas might have also picked up the bug and transported it to the hospital. While there have been reports of CRE in about 200 US hospitals, the superbug is thought to be an emerging issue in Australian hospitals, which are not required to publicly report such infections. A growing number of microbiologists and infectious disease experts are calling for urgent action to prevent the increasing spread of such superbugs in Australia. Writing in the Medical Journal of Australia, the president of the Australasian Society for Infectious Diseases, David Looke, and colleagues say health authorities need to be "brave enough" to make difficult decisions on the use of antibiotics if Australia is to avoid a "plague" of multi-drug-resistant bacteria that would make many illnesses untreatable.