Up to 50 people to one toilet, a leaking sewer pipe and an insufficient number of handwash basins were linked to a bacterial outbreak at New Zealand's Middlemore Hospital, according to an article on the New Zealand Herald website.

Documents identified the risk factors that could have spread vancomycin-resistant enterococcus (VRE) through the hospital's dialysis unit between October 2012 and May last year.

A report on the outbreak said the hospital's dialysis unit was "unfit for current purpose," including inadequate toilets with only one patient toilet in the facility.

The report also identified an exposed sewer pipe in a sterile store that had previously leaked; a lack of isolation facilities for infectious patients; an inadequate sluice area; an insufficient number of handwash basins; inadequate cleaning hours, with cleaning occurring while patients were undergoing dialysis; and a small, cluttered servicing room that became too hot, meaning the back door to the car park was wedged open to allow ventilation, the article said.

Read the article.