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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

UFS enhances Geography in schools
2015-05-11

The Green Box

The Department of Geography at the University of the Free State (UFS), in association with the Society of South African Geographers (SSAG), is doing their part in providing curriculum support to schools. Dr Ruth Massey and Anneri Pretorius are the project managers of Green Box, an initiative to advance Geography in schools.

The Green Box supports the intermediate phase of schooling (Grades 4, 5, 6). According to Dr Massey, the worksheets and activities provided in the Green Box are aligned with the Curriculum and Assessment Policy Statements (CAPS) and the new curriculum. “These worksheets are divided into three themes: map work, physical Geography, and human Geography.

“Map work includes symbols and keys, grid references, and compass work whilst physical Geography focuses on water and waste, biodiversity and conservation, and weather and climate issues. The human Geography theme has a focus on population, rural and urban development, migration, food and farming, and transport and trade,” she said.

Each worksheet has a fact sheet section which teaches theory on the specific topic (linked to the curriculum), an activity section (all resources needed for these activities are provided in the box), and a ‘take it home’ section for further learning and practice at home.

The Green Box is a recycled plastic crate that comprises worksheets, training materials, visual aids, and resources for teaching, learning, and active engagement in Geography classes.

Also included in the box are a felt story board and characters (that link with the worksheet activities), the ‘Climate Change memory game’ (which enhances learner’s memory capabilities and teaches various climate change facts) and the ‘Sustainable Development puzzle game’ (which teaches about the social, biophysical, economic, and political elements of Sustainable Development, and how they overlap).

“All items in the box are locally sourced, robust, and without copyright,” said Dr Massey.

The project is focusing on 10 under-resourced schools in the Bloemfontein area. Each school has received three boxes (one for each grade of the Intermediate Phase).

Dr Massey said: “This box is to be shared among the teachers. The Green Boxes were distributed at a training and information workshop held at three central schools in the various districts. These workshops introduced the teachers to the contents of their box, and provided basic training on the worksheets and the activities provided.”

“The schools will be joined up with ‘Box Buddies’ at more resourced schools in Bloemfontein. These buddy schools will assist in support and in replenishing the box’s stationery, etc. when needed.”

“Monitoring and evaluation will take place for six months after the boxes have been distributed. This will ensure support to, and the sustainability of, the project.” The Green Box project was made possible through a grant from the Society of South African Geographers (SSAG).

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