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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

Research into veld fires in grassland can now help with scientifically-grounded evidence
2015-04-10

While cattle and game farmers are rejoicing in the recent rains which large areas of the country received in the past growing season, an expert from the University of the Free State’s Department of Animal, Wildlife, and Grassland Sciences, says that much of the highly inflammable material now available could lead to large-scale veld fires this coming winter.

Prof Hennie Snyman, professor and  researcher in the Department of Animal, Wildlife, and Grassland Sciences, warns that cattle and game farmers should be aware, in good time, of this problem which is about to rear its head. He proposes that farmers must burn firebreaks as a precaution.

At present, Prof Snyman focuses his research on the impact of fire and burning on the functioning of the grassland ecosystem, especially in the drier grassland regions.

He says the impact of fire on the functioning of ecosystems in the ‘sour’ grassland areas of Southern Africa (which includes Kwazulu-Natal, Limpopo, Mpumalanga, the Eastern Cape, and the Harrismith environs) is already well established, but less information  is available for ‘sweet’ semi-arid grassland areas. According to Prof Snyman, there is no reason to burn grassland in this semi-arid area. Grazing by animals can be effectively used because of the high quality material without having to burn it off. In the sourer pasturage, fire may well form part of the functioning of the grassland ecosystem in view of the fact that a quality problem might develop after which the grass must rejuvenate by letting it burn.

Prof Snyman, who has already been busy with the research for ten years, says quantified data on the impact of fire on the soil and plants were not available previously for the semi-arid grassland areas. Fires start frequently because of lightning, carelessness, freak accidents, or damaged power lines, and farmers must be recompensed for this damage.

The shortage of proper research on the impact of fires on soil and plants has led to burnt areas not being withdrawn from grazing for long enough. The lack of information has also led to farmers, who have lost grazing to fires, not being compensated fairly or even being over-compensated.

“When above-and below-ground plant production, together with efficient water usage, is taken into account, burnt grassland requires at least two full growing seasons to recover completely.”       

Prof Snyman says farmers frequently make the mistake of allowing animals to graze on burnt grassland as soon as it begins to sprout, causing considerable damage to the plants.

“Plant roots are more sensitive to fire than the above-ground plant material. This is the reason why seasonal above-ground production losses from fire in the first growing season after the fire can amount to half of the unburnt veld. The ecosystem must first recover completely in order to be productive and sustainable again for the long term. The faster burnt veld is grazed again, the longer the ecosystem takes to recover completely, lengthening the problem with fodder shortages further.  

Prof Snyman feels that fire as a management tool in semi-arid grassland is questionable if there is no specific purpose for it, as it can increase ecological and financial risk management in the short term.

Prof Snyman says more research is needed to quantify the impact of runaway fires on both grassland plant productivity and soil properties in terms of different seasonal climatic variations.

“The current information may already serve as valuable guidelines regarding claims arising from unforeseen fires, which often amount to thousands of rand, and are sometimes based on unscientific evidence.”

Prof Snyman’s research findings have been used successfully as guidelines for compensation aspects in several court cases.

 

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