The Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses (CHARM) was established in April 2017. CHARM hosts two national reference laboratories and is supported by an epidemiology section. The centre was designated as a World Health Organization (WHO) Collaborating Centre for AMR (WHO SOA-43) in June 2017.
Healthcare-associated infections (HAIs) are among the commonest complications of hospital admission, are costly for the patient and the overall healthcare system, and may lead to patient deaths. This is an important new focus area for the centre. Antimicrobial resistance (AMR) is estimated to be associated with over 700 000 deaths every year, a number which could rise as high as 10 million in 2050.
AMR is a major focus area of the South African Department of Health and the NICD. CHARM works on AMR in bacterial and fungal pathogens causing human infections in healthcare facilities and in the community, spanning the public- and private-health sectors. The centre is supporting the “One Health” programme including surveillance for AMR in humans and animals.
Fungal diseases (mycoses) are responsible for an estimated 1.5 to 2 million deaths annually, including nearly half of those dying of AIDS and many of those with sepsis. Over the last seven years, the centre has led the scaling up of a cryptococcal antigen screening and pre-emptive treatment intervention, nested within the South African HIV treatment programme. The centre is now involved in evaluating the effectiveness of this national intervention to reduce mortality through a US National Institutes of Health R01-funded grant.
The national stock culture collection (NSCC) was established in April 2004 and is housed within CHARM. The NSCC provides a quality-controlled and reliable source of reference bacterial, fungal and mycobacterial strains to the National Health Laboratory Service laboratories.