Overcrowding, staff shortages, lack of cleaning materials, and inconsistent infection control practices are some of the contributing factors that could have increased the hospital-acquired infections in Gauteng last year.
According to Gauteng health MEC Nomantu Nkomo-Ralehoko's response to the DA at the legislature recently, 7,743 patients out of 217,490 got infections while in hospitals last year — a huge jump from the previous year's 2,034 infections.
Dr Angelique Coetzee from the Unity Forum of Family Practitioners said most public hospitals were under resourced and overcrowded, which makes them susceptible to infections. “The 7,743 hospital-acquired infections is really a significant number, and it points to systemic challenges that require urgent attention.
“The most common contributing factors in your public hospitals include overcrowding, staff shortages, stuff like aging infrastructure, inconsistent infection control practices, and the rising antibiotic resistance. Your ICU and high-care wards are particularly vulnerable due to the nature of invasive procedures and high patient acuity. Also, these infections not only increase patient suffering and length of stay, but also place, unfortunately, an additional strain on our already limited public health resources,” Coetzee explained.
The South African Medical Association (Sama) spokesperson, Vezi Silwanyana, pointed out that doctors working in the public sector had routinely raised concerns about the dire state of hygiene in the hospitals. “Many healthcare professionals have to work without access to essential infection prevention control (IPC) materials, or in environments where wards are cleaned irregularly due to overwhelmed cleaning staff.”
The most common contributing factors in your public hospitals include overcrowding, staff shortages, stuff like aging infrastructure, inconsistent infection control practices, and the rising antibiotic resistance.
— Dr Angelique Coetzee
She said in post-operative wards, delayed detection of early signs of infection, due to staff shortages or inadequate monitoring, can result in outbreaks affecting entire units, including vulnerable populations such as neonates.
Silwanyana said, in some cases, regular IPC monitoring procedures such as routine surface swabs or cleaning audits are not consistently carried out. Waste segregation is often not followed, further increasing cross-contamination risks.
Sama is urging the Gauteng health department to treat this situation with the urgency it demands.
According to Nkomo-Ralehoko's responses to DA spokesperson for health Jack Bloom, by far the worst hospital is Charlotte Maxeke Johannesburg Academic Hospital, where 1,473 out of 12,940 patients got nosocomial infections — meaning one in every 10 patients were infected.
At the Chris Hani Baragwanath Academic Hospital, there was 1,796 infections from 31,950 admissions.
Bloom said these new infections include antibiotic-resistant ones, which are difficult to treat and could be life-threatening. “These are known as nosocomial infections, which develop during a hospital stay when patients get an infection other than what they were admitted for. Nosocomial infections are more likely in the higher-level hospitals because they have more complex cases with long hospital stays, do more invasive procedures, and use more antibiotics.”
He said the department blamed staff shortages, overcrowding, inadequate hand hygiene facilities, broken equipment and frequent stock-outs of essential cleaning materials such as soaps and disposable paper towels. Linen shortages are also blamed as it forces patients to reuse bedding and pyjamas for long periods, and surgical patients are at extra risk due to inability to provide clean linen pre-and post-operatively.
Bloom further said he was concerned many patients were getting infections that can easily be avoided with basic improvements like decent cleaning and adequate linen.
Other hospitals with a concerning number of hospital-acquired infections include:
• Tembisa Hospital — 596 from 13,116 admissions
• Kalafong Hospital — 554 from 8,952 admissions
• Edenvale Hospital — 407 from 5,166 admissions
• Leratong Hospital — 365 from 1,026 admissions
• Pholosong Hospital — 249 from 5796 admissions
• Rahima Moosa Hospital — 217 from 4,320 admissions.
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