Wake up, South Africa! The antibiotic ‘horse’ has bolted
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.3 , 4
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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Source: SAMJ
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