Hong Kong CHP Investigates Two Clusters of Carbapenemase-Producing Enterobacteriaceae Carriers in Elderly Care Homes
Key Insights
The Centre for Health Protection (search) (CHP) is investigating two separate CPE carrier clusters in Mong Kok residential care homes for the elderly, involving five and nine residents respectively, with no epidemiological linkage between them.
All identified patients are asymptomatic carriers in stable condition; the CHP found substandard hygiene conditions and inadequate infection control measures at both facilities.
CPE produce carbapenemase (search) enzymes that deactivate carbapenems (search) and other beta-lactam antibiotics, limiting therapeutic options and making severe clinical infections difficult to treat.
The Centre for Health Protection (search) (CHP) of the Department of Health is investigating two distinct clusters of Carbapenemase-producing Enterobacteriaceae (search) (CPE) carrier cases at residential care homes for the elderly (RCHE) in Hong Kong's Mong Kok District. The investigations, announced on June 12 and July 21, 2026, have identified a total of 14 asymptomatic carriers across two separate facilities with no epidemiological linkage between them.
June Cluster: Five Residents Affected
In the first cluster reported on June 12, the CHP received notifications from the Hospital Authority (search) that three residents — two males and one female aged between 65 and 84 — living on the same floor of an RCHE in Mong Kok District had tested positive for CPE upon admission screening at a public hospital. These residents had been admitted for treatment of underlying illnesses, and all were identified as carriers without exhibiting symptoms associated with CPE infection. All patients were reported to be in stable condition.
Upon notification, the CHP immediately conducted epidemiological investigations and inspected the RCHE. The CHP found that the hygiene conditions of the facility were substandard. Given that there had been at least two known carriers previously on the same floor, the CHP stated it "could not rule out that the RCHE management had not fully implemented the related infection prevention and control measures leading to the transmission of CPE to the three residents through contaminated environment or sharing of items within the facility."
July Cluster: Nine Additional Cases at a Second Facility
On July 21, the CHP announced a second, unrelated cluster involving nine residents — six males and three females aged between 76 and 102 — at another RCHE, also in Mong Kok District. These residents had been admitted to a public hospital over the preceding two months for treatment of underlying illnesses, and their admission screening samples tested positive for CPE. The CHP noted that "it cannot be ruled out that they were infected at the RCHE before their admission."
The epidemiological investigation revealed that carriers had been detected on the same floor of this RCHE since May 2026. The CHP determined that "the RCHE management had not duly implemented the related infectious disease prevention and control measures, which led to transmission within the RCHE through the staff, contaminated environment or the sharing of items within the facility." All nine patients were asymptomatic carriers in stable condition.
Infection Control Measures and Ongoing Response
In both instances, the CHP reminded the RCHE management to strictly adhere to the Guidelines on Prevention of Communicable Disease in RCHEs, thoroughly clean and disinfect the environment, and ensure good hand hygiene among staff and residents. The CHP also recommended that both facilities cohort the carriers in the same area and provide adequate hand-washing facilities.
The CHP will continue to investigate both clusters and conduct screening at the affected RCHEs to determine whether there are additional CPE carriers. Both facilities have been placed under medical surveillance. For the sake of prudence, the CHP has also reminded all RCHEs in Hong Kong, through the Social Welfare Department (search), to implement infection prevention and control measures in accordance with the Guidelines.
Clinical Significance of CPE
Enterobacteriaceae, including Escherichia coli and Klebsiella species, are common pathogens capable of causing infections in various parts of the body, including urinary tract infections, intra-abdominal infections, and bloodstream infections. CPE are enterobacteriaceae that produce carbapenemase (search), an enzyme that can deactivate carbapenems (search) and other beta-lactam antibiotics such as penicillins (search). These bacteria are commonly resistant to multiple antibiotics, limiting therapeutic options and potentially rendering severe clinical infections difficult to treat.
The spectrum of disease associated with CPE ranges from asymptomatic carriage to potentially life-threatening or fatal infections. The level of risk depends on which part of the body is affected by the infection and the patient's general health status.
The CHP emphasized that proper use of antibiotics and maintaining good personal and environmental hygiene, especially hand hygiene, are important for preventing the emergence and cross-transmission of multi-drug resistant organisms such as CPE. Susceptible individuals — including the elderly, infants, young children, people with weakened immunity, and pregnant women — can reduce their risk of contracting MDROs by avoiding raw or undercooked foods.