18 inpatients died at Osaka Pref. hospital from drug-resistant bacteria infections

DAITO, Osaka -- Eighteen people died over a two-year period up to this past August from drug-resistant bacteria infections at a hospital in the western Japan prefecture of Osaka, those close to the institution said.

One of the victims, a 71-year-old man, developed symptoms of a disease caused by his infection with drug-resistant bacteria Acinetobacter before he passed away. It is highly likely that the patient died as a result of the infection, while a causal relationship between the infection and the deaths of 17 other patients has not been confirmed.

The institution, Hanna Hospital in Daito, Osaka Prefecture, failed to report the man's case for seven months although medical institutions are required by the Act on the Prevention of Infectious Diseases to report the case of patients developing infectious disease symptoms to health centers.

The Shijonawate Health Center that has jurisdiction over the hospital severely warned the institution.

Ichiro Kawase, director of the hospital, apologized over the incident, stating, "We should've considered the possibility of in-hospital infections. We weren't fully aware of the danger of bacteria. It's inexcusable."

According to the hospital and others involved, 19 inpatients aged between 58 and 97 were infected with Acinetobacter, which is highly resistant to antibiotics. Of them, 18 died while the other still remains hospitalized.

In August this year, an outside doctor who was commissioned by the hospital to examine the outbreak of another infectious disease found that at least one patient had been infected with Acinetobacter. This prompted the hospital to investigate cases of infections with the bacteria in the past five years.

The hospital then confirmed that at least one patient infected with the bacteria had been found at its tuberculosis ward about every two months since August 2017. From analysis of the bacteria's genes, the hospital concluded that they were infected with the bacteria inside the institution. However, the hospital has failed to identify the infection route.

In January this year, the hospital diagnosed that the 71-year-old man suffered from pneumonia that worsened as a result of symptoms of a disease caused by Acinetobacter. He died two weeks later. The doctor in charge of the patient apologized for his death to his family, saying, "He passed away from bacteria that were tough to treat."

However, the doctor failed to share information on the case with other medical staff members or to report the case to the health center until the infections came to light.

During an in-house probe, the doctor was quoted as saying, "I didn't know that I had a duty to report such a case."

In the meantime, the hospital has explained that it did not confirm any causal relationship between the infection and the deaths of the 17 other patients. The hospital had no duty under the infectious diseases prevention law to report the cases of the 17 other patients because they never developed symptoms caused by their infection with the bacteria.

If those whose immune system has weakened get infected with Acinetobacter and develop symptoms, they could die of pneumonia or blood poisoning. Numerous cases of in-hospital infections with the bacteria have occurred. In 2018, Kagoshima University Hospital in the southwestern Japan city of Kagoshima announced that eight inpatients died after being infected with the bacteria.

Hanna Hospital has a tuberculosis ward with 123 beds, the largest ward for patients with the illness in Japan.

(Japanese original by Koji Endo and Daisuke Kondo, Osaka Special Reports Department)