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09 October 2020 | Story Leonie Bolleurs | Photo Supplied
Disinfectants
Once they have an understanding of the development of disinfectant resistance, the Veterinary Biotechnology group will be able to make recommendations to hospitals and the agricultural industry on how to prevent the development of these resistant microorganisms.

SARS-CoV-2, an enveloped coronavirus, is susceptible to most disinfectants. Therefore, the majority of disinfectants, including those containing 70% ethanol, should be able to kill the virus fairly quickly.

Nevertheless, it was found that some bacteria are highly resistant to several commercially available disinfectants. These bacteria are currently still quite rare, and the work of the Veterinary Biotechnology group at the University of the Free State (UFS) aims to prevent the development of more highly resistant bacteria.

The research group in the Department of Microbial, Biochemical and Food Biotechnology is working on disinfectant resistance. They recently published an article, ‘Molecular basis of bacterial disinfectant resistance’.

Group members include: Prof Robert Bragg, professor in the department; Dr Charlotte Boucher, research associate; Samantha Mc Carlie, master’s student and laboratory manager; master’s students, Twyne Skein and Gunther Staats; honours students, Carlo Visser, Bernadette Belter, Boudine van der Walt, Jacky Huang, and Mart-Louise van Zyl; and an NRF intern, Gloria Kankam.

According to Mc Carlie, the work being done on disinfectant resistance is largely attributable to the major issues currently experienced with antibiotic resistance.

“Antibiotic resistance is becoming one of the biggest life-threatening challenges of our time – even overshadowing the current COVID-19 pandemic – as multidrug-resistant infections are becoming increasingly difficult to treat. Bacterial infections that are present in hospitals and agriculture are becoming unresponsive to many of the antibiotics currently in use, marking the start of a post-antibiotic era.”

It is predicted that by 2050, antimicrobial resistance could lead to as many deaths as cancer causes today and could account for between 10 million and 50 million deaths per year.

Lack of proper biosecurity

Mc Carlie says the resistance to antibiotics is spreading rapidly due to a lack of proper biosecurity measures in the food and agricultural industry as well as in the hospital environment, even if the COVID-19 pandemic has gone a long way towards increasing the awareness of hospital staff to the importance of good biosecurity. Millions of rands are lost every year due to multidrug-resistant infections in the dairy and poultry industries of South Africa, and superbugs are present in almost every major hospital in the country.

“Currently, the best viable protection we have against bacteria is biosecurity and disinfectants. Biosecurity relies heavily on the use of disinfectants to control bacterial growth. This makes it only more troubling that disinfectant resistance is emerging at an alarming rate.”

She believes it is important to understand the mechanisms of resistance in order to combat resistance to disinfectants. “Once the mechanisms are identified, possible solutions can be investigated.”

The research group is currently monitoring disinfectant resistance, looking at which microorganisms are resistant to which disinfectants. They take environmental samples and test the levels of disinfectant resistance to observe the development and spread thereof.

Once they have an understanding of the development of disinfectant resistance, the Veterinary Biotechnology group will be able to make recommendations to hospitals and the agricultural industry on how to prevent the development of these resistant microorganisms.

“As we learn more about these highly resistant isolates, it will direct day-to-day treatment of multidrug-resistant infections and hopefully aid in the fight against antibiotic and disinfectant resistance,” says Mc Carlie.

The dangers of over-prescribing

“Resistance to antimicrobials such as antibiotics and disinfectants is a natural occurrence. We did not invent antibiotics, we discovered them, and so bacterial resistance has been around for as long as antibiotics have – as a survival strategy.”

“However, the widespread use of antimicrobials creates selective pressure for those microorganisms that are resistant to the antimicrobial being used. Over-prescribing and improper use of antibiotics has led to widespread antibiotic resistance. We expect the same trend to be seen with disinfectant resistance in the near future,” says Mc Carlie.

She urges the public to take note that disease-causing microorganisms can become resistant to antibiotics and disinfectants if they are not used correctly. A course of antibiotics should always be taken at the correct time and until the last dose. In the same way, disinfectants should be used at the recommended level and not diluted below that level.

These resistant organisms are causing major issues in the agricultural and medical industries, but this effect has not been seen in households yet. As long as disinfectants are used correctly, most will be able to kill the novel coronavirus.

There is, however, a need to establish tests on the efficacy of the massive number of ‘hand sanitisers’ that are now suddenly available.

According to Prof Bragg, existing disinfectants and hand sanitisers have been specifically tested against SARS-CoV-2 and have been found to be effective. He says the undergraduate students in the department will be evaluating a wide range of different hand sanitisers as part of their practical training.

Mc Carlie adds that the excessive use of poor-quality disinfectants as hand sanitisers can result in bacteria developing resistance to these disinfectants. “It is therefore very important that reliable high-quality disinfectants are used as hand sanitisers during this COVID-19 crisis, otherwise we will be replacing one crisis with a potentially even bigger crisis.”

Mc Carlie believes there is a need to start looking at alternatives to control bacterial growth. “Disinfectants are currently the only viable option, and if these microorganisms become resistant to disinfectants as well, we will have nowhere else to turn,” she says.

News Archive

UFS researcher selected as emerging voice
2016-11-03

Description: Andre Janse van Rensburg  Tags: Andre Janse van Rensburg

André Janse van Rensburg, researcher at the
Centre for Health Systems Research and Development
at the University of the Free State, will be spending
almost three weeks in Vancouver, Canada. He will be
attending the Emerging Voices for Global Health programme
and Global Symposium on Health Systems Research.
Photo: Jóhann Thormählen

His research on the implementation of the Integrated School Health Programme (ISHP) in rural South Africa led to André Janse van Rensburg being selected to become part of the Emerging Voices for Global Health (EV4GH) group.

It is a collection of young, promising health policy and systems researchers, decision-makers and other health system professionals. A total of 222 applications from 50 countries were received for this programme, from 3-19 November 2016 in Vancouver, Canada.

The EV4GH is linked to the fourth Global Symposium on Health Systems Research (HSR2016), from 14-18 November 2016. It also taking place in Vancouver and Janse van Rensburg will be taking part, thanks to his research on the ISHP in the Maluti-a-Phofung area. He is a researcher at the Centre for Health Systems Research & Development (CHSR&D) at the University of the Free State (UFS).

The theme of the HSR2016 is Resilient and Responsive Health Systems for a Changing World. It is organised every two years by Health Systems Global to bring together roleplayers involved in health systems and policy research and practice.

Janse van Rensburg also part of Health Systems Global network
The EV4GH goals relate to the strengthening of global health systems and policies, particularly from the Global South (low-to-middle income countries with chronic health system challenges). The initiative involves workshops, presentations, and interactive discussions related to global health problems and solutions.

As an EV4GH alumni, Janse van Rensburg will become part of the Health Systems Global network. Partnering institutions include public health institutes from China, India, South Africa, Belgium, and the UK.

“The EV4GH is for young, promising health
policy and systems researchers, decision-makers
and other health system professionals.”

Research aims to explore implementation of schools health programme
In 2012, the ISHP was introduced in South Africa. This policy forms part of the government's Primary Health Care Re-engineering Programme and is designed to offer a comprehensive and integrated package of health services to all pupils across all educational phases.

Janse van Rensburg, along with Dr Asta Rau, Director of the CHSR&D, aimed to explore and describe implementation of the ISHP. The goals were to assess the capacity and resources available for implementation, identify barriers that hamper implementation, detect enabling factors and successful aspects of implementation and disseminate best practices in, and barriers to, ISPH implementation with recommendations to policymakers, managers and practitioners.

“A lot of people were saying they don’t
have enough resources to adequately
implement the policy as it is supposed to
be implemented.”

Findings of project in Maluti-a-Phofung area
Janse van Rensburg said the ISHP had various strengths. “People were impressed with the integrated nature of the policy and the way people collaborated across disciplines and departments. The school team were found to work very well with the schools and gel well with the educators and principles.”

He said the main weakness of the implementation was resources. “A lot of people were saying they don’t have enough resources to adequately implement the policy as it is supposed to be implemented.

“Another drawback is the referral, because once you identify a problem with a child, the child needs to be referred to a hospital or clinic.” He means once a child gets referred, there is no way of knowing whether the child has been helped and in many cases there is no specialist at the hospital.

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