Southern African Journal of Infectious Diseases最新文献

{"title":"Pandem-ethics: Post-mortem reflection on healthcare worker ethics during the time of coronavirus disease 2019 pandemonium.","authors":"Liesel H Bösenberg, Veronica Ueckermann","doi":"10.4102/sajid.v41i1.798","DOIUrl":"10.4102/sajid.v41i1.798","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic created ethical and legal tension for healthcare workers (HCWs), who had to balance professional obligations with personal safety, family responsibilities and resource limitations. The concept of 'duty to care' re-emerged as a contested ethical construct during periods of workforce vulnerability and healthcare scarcity.</p><p><strong>Aim: </strong>This article examines the ethical and juridical dimensions of HCWs' duty of care during the COVID-19 pandemic, focusing on the South African constitutional framework, occupational health obligations and professional regulation, and whether this duty is absolute or subject to reasonable limits.</p><p><strong>Setting: </strong>The discussion is situated within South Africa's healthcare response to the COVID-19 pandemic and the ethical expectations placed on clinicians in high-risk and emergency settings.</p><p><strong>Method: </strong>A narrative review was conducted using PubMed, Google Scholar and grey literature. Sources included peer-reviewed ethical analyses, legal frameworks and policy documents. A thematic synthesis analysed moral theory, legal duty, reciprocity and public health ethics.</p><p><strong>Results: </strong>The duty of care is substantial but not limited. South African law supports coexistence of rights rather than hierarchical obligations. Ethical analysis shows that proportionality, reciprocity and reasonable risk mitigation conditions professional duty. Employers must ensure adequate protection, transparent triage systems and psychosocial support. Failure to ensure reciprocity risks moral coercion and workforce attrition. The pandemic highlighted the need to define the thresholds where professional obligation yields to legitimate self-protection.</p><p><strong>Conclusion: </strong>The duty of care should be reconceptualised as a conditional, relational obligation grounded in constitutional values and public health ethics, with clear risk thresholds and enforceable reciprocal protections.</p><p><strong>Contribution: </strong>This article contributes to post-COVID-19 pandemic ethics literature by clarifying between the duty to treat, care and serve, proposing a Decatrad of operational reforms, reframing the duties as conditional, reciprocal and legally bounded.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"798"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting of notifiable medical conditions among emergency department doctors in Gauteng.","authors":"Kate I Smith, Patricia M Saffy, Margaret P Fitchett","doi":"10.4102/sajid.v41i1.832","DOIUrl":"10.4102/sajid.v41i1.832","url":null,"abstract":"<p><strong>Background: </strong>Surveillance of notifiable medical conditions (NMCs) is vital for a prompt, appropriate response. In South Africa, studies have demonstrated under-reporting of NMCs despite it being mandatory. Emergency departments (EDs) are often the first point of contact for patients with NMCs.</p><p><strong>Objectives: </strong>This study aimed to assess ED clinicians' knowledge, attitudes, and practices regarding the reporting of conditions that are relevant to the ED, and the use of the new mobile application for reporting.</p><p><strong>Method: </strong>A cross-sectional survey was conducted between November 2024 and April 2025, including 99 doctors at three public hospital EDs in Gauteng. The study assessed knowledge, attitudes and practices regarding NMCs and the use of the recently launched National Institute for Communicable Diseases (NICD) mobile application.</p><p><strong>Results: </strong>The overall mean knowledge score was 61% (standard deviation [s.d.] 11.2). Knowledge accuracy of category 1 NMCs (mean 72%) exceeded that of category 2 NMCs (mean 56%; <i>p</i> < 0.001). Although 95% of respondents were aware that reporting NMCs is mandatory, 49% acknowledged under-reporting. Barriers to reporting included high workload, forgetfulness, and difficulty in locating the paper notification booklet. While 81% of respondents knew about the NICD mobile application, 68% had used it, and 17% had received formal training. Preference for the application versus the paper-based system was expressed by 78% of respondents.</p><p><strong>Conclusion: </strong>Under-reporting persists primarily because of high workload. A significant knowledge gap exists, particularly concerning category 2 NMCs. While the mobile application was preferred, a lack of formal training hinders its adoption. Staff training, feedback and reminders would improve the timely notification of these conditions.</p><p><strong>Contribution: </strong>This study identifies under-reporting of NMCs and offers recommendations to strengthen the disease surveillance system and encourages the use of digital technology for reporting.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"832"},"PeriodicalIF":1.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare case of <i>Colletotrichum coccodes</i> causing chronic fungal keratitis in an elderly female: Diagnostic delay and antifungal resistance.","authors":"Karabo Mathosa","doi":"10.4102/sajid.v41i1.809","DOIUrl":"10.4102/sajid.v41i1.809","url":null,"abstract":"<p><p>Fungal keratitis is a vision-threatening corneal infection, most commonly caused by <i>Fusarium</i> and Aspergillus. We report a rare case of keratitis caused by <i>Colletotrichum coccodes</i> in an elderly patient with a chronic corneal ulcer refractory to fluconazole. Initial corneal scrapings were negative, delaying diagnosis. Repeat deep biopsy, fungal culture and pan-fungal polymerase chain reaction confirmed <i>C. coccodes</i>. The patient was managed with intensive topical amphotericin B and voriconazole, alongside a glycerol-preserved corneal patch graft to provide tectonic support.</p><p><strong>Contribution: </strong>This case highlights the diagnostic and therapeutic challenges of chronic fungal keratitis and illustrates the limitations of empiric antifungal therapy in the absence of culture-based guidance.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"809"},"PeriodicalIF":1.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical hepatitis B surface antigen escape mutations in an HIV-positive patient in South Africa.","authors":"Menzi B Nkosi, Marije van Schalkwyk, Tongai G Maponga, Yoliswa Z Chili, Devon Muir, Paula R Delport, Susan S Hugo, Zahiera Ismail, Jantjie Taljaard, Gert U van Zyl, Wolfgang Preiser","doi":"10.4102/sajid.v41i1.818","DOIUrl":"10.4102/sajid.v41i1.818","url":null,"abstract":"<p><p>A 44-year-old woman with human immunodeficiency virus (HIV), chronic kidney disease and chronic diarrhoea presented with worsening gastrointestinal symptoms and renal impairment. Despite reported adherence, she had HIV viraemia and atypical hepatitis B serology (absence of hepatitis B core antibody and co-existence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody) with high hepatitis B virus DNA. Whole genome sequencing of hepatitis B virus was performed using Oxford Nanopore Technologies sequencing on the Oxford Nanopore Technologies GridION (ONT, Oxford, United Kingdom). Genotype A infection with HBsAg immune escape mutations D144G/G145E was identified, without drug-resistance mutations.</p><p><strong>Contribution: </strong>Findings are most consistent with hepatitis B virus reactivation following prior natural infection and subsequent loss of immune control.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"818"},"PeriodicalIF":1.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe mpox in an immunocompromised, non-traveller South African male.","authors":"Preethi A John, Omphemetse Matikane, Matilda Mphahlele, Barbara B Makumbi","doi":"10.4102/sajid.v41i1.814","DOIUrl":"10.4102/sajid.v41i1.814","url":null,"abstract":"<p><p>Mpox is a zoonotic orthopoxvirus infection historically linked to being in endemic regions, travel and close physical contact, including within men who have sex with men (MSM) communities. We report a case of severe mpox in a heterosexual man with advanced human immunodeficiency virus (HIV) disease and no travel history to endemic areas. The patient developed extensive cutaneous disease and transmitted mpox to household contacts, illustrating non-sexual transmission. Management included supportive care and tecovirimat under Section 21 authorisation (a regulatory mechanism in South Africa permitting access to an unregistered medicine) with good clinical response.</p><p><strong>Contribution: </strong>This case highlights the changing epidemiology of mpox, the risk of severe disease in immunocompromised patients, household and non-sexual transmission. We also emphasise the importance of early diagnosis, infection control and antiviral therapy when indicated.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"814"},"PeriodicalIF":1.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective review of leprosy diagnosed histopathologically from skin biopsy specimens in central South Africa.","authors":"Ruben B van Wyk, Danita L le Grange, Liska Budding","doi":"10.4102/sajid.v41i1.802","DOIUrl":"10.4102/sajid.v41i1.802","url":null,"abstract":"<p><strong>Background: </strong>Leprosy, caused by <i>Mycobacterium leprae</i>, remains a condition designated by the World Health Organization (WHO) as a neglected tropical disease, despite formal eradication in South Africa. Histopathology is pivotal in the diagnosis of leprosy, particularly in resource-limited settings.</p><p><strong>Objectives: </strong>The study aimed to describe the histopathological spectrum and clinical features of leprosy diagnosed on skin biopsies over a 10-year period in central South Africa.</p><p><strong>Method: </strong>A retrospective review was performed of histologically confirmed leprosy cases diagnosed from January 2015 to December 2024. Data were extracted from laboratory records and analysed descriptively.</p><p><strong>Results: </strong>Twelve patients were included (mean age 43.9 years, range 25 years - 64 years; male-to-female ratio 1.4:1). Most resided in the Mangaung Metropolitan area, with additional cases dispersed across the Free State and Northern Cape provinces. Punch biopsies predominated, most commonly obtained from the head and/or neck and the upper limbs. World Health Organization classification identified 62% of cases as multibacillary (MB). Ridley-Jopling (RJ) subtypes were mostly lepromatous leprosy (38%), while 23% of cases were indeterminate. Repeat biopsies revealed treatment response or persistent disease. Comorbidities included HIV and tuberculosis.</p><p><strong>Conclusion: </strong>Leprosy persists as a sporadic but geographically widespread disease in central South Africa, often presenting in advanced MB forms. Histopathology remains essential for diagnosis and subtyping. Strengthening clinician awareness, biopsy protocols, and treatment continuity is critical to achieving the goal of zero leprosy of the WHO.</p><p><strong>Contribution: </strong>The findings confirm that, although rare, leprosy still prevails in central South Africa. Therefore, clinicians and anatomical pathologists should consider a diagnosis of leprosy in patients with atypical or non-resolving signs and symptoms.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"802"},"PeriodicalIF":1.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B immunity and response to booster vaccination in South African students following childhood immunisation.","authors":"Dineo Monaheng, Pakiso Makhoahle, Sabeehah Vawda, Molefi D Morobadi, Dewald Steyn, Lynette van der Merwe, Gina Joubert, Dominique Goedhals","doi":"10.4102/sajid.v41i1.803","DOIUrl":"10.4102/sajid.v41i1.803","url":null,"abstract":"<p><strong>Background: </strong>Despite the introduction of hepatitis B virus (HBV) vaccination into the South African Expanded Programme on Immunization in 1995, HBV remains an important occupational risk to healthcare workers and students. Data regarding the duration and level of HBV immunity following childhood vaccination and response to booster vaccination are required to guide vaccination policies.</p><p><strong>Objectives: </strong>The study aimed to investigate pre- and post-vaccination immunity to hepatitis B in healthcare students born after implementation of infant immunisation.</p><p><strong>Method: </strong>Healthcare students were recruited from the Central University of Technology and the University of the Free State in Bloemfontein, South Africa. Hepatitis B surface antibody (HBsAb) levels were determined at baseline, month one and month seven, while booster vaccines were administered at 0 month, 1 month and 6 months. Hepatitis B total core antibody (HBcAb) was also tested at baseline. A total of 122 students were enrolled into the study from approximately 320 eligible students. Two participants did not return following the baseline visit, and one additional participant did not return for the final sampling visit.</p><p><strong>Results: </strong>At baseline, only 43% (<i>n</i> = 52/122) of participants had HBsAb levels which are considered to provide adequate protective immunity. Following a single booster, 92% (<i>n</i> = 111/120) of healthcare students had protective HBsAb levels, which increased to 100% (<i>n</i> = 119/119) following three vaccine doses. No significant differences were observed when HBsAb results were grouped by race or sex. Only one case of previously resolved HBV was identified.</p><p><strong>Conclusion: </strong>The study confirmed persistence of immunological memory in most healthcare students following childhood vaccination, as evidenced by anamnestic responses to a single dose of HBV vaccine.</p><p><strong>Contribution: </strong>Laboratory confirmation of adequate responses is essential to identify those requiring further vaccination and ensure protection in the event of HBV exposure.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"803"},"PeriodicalIF":1.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporaneous varicella and zoster or disseminated zoster? A diagnostic challenge in an HIV-positive child.","authors":"Wendy Batyi, Tshepile Tlali, Preethi John, Matilda Mphahlele","doi":"10.4102/sajid.v41i1.824","DOIUrl":"10.4102/sajid.v41i1.824","url":null,"abstract":"<p><p>Primary infection with Varicella-Zoster virus causes varicella (chickenpox). Thereafter, following reactivation after a period of latency, it can cause zoster (shingles). Simultaneous occurrence of varicella and zoster is rare, particularly in children.</p><p><strong>Contribution: </strong>We describe an 11-year-old girl, HIV-positive, but not receiving antiretrovirals, who presented with contemporaneous varicella and zoster, with the possibility of disseminated zoster also considered.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"824"},"PeriodicalIF":1.2,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, pattern of disease and antimicrobial susceptibility of <i>Candidozyma auris</i> in the greater Pretoria region from 2021 to 2024.","authors":"Abdullah Moola, Marko G Thom, Jonah M Finlay, Roxanne Rule, Mohamed Said","doi":"10.4102/sajid.v41i1.817","DOIUrl":"10.4102/sajid.v41i1.817","url":null,"abstract":"<p><strong>Background: </strong><i>Candidozyma auris</i> has emerged as a nosocomial pathogen in South Africa, characterised by multidrug resistance and environmental persistence.</p><p><strong>Objectives: </strong>This study aimed to describe the prevalence, disease patterns, and antifungal susceptibility patterns of <i>C. auris</i> isolates recovered from public-sector healthcare facilities in the greater Pretoria region from 2021 to 2024.</p><p><strong>Method: </strong>A retrospective laboratory-based surveillance study was conducted using data from the National Health Laboratory Service Tshwane Academic Division laboratory. Isolates were classified as invasive or non-invasive based on specimen source. Temporal trends in antifungal minimum inhibitory concentrations (MICs) were analysed using interval-censored regression.</p><p><strong>Results: </strong>A total of 592 <i>C. auris</i> isolates were identified. Blood cultures were the most frequent specimen source overall, comprising 237 isolates (40.03%). Intravascular catheter tip isolates predominated in 2023 and 2024, with 48 and 72 isolates, respectively. The proportion of invasive isolates declined from 56.8% to 40.8% over the study period. Among tested isolates, fluconazole resistance exceeded 99%. Resistance to amphotericin B and echinocandins was uncommon, with eight total isolates identified. Decreasing MIC trends were observed for amphotericin B (β = -0.059 per year; <i>p</i> = 0.012) and micafungin (β = -0.081 per year; <i>p</i> = 0.026).</p><p><strong>Conclusion: </strong><i>Candidozyma auris</i> remains established in the public-sector within the greater Pretoria region. There is a shift from invasive bloodstream infections towards non-invasive, device-associated isolates. Fluconazole resistance remained high while amphotericin B and echinocandins retained good <i>in vitro</i> activity.</p><p><strong>Contribution: </strong>This study contributes to the knowledge of <i>C. auris</i> in the greater Pretoria region, providing insight into epidemiology and antifungal susceptibility.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"817"},"PeriodicalIF":1.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with <i>Klebsiella pneumoniae</i> colonisation in adults hospitalised in Johannesburg, South Africa.","authors":"Denasha L Reddy, Ziyaad Dangor, Lyle Murray, Jacob M Tsitsi, Jeremy S Nel, Trusha Nana, Jeannette Wadula, Rispah Chomba, Sinenhlanhla Ndzabandzaba, Vicky L Baillie, Courtney P Olwagen, Shabir A Madhi","doi":"10.4102/sajid.v41i1.804","DOIUrl":"10.4102/sajid.v41i1.804","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data on gastrointestinal colonisation with <i>Klebsiella pneumoniae</i> (KPn) in African adults, although it is a known risk factor for developing KPn invasive disease (KPn-ID).</p><p><strong>Objectives: </strong>We investigated the risk factors for KPn gastrointestinal colonisation among a cohort of hospitalised adults without KPn-ID in South Africa, and described their clinical outcomes.</p><p><strong>Method: </strong>A cohort of hospitalised adults without KPn-ID was enrolled between 15 May 2023 to 14 May 2024 across three hospitals in Johannesburg, South Africa. Study participants had rectal swab cultures performed once, at enrolment, to determine the presence or absence of KPn gastrointestinal colonisation, and were followed up until in-hospital death or discharge.</p><p><strong>Results: </strong>Among the cohort of hospitalised adults without KPn-ID (<i>n</i> = 651), the rate of KPn gastrointestinal colonisation was 34.4% (224/651). Risk factors for KPn colonisation were peptic ulcer disease (adjusted odds ratio [aOR] 7.75; 95% confidence interval [CI]: 1.34-44.78), a central venous catheter (aOR 3.07; 95% CI: 1.00-9.40), a presumed healthcare-associated infection (pHAI) (aOR 3.13; 95% CI: 1.06-9.28), and length of stay more than seven days prior to enrolment (aOR 1.84; 95% CI: 1.23-2.75). There was no difference in in-hospital case fatality risk (CFR) between participants with (3.1%; 7/224) and without (3.0%; 13/427, <i>p</i> = 0.955) KPn colonisation.</p><p><strong>Conclusion: </strong>KPn gastrointestinal colonisation rates among hospitalised adults without KPn-ID were higher than that of high-income settings and also varied between study sites. Length of hospital admission prior to swabbing and pHAI were associated with KPn colonisation, suggesting that infection prevention control measures play a significant role in KPn colonisation.</p><p><strong>Contribution: </strong>Large prospective cohort studies and community surveillance studies are required in settings such as ours to further investigate KPn colonisation dynamics and explore preventive strategies against KPn-ID.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"41 1","pages":"804"},"PeriodicalIF":1.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}