The Gauteng Health Department says an interim report revealed that “extreme overcrowding” played a major factor in the spreading of the antibiotic-resistant bacteria Klebsiella Pneumonia at the Thelle Mogoerane Hospital in Vosloorus. According to News24, a report by the National Institute for Communicable Diseases (NICD) found that due to the overcrowding, control measures were compromised. The NICD also found that 90 new-born babies were placed in a ward with a capacity of 61.
“The issue of overcrowding is of particular concern because all neonatal wards in the province were found to be overcrowded – on average 132% bed utilisation,” Minister of Health Aaron Motsoaledi is quoted in News24 as saying. Motsoaledi and Gauteng MEC for Health Gwen Ramokgopa visited the hospital on Sunday afternoon.
The NICD report further found that “low birth weight babies due to prematurity, driven by a multitude of social factors among which are teenage pregnancy, HIV and poor socio-economic conditions.”
In an attempt to curb the outbreak, the hospital grouped affected babies and delegated staff to look after them. Infection control was intensified and new baby admissions were kept in a separate area. Two babies died at the hospital, one in July and the second one in August when they contracted the bacterial infection.
Motsoaledi said in the News24 report that the outbreak was contained at the unit where babies were infected in the past. He said the Gauteng province needed six more new hospitals to deal with the overcrowding.
The only available facilities were the Nelson Mandela Children’s Hospital and Charlotte Maxeke Hospital. Motsoaledi said the unused space at the Nelson Mandela Children’s Hospital is expected to be used for the new-borns from Thelle Mogoerane Hospital.
“Premature babies are always vulnerable to infections and overcrowding exacerbates the situation. In addition, we are concerned about the design of the neonatal, antenatal, postnatal, labour ward and theatre.
“The passage from these wards to theatre passes through the neonatal ward adding to the risk and this is an undesirable situation,” he said.
A plan to transfer the patients is already in place, Motsoaledi said in the News24 report.
Motsoaledi and Ramokgopa said that 11 babies had contracted Klebsiella since 11 July and six of these babies had died. Motsoaledi said in a report in The Times that the hospital would work with the Nelson Mandela Children’s Hospital‚ which offers specialist paediatric care‚ in managing the Klebsiella outbreak.
“The decanting of these children to Nelson Mandela Hospital with Charlotte Maxeke Hospital will give the hospital a chance to scrub and decontaminate the neonatal wards‚” the minister said. Ramokgopa said the maternity ward would be decanted as well.
The report says according to the NICD, Klebsiella pneumoniae is a bacterium that is known to cause different types of healthcare-associated infections‚ such as pneumonia‚ meningitis‚ sepsis‚ wound or surgical site infections.
“Due to their increasing resistance to a class of antibiotics known as carbapenems‚ some strains of Klebsiella bacteria can cause infections which can no longer be treated by carbepenems.
“Persons who are at risk for infections with carbapenem-resistant organisms such as Klebsiella are those who have severe illness‚ surgical patients‚ patients who stay in hospital for prolonged periods‚ persons undergoing organ or stem cell transplantation‚ persons in intensive care and those who are on mechanical ventilation‚” said the NICD.