TWO patients who contracted the superbug vancomycin-resistant enterococci during an outbreak at Coffs Harbour Hospital have died, but the North Coast Area Health Service said the bacteria did not cause their deaths.

A health service spokesman said one was a palliative care patient and the other had multiple organ failure. One died at Coffs Harbour Hospital while the other died after being transferred to Royal North Shore Hospital.

"They did not die as a result of VRE," the spokeswoman said. The hospital reported three cases of the superbug on Friday but this week 22 cases were confirmed.

Ten patients remain at Coffs Harbour Hospital, one is in Bellinger River District Hospital and the remaining patients have been discharged free of infection.

Despite the outbreak, which has stopped elective surgery at the hospital this week, Coffs Harbour Hospital's general manager, Margaret Bennett, said there was no indication of a hygiene problem as the hospital regularly conducted audits of handwashing.

"Without any doubt the leading thing that can be done to reduce the risk of transfer of VRE is adequate hand hygiene and observing contact precautions," she said.

David Hutton, the director of clinical governance at the hospital, will review the outbreak. John Kramer, the chairman of the Mid North Coast Division of General Practice, blamed the outbreak on under-resourcing of the state hospital system. "The fact that [VRE] is there at all is a cause for concern," he said.