Infection controls in place for superbug
Johannesburg - Additional infection control measures have been put in place at the Life Glynnwood Hospital in Benoni where two people with an antibiotic resistant infection died, the National Institute for Communicable Diseases (NICD) said on Monday.
"In response to the outbreak, additional infection control measures to reduce [the] spread of these organisms within the hospital have been instituted, and a monitoring programme for patients has been set up to detect any new infections or colonisation...," the NICD said in a statement.
"Two of the patients have died; both had advanced disease due to underlying chronic illness and it is likely that these co-morbidities played a major role in their demise," the NICD said.
In a separate statement, posted on the hospital's website, Dr Steve Taylor, medical director for Life Healthcare said by October 14 nine patients had been confirmed as being either carriers or infected with New Delhi metallo-b-lactamase - which produces an enzyme NDM-1 which makes it extremely antibiotic resistant.
Previously most patients infected with NDM-1 producing bacteria could be traced back to people who had recently visited India or received medical treatment there, the hospital explained.
However, the ability of NDM-1 bacterial resistance to spread rapidly means that secondary infections unrelated to travel to the Indian sub-continent have begun to surface around the world.
NDM-1 bacterial infections can occur in any healthcare facility worldwide and in South Africa, and have been identified in both private and public sector hospitals in the UK, US, Australia, Japan and Kenya, Taylor said.
In most cases, the NDM-1 producing bacteria lived within the gastro-intestinal tract of a person without causing harm.
Months without knowing
People could live for months without even knowing they were carriers of these bacteria and would not present with any symptoms.
However, when human host immune systems become compromised, or when gut colonising NDM-1 producing bacteria spread to the bloodstream or urinary tract, or when they are spread from an infected source to a new patient, potentially serious infections could occur, the hospital said.
All patients admitted to the hospital's intensive care unit and high care unit would be screened, and doctors would review cases where patients had been on antibiotics for longer than five days.
The NICD said that most of the patients had underlying conditions that would place them at greater risk of acquiring these organisms, and had been hospitalised for an extended period.
The NICD said the NDM-1 enzyme made bacteria resistant to a broad range of "beta-lactam" antibiotics, used to treat antibiotic-resistant infections.
This group included antibiotics such as the penicillins and cephalosporins.
Specific laboratory tests were required to identify these strains, and these tests were available in some laboratories in South Africa.
The NICD was setting up a monitoring programme for the public sector as well as a referral diagnostic service.
A number of laboratories in the private sector had the capacity for diagnosis, and were responsible for the diagnosis in the current cluster of patients.
Not all patients who harboured these bacteria were ill, but some had systemic infections and required definitive antibiotic treatment.
"Infection control measures and prudent antibiotic usage are overall critical factors in reducing the ongoing emergence of antibiotic resistance worldwide," the NICD said.