Annual Report March 2006 – March 2007
Hospital Epidemiology and Infection Control
Head: Prof AG Duse
Staff Compliment
Academic Staff
Lecturer: Dr Else Marais. Qualifications: Phd. Appointed 05/2002. Associate Lecturer: Ms
Catherine Thorrold. Qualifications: MSc
Administrative staff
Laboratory Clerk: Mrs Gwen Rosenberg
Support Laboratory Staff
Medical Technologist: Mr Vusi Dlamini. Qualifications: MT. Appointed 31/05/2003. Lab
Supervisor: Ms Naseema Aithma. Qualifications: MT. Appointed 06/1989. Biotechnologist: Ms
Refilwe Diale. Appointed 01/07/2005. Senior Technician: Mrs Branca Fernandes. Qualifications:
Medical Technician.Appointed November 1994. Medical Technologist: Tshepo Leolo.
Qualifications: MT. Appointed 01/07/2004-Left December 2006.
Laboratory Manager: Mrs Janet Loakes. Qualifications:MT. Appointed 15/02/1996. Chief
Medical Technologist: Ms Zandile Mjindi. Qualifications: MT. Appointed 01/11/2005.
Biotechnologist: Mrs Faith Mkhwanazi. Qualifications: Dip Biotechnology. Appointed
01/02/2003. Biotechnologist: Mrs Oliva Mosoma Qualifications: Dip Biotechnology. Appointed
04/2002. Biotechnologist: Mrs Dorcas Phetla. Qualifications: Dip B Biotechnology. Appointed
01/02/2004.Lab Controller: Mr Robert Stewart. Qualifications: MT HND. Appointed 02/1983.
Senior Scientist: Dr Else Marais. Appointed 01/05/2002.Student biotechnologist: Mr Andrew
Khoza. Appointed 1/02/2006(Contract ended Feb 2007). Student biotechnologist: Mr Malesela
Mthenjane. Appointed 1/02/2007. Student biotechnologist: Ms Khumo Legoale. Appointed
1/02/2007. Senior Scientist: Dr Mrudula Patel. Appointed 1/02/2006(Contract ended Feb 2007).
Intern Scientist: Mr Wilhelm Oosthuysen. Resigned 31/03/2007.
Central Research Areas
The role of the Infection Control molecular laboratory is to perform basic and applied research on
clinical pathogens, to perform limited molecular diagnostics, to fingerprint organisms involved in
outbreaks and to contribute to the teaching of postgraduate Science students, GEMP students
and microbiology registrars. The research interests of the laboratory are wide-ranging and
includes studies on bacteria involved in hospital and community related infections (methicillin
resistant Staphylococcus aureus) yeast involved in HIV/AIDS related opportunistic infections
(Candida albicans), and clinically important mycobacteria.
Research Projects
Molecular and epidemiological characterization of multidrug-resistant Mycobacterium
tuberculosis isolates in Johannesburg, South Africa
Student: Charmaine Mlambo
This PhD project has been underway for 2.5 years, and should end in mid-2008. Cosupervisors are Professors Robin Warren and Tommie Victor of the DST/NRF Centre of
Excellence, MRC Centre for Molecular and Cell Biology, University of Stellenbosch,
Tygerberg. Funding has been received from the Medical Research Council (MRC), NHLS
Research Trust and the Faculty of Health Sciences Research Committee (FRC).
All multi-drug resistant Mycobacterium tuberculosis strains (ie. resistant to isoniazid and
rifampicin) from 2005 to date have been collected from the NHLS TB diagnostic laboratory for
investigation. These are being fingerprinted by spoligotyping and restriction fragment length
polymorphism (RFLP) analysis to determine the genotypic population structure of MDR-TB
strains in the area. This project has also led to the study of extensively resistant TB strains (XDRTB), with spoligotyping done on strains received at the diagnostic laboratory.
Molecular Characterisation Of Clinical And Environmental Isolates Of Mycobacterium
Kansasii In South Africa
Student: Geoffrey Kwenda
The PhD project was started in 2005, and should be finished towards the beginning of
2009. Professor Gavin Churchyard of the Aurum Institute and Anglo-Gold mines are
collaborators in this study. Funding has been received from the MRC, the Mines Health
and Safety Committee and FRC.
Mycobacterium kansasii is an organism that results in a TB-like disease, and is often associated
with immunocompromised persons, or those who have had lung disease previously. The gold
mines in South Africa have been found to have relatively high rates of M. kansasii disease,
however the reservoir and genotypic diversity of the strains is not known. The aim of this project
is to determine whether mining and residential water is the source of the bacterium, to assess the
diversity of clinical and environmental strains, and to determine virulence properties of the subtypes associated with disease.
Completed projects
Effects of anti-HIV nucleoside analog drugs on the virulence of clinically relevant Candida
species
Student: Bintou Ahidjo Ahmadou
This project was completed beginning of 2006, and the MSc student graduated at the end
of 2006. Funding was obtained from the MRC and the FRC. Professor Rob Veale,
University of the Witwatersrand was a collaborator.
This project was undertaken to investigate whether the use of nucleoside analog drugs as antiHIV therapy would impact on the properties of the opportunistic pathogen, Candida albicans.
Buccal swabs were collected from anti-retroviral naïve patients at the HIV clinic at the
Johannesburg hospital. C. albicans cultured from these swabs were exposed to various
nucleoside inhibitors in vitro, and virulence characteristics such as proliferation, adherence,
biofilm formation and antifungal resistance measured. This project was completed beginning
of 2006, and the MSc student graduated at the end of 2006. Funding was obtained from the
MRC and the FRC. Professor Rob Veale, University of the Witwatersrand was a
collaborator.
MRSA
Student: Wilhelm Oosthuysen
This project was completed in the beginning of 2007, and the thesis has been submitted
for examination. The MRC and FRC funded this project.
In order in investigation the genotypic population structure of methicillin resistant S. aureus, 340
isolates were collected from private and NHLS laboratories around the country. These isolates
were chararacterized by mecA PCR, spa typing, macro-restriction analysis, and PCR for the
Panton-Valentin toxin.
Future plans
In addition to the current projects, a MSc project aiming to identify the etiological agents of
community acquired pneumonia by real-time PCR has been initiated. A newly acquired real-time
thermal cycler will be used together with fluorescent probe technologies to detect the presence of
16 bacteria and viral pathogens. It is anticipated that the experience gained in the application of
these methods will lead to the development of a microbiology PCR diagnostic section that can
perform routine tests for the NHLS.
Research Publications in Local (South African) Journals/Books
Title Of Article/Book Chapter: Clusters of Klebsiella pneumoniae infection in neonatal intensive
care units in Gauteng. Authors: E Marais; A Moodley; N Govender; R Kularatne; J Thomas and
A Duse. Publication Date: 2006.Journal: SAMJ. Volume: 9. Page: 813.
Research Publications in International Journals/Books
Title Of Article/Book Chapter: Efflux pump activity in floroquinolone and tetracycline resistant
Salmonella and E. coli implicated in reduced susceptibility to household antimicrobial cleaning
agents. Authors: CA Thorrold; OME Letsoal; AG Duse and E Marais. Publication Date: 2007.
Journal: Int J Food Microbiol. Volume 113. Pages: 315-320.
Diagnostic Services
Culture of Catheter Tips: 1244 Specimens Processed; Culture of peritoneal dialysis bags:
177 Specimens Processed; Examination of Vaginal Secretions for bacterial vaginosis and
Trichomonas vaginalis: 9021 Specimens Processed; Culture of infusates: 13745 Specimens
Processed; Culture of Surface Swabs: 5971 Specimens Processed; Validation Cultures: 778
Specimens Processed; Media Fills: 1181 Specimens Processed; Culture of food samples:
1004 Specimens Processes; Culture of milk samples: 367 Specimems Processed; Culture of
water for cholera: 232 Specimems Processed; Culture of water for portability: 2585
Specimen Processed; Culture of water for Legionella: 3332 Specimens Processed; Culture of
pathogens from other non-human samples: 455 Specimens Processed; MIC tests (broth
dilution and E-test): 1264 Specimens Processed; Synergy tests: 38 Specimens Processed;
Bordetella pertussis PCR: 22 Specimens Processed.
Poster Presentation
Charmaine Mlambo
Characterisation of Multi-drug resistant (MDR) of Mycobacterium tuberculosis isolates from
Johannesburg, South Africa. University of the Witwatersrand Faculty of Health Sciences
Research Day, 23 August 2006.
Oral presentation of results: Characterisation of Multi-drug resistant (MDR) of Mycobacterium
tuberculosis isolates from Johannesburg, South Africa. Molecular and Cell Biology Group, WITS
Medical School, 5 October 2006
Oral presentations
Wilhelm Oosthuysen
Molecular characterisation of methicillin-resistant Staphylococcus aureus in South Africa, at
University of the Witwatersrand Faculty of Health Sciences Research Day, 23 August 2006.
Molecular and Cell Biology Group, WITS Medical School, 5 October 2006
External Teaching Activities
Company: NHLS
Teaching Topic: Management of a Microbiology Laboratory
Company: NHLS
Teaching Topic: Revision course for student medical Technologists
Courses obtained from External Institutions
Staff Attended: Janet Loakes
Training Course Attended: Advanced Disalab training course and Microscan super user
training.
Staff Attended: Rob Stewart
Training Course Attended: Advanced Disalab training course.
Staff Attended: Tshepo Leolo
Training Course Attended: Advanced Antibiotic susceptibility testing.
Staff Attended: Naseema Aithma
Training Course Attended: Microscan super user training.
Staff Attended: Zandile Mjindi
Training Course Attended: Antibiotic susceptibility testing.
Staff Attended: Dorcas Phetla
Training Course Attended: Antibiotic susceptibility testing and Basic bacteriology workshop.
Staff Attended: Faith Mkhwanazi:
Training Course Attended: First aid course and Basic bacteriology workshop.
Staff Attended: Olivia Mosoma
Training Course Attended: Antibiotic susceptibility testing.