Safer not to move new-born, despite klebsiella infection deaths

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Doctors say it is safer to keep 52 new born babies in the neonatal intensive care units and maternity wards at the Thelle Mogoerane Hospital in Vosloorus – where six babies died of drug-resistant klebsiella bacteria infection – than to move them elsewhere, reports The Times. The risk of moving sick babies is too high‚ they said.

An infection control expert at Wits Medical School‚ critical care professor Guy Richards‚ also said there would not be a hospital in South Africa that didn’t have the increasingly common antibiotic resistant klebsiella bacteria.

The report says overcrowded wards and under-staffing has been blamed for the deadly outbreak in the Thelle Mogoerane Hospital‚ which led to 11 infections and six baby deaths.

Gauteng Health Department’s head of hospital services‚ Dr Medupe Modisane‚ said: “There are two babies who have Klebsiella pneumonia currently at the hospital and are receiving necessary treatment.”

Health minister Aaron Motsoaledi was quoted in the report as saying earlier that the hospital’s maternity ward and neonatal ICU would be closed‚ cleaned and the babies moved elsewhere. He said: “A plan to transfer the patients is already in place.” But his spokespersonPopo Maja said that a medical committee who looked at the issue decided otherwise. Modisane explained: “After a careful consideration of risks versus benefits inherent in the process of moving babies‚ and also in keeping with evidence-based medicine‚ a decision was taken not to remove the babies.”

Richards said klebsiella pneumoniae bacteria was an extremely common organism‚ present in all hospitals and there was no way to get rid of it. “It is found throughout the world in increasing numbers. The klebsiella bacteria is present at Chris Hani Baragwanath Hospital and all the private hospitals to greater or lesser extent‚ and at Charlotte Maxeke Johannesburg Academic Hospital‚” he said.

According to the report, Richards added: “If all wards or ICUs that have a patient with a klebsiella infection had to close‚ (then) every hospital in the country would close.” He said the growing number of bacteria that are resistant to antibiotics “is a global emergency”.

“It is not just with klebsiella‚ but with the group of organisms that fall into the same class‚” he said‚ referring to bacteria treated by the same type of antibiotics that develop resistance. “There are some forms that are more resistant and some that are extremely resistant to antibiotics.” Infection control was critical to reduce transmission of the bug‚ he said.

“I am sure their (Thelle Mogoerane) infection control procedures were not adequate‚ but even if they were the organism cannot be eradicated and babies are especially susceptible to infection and they die easily.”

The report says Richards‚ a world leader in infection control‚ explained that good infection control meant washing hands between patients‚ ensuring stethoscopes and pens are washed between patients so they don’t spread germs‚ and making sure doctors wore disposable aprons. Hydrogen peroxide can also be sprayed to kill klebsiella pneumoniae‚ as well as other organisms.

SA Human Rights Commission spokesperson Buang Jones said in the report that it was in contact with the families who had lost babies to help them with a civil claim against the department. “We have offered to mediate between families and the department to reach a settlement.” This would prevent a drawn-out court battle‚ he said. Should their mediation offer be refused by the Gauteng Health Department‚ the commission will offer the mothers legal assistance for a court case‚ he said.

The report says that according to a Gauteng legislature reply by MEC Health Gwen Ramokgopa earlier this year, Gauteng Health Department has more than R21bn in medical negligence suits against it. This is nearly half its R46bn annual budget. A lot of the claims are related to injuries that babies and mothers suffer during labour‚ she said.
Ramokgopa also said the department had R6bn in unpaid debt.

The CEO of the Thelle Mogoerane Hospital‚ Nomonde Mqhayi-Mbambo‚ has been placed on special leave. The report says the Democratic Alliance’s (DA’s) Jack Bloom has highlighted her alleged mismanagement and severe staff shortages at the four-year-old hospital since 2015.

The Times report

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