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09 November 2023 | Story André Damons | Photo SUPPLIED
UFS experts give presentations on hospital-acquired infections at Africa Health
From left (bottom) Samantha Mc Carlie, Prof Robert Bragg and Caroline Bilen. (Back) Hugo La Reserve (from PMB Health and Safety) and Dr Noor Zakhura (from Free State Department of Health) at the Africa Health Exhibition.

It was recently discovered that bacteria are capable of growing inside bottles of disinfectants, hand sanitisers and antiseptics. These cleaning products, which are actively used in South African hospitals, are doing more harm than good by contaminating the environment they are designed to clean. Upon testing, some of these contaminated bottles harbouring harmful microorganisms were still actively in use in hospitals and instead of killing microorganisms, the contaminated cleaning solutions were spreading pathogens throughout the hospital with their use. 

This is according to Samantha Mc Carlie from the Department of Microbiology and Biochemistry at the University of the Free State (UFS). She, with her promotor, Prof Robert Bragg, were part of a workshop at the Africa Health Exhibition – the biggest gathering of health care professionals in South Africa and Africa. This was held at Gallagher Estate, Midrand, from 17 to 19 October 2023. 

Increasing mortalities in health-care setting

In a workshop titled: “Developing and sustaining safe health-care environments”, they were part of the main presenting panel, together with Caroline Bilen from the Compass Health Consultancy in Dubai 

Prof Bragg, whose main research is in disease-control, first in the agricultural industry, and now human health, started off the session by highlighting the problems with the increasing mortalities in the health-care setting. He presented data indicating that in the not too distant future, deaths from hospital-acquired infections would be the leading cause of human deaths. “This problem is rapidly growing as most of the pathogens which people contract while in hospital are now resistant to antibiotics, making them very difficult to treat,” he explained.

He used an analogy from San Tzu from the book The Art of War to explain why humankind is losing the war against the microbes. “San Tzu stated that if you know yourself and know your enemy, you will be victorious in every battle. On the other hand, if you do not know yourself or the enemy, you will be defeated in every battle. He pointed out that we do not know the enemy and we do know ourselves (or rather the weapons we have to defeat the enemy) and for this reason we are being defeated,” according to Prof Bragg. 

He continued: “We know the names of the different pathogens causing diseases, but do we really understand them? The answer to that must be ‘no’. A typical example is people are using ethanol-based or chlorine-based products to disinfect and then they wonder why there are increasing problems with Clostridioides difficile infections. If we knew the enemy, we would know that this bacterium producers endospores  and chlorine and ethanol-based disinfectants do not inactivate bacterial endospores, and so will not kill this bacterium,” said Prof Bragg. 

He stated that a major concern for hospitals is that they are currently unaware of whether the disinfectants they are using are effective against the pathogens in their hospital. It is assumed that their cleaning products are working but no testing is being done.

Bacterial resistance to disinfectants

Mc Carlie, in her presentation, highlighted the development of bacterial resistance to disinfectants and why this is important in the health-care setting. She pointed out that the standards for the registration of disinfectant products is based on the use of reference strains of bacteria.

“Bacteria found in hospital environments often exhibit significantly greater resistance to disinfectant compounds compared to the standard strains used for product testing. The presence of these resistant bacteria can result in microbial growth and contamination within containers of disinfectants, hand sanitisers, and antiseptics intended for hospital cleaning purposes. Instead of effectively eliminating microorganisms, these contaminated products inadvertently spread these resilient bacteria throughout the hospital environment, contributing to overall contamination,” said Mc Carlie.

She also discussed the consequences of using incorrectly diluted disinfectant products at concentrations that will not be effective against resilient hospital pathogens. 

Prof Bragg finished the session with a discussion on the solutions to the current problem and highlighted the need for a paradigm shift in medicine. “The current paradigm, since the discovery of antibiotics, has been treatment. As we are entering into a post-antibiotic era, this paradigm of treatment needs to change to one of ‘prevention’. The old saying ‘Prevention is better than cure’ has never been more true.”

He concluded by discussing various options which could be used when focus is placed on biosecurity for the prevention of hospital-acquired infection; including the installation of UV lights, monitoring of the laundry process, correct disinfecting of surfaces, using products with proven efficacy against the pathogens isolated from the different health-care setting and finally, the use of antimicrobial bedside privacy curtains.

The workshop ended with a panel discussion on biosecurity and the efforts needed to reduce the ever-increasing numbers of hospital-acquired infections. It is hoped that the message of this workshop will have a significant impact on the reduction of hospital acquired infections. 

Click to view documentProf Bragg's presentation.

Click to view documentMc Carlie's presentation.

News Archive

Inaugural lecture: Prof André Pelser
2004-06-04

Tendencies and changes in the South African population structure in future decades.

Within the next five years South Africa will for the first time in the past century enter a period where the death rate will exceed the birth rate, largely due to the impact of HIV / AIDS.

According to sociologist Prof André Pelser, sociologist at the of the University of the Free State’s (UFS) Department of Sociology, the death rate exceeding the birthrate is only one of three demographic trends which will fundamentally change South Africa’s population structure in the following decades.

He was speaking at the UFS in Bloemfontein during his inaugural lecture as professor this week.

Prof Pelser said that according to some models the South African population will decrease within the next five decades by between 10 and 26 percent.

A second important trend which will impact on the population structure is the progressive ageing of the population.

He said the group above 65 years is the only age category in the South African population which will witness sharp increases in the next few decades.

In the next 50 years, the group younger than 15 years will reflect a decrease of 39% and those older than 65 years in South Africa will increase by approximately 110% in the next two decades.

“The systematic “greying” of the South African population will create the same economic and welfare issues as those with which governments in some more developed countries are already grappling,” said Prof Pelser.

A third trend affecting the South African population structure is the constant decrease in life expectancy.

Life expectancy at birth for the total population is projected to decrease from approximately 62 years at the beginning of the 1990’s to 43 years in 2015-2020, with sharp differences between the various population groups.

These tendencies and changes to the South African population structure have serious implications, he said.

For example, he said, the reduction in life expectancy could compromise national development objectives.

“It is estimated that more than a quarter of the economically active population will be infected with HIV by 2006,” said Prof Pelser.

The increase in the population, in age category 65, will place a financial burden on government and the economically active sector.

“Especially worrying is the fact that ever-increasing proportions of the state budget will be allocated to health and welfare services and this at the expense of other priorities like education, infrastructure, criminal justice system and trade and industry, to name but a few,” he said

“A comprehensive and integrated strategy is thus vitally important in addressing the overarching issues caused by changes in the population structure,” said Prof Pelser.

 

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