The superbug NDM-1, what is the truth behind

Researchers said on Wednesday they had found a new gene called New Delhi metallo-beta-lactamase, or NDM-1, in patients in South Asia and in Britain.

U.S. health officials said on Wednesday there had been three cases so far in the United States -- all from patients who received recent medical care in India, a country where people often travel in search of affordable healthcare.

NDM-1 makes bacteria highly resistant to almost all antibiotics, including the most powerful class called carbapenems. Experts say there are no new drugs on the horizon to tackle it.

"It's a specific mechanism. A gene that confers a type of resistance (to antibiotics)," Dr. Alexander Kallen of the U.S. Centers for Disease Control and Prevention in Atlanta said in a telephone interview.

With more people traveling to find less costly medical treatments, particularly for procedures such as cosmetic surgery, Timothy Walsh, who led the study, said he feared the new superbug could soon spread across the globe.

"At a global level, this is a real concern," Walsh, from Britain's Cardiff University, said in telephone interview.

"Because of medical tourism and international travel in general, resistance to these types of bacteria has the potential to spread around the world very, very quickly. And there is nothing in the (drug development) pipeline to tackle it."

Almost as soon as the first antibiotic penicillin was introduced in the 1940s, bacteria began to develop resistance to its effects, prompting researchers to develop many new generations of antibiotics.

But their overuse and misuse have helped fuel the rise of drug-resistant "superbug" infections like methicillin-resistant Staphyloccus aureus, or MRSA.

MEDICAL TOURISM

In a study published in The Lancet Infectious Diseases journal on Wednesday, Walsh's team found NDM-1 was becoming more common in Bangladesh, India, and Pakistan and was also imported back to Britain in patients returning after treatment.

"India also provides cosmetic surgery for other Europeans and Americans, and it is likely NDM-1 will spread worldwide," the scientists wrote in the study.

Walsh and his international team collected bacteria samples from hospital patients in two places in India, Chennai and Haryana, and from patients referred to Britain's national reference laboratory from 2007 to 2009.

They found 44 NDM-1-positive bacteria in Chennai, 26 in Haryana, 37 in Britain, and 73 in other sites in Bangladesh, India and Pakistan. Several of the British NDM-1 positive patients had traveled recently to India or Pakistan for hospital treatment, including cosmetic surgery, they said.

NDM-1-producing bacteria are resistant to many antibiotics including carbapenems, the scientists said, a class of the drugs reserved for emergency use and to treat infections caused by other multi-resistant bugs like MRSA and C-Difficile.

Kallen of the CDC said the United States considered the infection a "very high priority," but said carbapenem resistance was not new in the United States. "The thing that is new is this particular mechanism," he said.

Experts cited two drugs that can stand up to carbapenem-resistant infections -- colistin, an older antibiotic that has some toxic side effects, and Pfizer's Tygacil.

For many years, antibiotic research has been a "Cinderella" sector of the pharmaceuticals industry, reflecting a mismatch between the scientific difficulty of finding treatments and the modest sales such products are likely to generate, since new drugs are typically saved only for the sickest patients.

But the increasing threat from superbugs is encouraging a rethink at the few large drugmakers still hunting for new antibiotics, including Pfizer, Merck, AstraZeneca, GlaxoSmithKline and Novartis.

Anders Ekblom, global head of medicines development at AstraZeneca, whose Merrem antibiotic was the leading carbapenem, said he saw "great value" in investing in new antibiotics.

"We've long recognized the growing need for new antibiotics, he said. "Bacteria are continually developing resistance to our arsenal of antibiotics and NDM-1 is just the latest example."

(Additional reporting by Julie Steenhuysen in Chicago; Editing by Myra MacDonald and Peter Cooney

So what is the truth.

I dont understand why the gene had to be named New Delhi metallo-beta-lactamase, or NDM-1 . As per the figures quoted in the article the positive cases were found in Chennai, britain, bangladesh, pakistan. So how did New Delhi slip in 😕 unless someone deliberately wanted to wrongly implicate India as being the origin of that gene , Delhi being the capital it would immediately get associated with India. Drug resistance is developing the world over and India cannot be singled out. Cases of MRSA are common in USA and UK too ! When H1Ni1 virus was discovered as the cause of swine flu i mexico it did not get named as Mexico Virus, nor did HIV get named as Zimbabwe virus so why name the gene as NDM-1 ? Clearly a case of vested interests as India is emerging as the new hub of Medical tourism.

Excellet remarks angie 4 u. Very well said.

Originally posted by: Indradhanush

So what is the truth.

This is true tha t there is misuse of antibiotics of higher order in India.

There are no clear cut guidelines regarding what to use when.......

What is the answer; Strict regulatory body on antibiotics.
Clear cut protocols in place, abiding must be necessary to retain licence,

There are guidelines regarding using antibiotics. Ideally a sensitivity test must be performed before prescribing them. But self prescription is common. Over-the-counter antibiotics are easily available without a prescription. People do not take the full course of antibiotics as prescribed but stop medication midway as soon as they get some relief from their ailment. These are some causes that contribute to developing drug resistance, which is a serious problem. Discovery of new drugs cannot keep pace with such resistance.

Originally posted by: angie.4u

There are guidelines regarding using antibiotics. Ideally a sensitivity test must be performed before prescribing them. But self prescription is common. Over-the-counter antibiotics are easily available without a prescription. People do not take the full course of antibiotics as prescribed but stop medication midway as soon as they get some relief from their ailment. These are some causes that contribute to developing drug resistance, which is a serious problem. Discovery of new drugs cannot keep pace with such resistance.

Linking superbug to India irrational: Govt

[quote]NEW DELHI: India described as "totally irrational" British scientists linking a new superbug resistant to antibiotics to this country and said it was responding to an alert issued by Britain in this regard.

V M Katoch, Secretary of Health Research, told media that the government would soon draft a reply to this after a meeting of the National Centre for Disease Control (NCDC), a nodal agency under the Health Ministry.

"When you link it to something to our anti-biotics policy, say India specific, say it is dangerous to get operated in India then you will get more infections, that is totally irrational," he said.

Katoch said the Health ministry will examine the issue in detail but it was "unfortunate that this new bug, which is an environmental thing, has been attached to a particular country which is India in this case".

"I am surprised," he said, adding that, "this (the bug) is present in nature. It is a random event and cannot be transmitted".

Katoch said that he was surprised that a research paper linked it with India as they should know it was a biological phenomenon.

The issue also figured in the Rajya Sabha where members suspected the hands of multinational pharmaceutical and hospital companies behind the claims.

"When India is emerging as a medical tourism destination, this type of news is unfortunate and may be a sinister design of multinational companies" to defame the Indian medical sector, S S Ahluwalia (BJP) said.

Demanding a response from the government, he said some foreign tourists after returning from India reported some infection and attributed it to Indian hospitals. "It may not be true," he said.

Ahluwalia, who was supported by Jayanti Natarajan (Congress), said there should be a system of maintaining a registry for patients suffering from infectious diseases.

Natarajan said reports of superbug, attributable to India, is a "wrong propaganda against the country".

According to a paper published in scientific journal 'Lancet', the new superbug, which is said to be resistant even to most powerful antibiotics, has entered UK hospitals and is travelling with patients who had gone to countries like India and Pakistan for surgical treatments.

Bacteria that make an enzyme called NDM-1 or New Delhi-Metallo-1, have travelled back with NHS patients who went abroad to countries like India and Pakistan for treatments such as cosmetic surgery, it said.

Although there have only been about 50 cases identified in the UK so far, scientists fear it will go global. NDM-1 can exist inside different bacteria, like Ecoli, and it makes them resistant to one of the most powerful groups of antibiotics-carbapenems.[/quote]



http://economictimes.indiatimes.com/articleshow/6299597.cms

Its a tussle between Man and the bug . Man discovers ever stronger drugs to tackle the bug. Bug keeps finding ways to overcome and survive those. Who will emerge the winner ? Any guesses?

Originally posted by: angie.4u

Its a tussle between Man and the bug . Man discovers ever stronger drugs to tackle the bug. Bug keeps finding ways to overcome and survive those. Who will emerge the winner ? Any guesses?

Survival of the fittest.

(natural selection)

I'd add humans who naturally fight bugs without dependence on drugs have higher chances of survival and adapting to super-bugs.

Current humans can be divide as naturally selected and strong vs. Unnaturally modified to appear strong. Considering we are the only species that sustains and protects the weak and ill of our species, in the long run - humans will be extinguished by nature.