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17 February 2025 | Story Andre Damons | Photo Supplied
Prof Carolina Pohl-Albertyn
Prof Carlien Pohl-Albertyn is the NRF SARChI Research Chair in Pathogenic Yeasts at the UFS.

A new study by researchers from the University of the Free State (UFS), the National Health Laboratory Service, and the University of Venda has confirmed for the first time that common brown locusts are carriers of pathogenic yeasts that can cause severe infections in humans – especially in people with compromised immune systems or who are seriously ill.

The study, ‘South African brown locusts, Locustana pardalina, hosts fluconazole resistant, Candidozyma (Candida) auris (Clade III)’, highlights for the first time the presence of the pathogenic (disease-producing) fungal yeast C. auris in the digestive tract of the locusts, and shows their potential in disseminating this emerging pathogen. The research started in April 2022, when 20 gregarious (swarming) adult locusts were collected during a large locust outbreak which occurred from September 2021 to May 2022 in the semi-arid Eastern Karoo region in the Eastern Cape. The study is still under peer review.

According to Prof Carlien Pohl-Albertyn, National Research Foundation (NRF) SARChI Research Chair in Pathogenic Yeasts, three C. auris strains were isolated from three different adult locusts, two of which also harboured strains of another potentially pathogenic yeast, Candida orthopsilosis. “The fact that we were able to isolate C. auris from 15% of the sampled locusts, using non-selective media and a non-restrictive temperature of 30°C, may indicate that C. auris is abundant in the locusts and that specific selective isolation is not mandatory,” Prof Pohl-Albertyn said.

“Interestingly, C. auris was isolated from the fore- and hindgut of the locusts. Isolation from the foregut, which is dedicated to food intake and storage, filtering and partial digestion, indicates that C. auris was probably obtained by the locusts via feeding activities. Isolation from the hindgut confirms that C. auris can survive the digestive processes in the midgut and is likely to be released back into the environment via faeces.”

Healthy humans are not at great risk

One of the C. auris strains was studied in more detail. This strain was not resistant to disinfectants but showed decreased susceptibility to the common antifungal drug fluconazole. This is a characteristic of this yeast species and thus not surprising. Most of the emerging pathogenic yeasts show this intrinsic resistance. This highlights the urgent need to discover and develop new antifungal drugs.

Prof Pohl-Albertyn, also a Professor of Microbiology in the UFS Department of Microbiology and Biochemistry, says, “Healthy humans are not at great risk for infection by this yeast and there is currently no proof that ingestion may be harmful to them. This is unfortunately not the case for people with compromised immune systems or who are seriously ill. However, few susceptible people come into direct contact with the locusts in South Africa.”

She added that there are treatment options available, using other antifungal drugs, but C. auris can become resistant to all the currently available antifungal drugs.

Importance of the study

“The fact that locusts are a food source for other animals, such as birds, could lead to eventual distribution of the yeast to people. In other countries, wild locusts are a food source for humans and there more direct transmission may be possible,” Prof Pohl-Albertyn said.

She explained that this study tries to answer questions regarding the natural hosts of this emerging pathogen and how it may facilitate the spread of the pathogen to the rest of the environment. The study is one part of the puzzle regarding how new pathogens may emerge from the environment and spread to people.

“One of the questions in the field of pathogenic yeasts is how C. auris was able to emerge as a pathogen in several different countries in a relatively short period. It is well known as a hospital-acquired pathogen, but it is not known where in the environment it occurs naturally, and which environmental factors may have shaped its evolution and ability to cause human infections. This has implications for the prevention of the spread of this specific yeast species, as well as our preparedness for new pathogenic yeasts that may be emerging from the environment.”

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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