Decades of poor medical and veterinary antibiotic prescribing and a lack of regard for the practice of infection prevention and control(IPC) in our hospitals have left South Africa, like the rest of the international community, on the brink of a return to an era of untreatable bacterial infection.
The recent emergence in South Africa of bacteria carrying the highly mobile New Delhi metallo-β-lactamase-1 (NDM-1) gene,1 which has been associated with rapid spread of carbapenem-resistant Enterobacteriaceae (CRE), and, for the first time in Africa, Klebsiella pneumoniae carbapenemases (KPCs),2 will have a profound effect on the lives of our patients and on the health service.
The acquisition of drug-resistant hospital-acquired infections (HAIs) increases morbidity, mortality and the cost of patient management to an already beleaguered health system by increasing the duration of hospital stay, often in expensive intensive care units (ICUs), and antibiotic prescribing costs.
Unlike the case of multidrug-resistant (MDR) and extensively drug-resistant tuberculosis, the situation we find ourselves in with MDR Gram-negative bacteria such as CRE cannot be blamed on poor patient compliance, or merely on the introduction of resistant strains from foreign climes. Rather, this is a home-grown problem, generated and perpetuated by doctors, nurses and allied healthcare workers in South Africa.
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(Health-E news service, July 2012)
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