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India rejects UK scientists' 'superbug' claim
CHENNAI: Scientists have tracked down a drug-resistant superbug that infects patients and causes multiple organ failure to Indian hospitals but doctors here see in it the germ of a move to damage the country's booming medical tourism industry. The 'superbug' resistant to almost all known antibiotics has been found in UK patients treated in Indian hospitals. Named after the Indian capital, it is a gene carried by bacteria that causes gastric problems, enters the blood stream and may cause multiple organ failure leading to death. "India also provides cosmetic surgery for Europeans and Americans, and it is likely the bacteria will spread worldwide," scientists reported in The Lancet Infectious Diseases Journal on Wednesday. While the study has the medical world turning its focus on infection control policies in Indian hospitals, the Indian Council of Medical Research has alleged a bias in the report and said it is an attempt to hurt medical tourism in the country that is taking away huge custom from hospitals in the West. "Such infections can flow in from any part of the world. It's unfair to say it originated from India," said ICMR director Dr VM Katoch. Katoch has reasons to fume, as the superbug NDM-1 (New Delhi metallo-beta-lactamase) is named after the national capital, where a Swedish patient was reportedly infected after undergoing a surgery in 2008. Since then there have been several cases reported in the UK and in 2009, the health protection agency in the UK issued an alert on the 'gram negative' bacterial infection that is resistant to even the most powerful and reserved class antibiotics called carbapenems. In a joint study led by Chennai-based Karthikeyan Kumarasamy, pursuing his PhD at University of Madras and UK-based Timothy Walsh from department of immunity, infection and biochemistry, department of medicine, Cardiff University researchers sought to examine whether NDM-1 producing bacteria was prevalent in South Asia and Britain. "We saw them in most of the hospitals in Chennai and Haryana. We estimate that the prevalence of this infection would be as high as 1.5%," Kumarasamy told TOI. "We found the superbug in 44 patients in Chennai, and 26 in Haryana, besides 37 in the UK and 73 in other places across India, Pakistan and Bangaladesh," he said. What makes the superbug more dangerous is its ability to jump across different bacterial species. So far, it has been found in two commonly seen bacteria, E coli and K pneumoniae. "We have found that the superbug has the potential to get copied and transferred between bacteria, allowing it to spread rapidly. If it spreads to an already hard-to-treat bacterial infection, it can be turn more dangerous," Kumarasamy said. Senior doctors working in infection control said India lacks policies on antibiotics, infection control and registries for hospital-acquired infections. By the ICMR director's own admission, India cannot scientifically fight back allegations of being the source of such
department of medical research." he said. in . Christian Medical College. We have seen at least 3% of people infected with this do not react to these reserved drugs. and. the two bacteria in which the new superbug has been found. as the country does not have a registry of such hospital-acquired infections. The article has drawn attention to the issue of AMR. agrees.The Times of India http://timesofindia.indiatimes." said Dr Dilip Mathai. "Two in every five patients admitted to hospitals acquire infections. "An article published in The Lancet on 11 August 2010 identified a new gene that enables some types of bacteria to be highly resistant to almost all antibiotics. The report has identified a new gene due to which some bacteria are resistant to almost every antibiotic . Public health experts say globalisation has allowed bacteria to spread rapidly across the world and India. who is also the secretary.E coli and K pneumoniae. should be geared for the challenge. ESBL enzymes are most commonly produced by two bacteria . There are neither rules for hospitals nor a registry to record hospital-acquired infections.superbugs. Vellore. increases the expenses and causes side-effects. This extends the patient's stay in the hospital. head of the department of internal medicine. "At present.India . We are now in the process of forming a cell that will activate a registry and issue guidelines for an integrated surveillance system. India has been seeing Extended Spectrum Beta-Lactamase (ESBL).com/india/Drug-resistant-superbug-traced-toIndia/articleshow/6295662. Katoch. It has endorsed a recent report in The Lancet Infectious Diseases study which stated that the super bug had evolved in India. Read more: Drug-resistant 'superbug' traced to India . we don't have any system in place.cms#ixzz0xLO1KW89 The World Health Organization (WHO) on Friday announced that the health governing bodies and governments across the globe should closely monitor the multi-drug resistant super bug that had surfaced in South Asia and has now spread to Britain. which are enzymes that have developed a resistance to antibiotics like penicillin. as a medical hub. "These were treated by a reserved class of antibiotics called carbapenems. For a long time." he said.
What is Superbug ? : UK scientists warn of worldwide spread of Super bug Antibiotic resistant organism Posted on Aug 11. Yet many of us don't know about it until it's too late. 4. 2. 2010 . this development requires monitoring and further study to understand the extent and modes of transmission. It urges governments to have strict surveillance in place for antimicrobial resistance. there should be strict adherence to infection prevention and control measures. which can survive various antibiotics that are the only cure for infectious diseases worldwide. 3. Super bug timebomb? It's Britain's deadliest super bug.particular. The WHO has urged countries to take immediate action against the spread of the bacteria." the statement says. Lastly. killing twice as many people as MRSA." it added in a statement. Legislation related to stopping the selling of antibiotics without prescription should be introduced and enforced legally. Health workers and the public ought to be educated about the appropriate use of antibiotics. including the use of hand -washing measures. Focus on four major areas The WHO recommends bodies to currently focus on four main areas: 1. and to define the most effective measures for control. Scientists in the East Midlands are at the forefront of research into C-difficile and are working on a cure. has raised awareness of infections caused by multi -drug resistant bacteria. Antibiotic use should be rational. particularly in healthcare facilities. "While multi-drug resistant bacteria are not new and will continue to appear.
The researchers said that since many Americans and Europeans travel to India and Pakistan for elective procedures like cosmetic surgery. consider whether patients have recently been treated abroad and send samples to HPA for testing. the resistant gene has also been detected in Australia.K. superbug is now calling as New Delhi metallo inappropriate In an article published online in the journal Lancet Infectious Diseases today on August 11.. the most common cause of urinary tract infections. The potential of NDM-1 to be a worldwide public health problem is great. Doctors say that the findings of the study will have a damaging effect on Indian medical tourism. Canada.´ Infections have already been passed from patient to patient in UK hospitals. Dr David Livermore. This Superbug is as much powerful that it is resistant to most Powerful antibiotics so UK/ British scientists passed a warning that it will appear worldwide. The spread of these multi-resistant bacteria merits very close monitoring. the Netherlands. 2010. Researchers already passing warning about this Super Bug as it will spreads more where the health system is low which is not having adequate medicines/ antibiotics.S. ³The nomenclature and the conclusions of the study are not appropriate. Experts say the nomenclature of the superbug ² New Delhi metallo-beta-lactamase 1 (NDM-1) ² is inappropriate as the bug was isolated from Chennai and Haryana.´ the authors wrote. The medical fraternity in the capital is miffed at the report on a superbug published in the Lancet Infectious Disease journal. It has been seen largely in E. it was likely the superbug would spread worldwide. and on DNA structures that can be easily copied and passed onto other types of bacteria. Super bug is a bacteria of Antibiotic resistant organism as its is identified in 37 people who returned to the UK after undergoing surgery in India or Pakistan. Aside from the U. called NDM-1. the U. in an . Though India plans to contest the finding of the study and present its side strongly at international forums. one of the researchers and who works for the UK¶s Health Protection Agency (HPA). ³Hospitals need to ensure they continue to provide good infection control to prevent any spread. and coordinated international surveillance is needed. doctors reported finding a new gene. said: ³The NDM-1 problem is likely to get progressively worse in the foreseeable future. allowing them to become resistant to nearly all known antibiotics. doctors say it¶s high time we take a serious look at hospital infections here and the irrational use of antibiotics. coli bacteria.1 . ³The potential for wider international spread and for NDM-1 to become endemic worldwide are clear and frightening.´ wrote Johann Pitout of the division of microbiology at the University of Calgary. and Sweden.UK scientists warn of worldwide spread of Superbug first let us know What is Superbug ?. The bug was not isolated in Delhi. India today described as ³totally irrational´ a report that a new superbug resistant to antibiotics originated from the country and strongly protested a British alert in this regard and the new enzyme being named as µNew Delhi Metallo. Canada. The gene alters bacteria. then how can they name it after the capital?´ Dr Sharman Singh of AIIMS asks. Researchers say the way to stop NDM-1 is to identify and isolate any patients who are infected.
´ Dr. It said Indian hospitals were safe as a number of such bacteria survived in nature and were reported from several other countries. to link it with the safety of surgery hospitals in India and citing isolated examples to show that India is not a safe place to visit due to the presence of such organism in Indian environment are wrong. The consequences will be serious if family doctors have to treat infections caused by these multi-resistant bacteria on a daily basis. Several authors had declared a conflict of interest in the publication of the study.accompanying commentary. Pitout called for international surveillance of the bacteria. Though not disputing the validity of the study. Katoch said correct reporting by the media should inform the people and set the matter right. particularly in countries that actively promote medical tourism. The study was funded by the European Union and two pharmaceutical companies ² Wellcome Trust and Wyeth ² that produce antibiotics for treatment of such cases. said here. Katoch said. the statement said.´ The conclusions and interpretations of the study were wrong. Katoch.M. Director-General.´ conclusion about superbug India rejects superbug linkage Aarti Dhar Share · Comment (6) · print · T+ T+ · T- India has reacted strongly to a study linking a multiple drug-resistant superbug detected in Britain to India and said the bacteria are not a public health threat. Dr. Indian Council of Medical Research. Admitting that such news reports were likely to dent the prospects of medical tourism in the country. an official statement by the Ministry of Health and Family Welfare said here on Thursday.´ V. he said the conclusions were ³unfair´ and ³scary. . The government also strongly objected to the naming of this enzyme as New Delhi metallo beta lactamase -1 (NDM-1) and refuted the conclusion that hospitals in India were not safe for treatment. ³Indian hospitals are world class and follow the best practices. scientifically invalid and aimed at creating a scare. The conclusions of the study are ³loaded with inference'' that the antibiotic-resistant organism possibly originated in India. ³While such organisms may be circulating more commonly in the world due to international travel.
In an article published online Wednesday in the journal Lancet Infectious Diseases. where the health system is much less likely to identify its presence or have adequate antibiotics to treat patients. doctors reported finding a new gene. it was likely the superbug would spread worldwide... and on DNA structures that can be easily copied and passed onto other types of bacteria. Aside from the U. The researchers said the superbug appeared to be already circulating widely in India." 22 superbug cases in just one hospital. "The potential of NDM-1 to be a worldwide public health problem is great. if available would potentially be more interesting and shocking than the human genome project data. allowing them to become resistant to nearly all known antibiotics. coli bacteria.Superbug on the prowl in India London: British scientists have found a superbug that is resistant to most antibiotics and are warning that it is widespread in India and could soon appear worldwide. the US and Sweden. which is . "The consequences will be serious if family doctors have to treat infections caused by these multi-resistant bacteria on a daily basis. This has happened within a year of the bacteria being isolated for the first time by European doctors in a Swedish patient who had travelled to New Delhi for an operation. in an accompanying commentary. Hinduja Hospital in Mahim isolated the super bacteria in 22 patients within a span of three months." wrote Johann Pitout of the division of microbiology at the University of Calgary. MUMBAI: Twenty-two patients in three months in a single hospital. The superbug has so far been identified in 37 people who returned to the UK after undergoing surgery in India or Pakistan. This statistic should serve as an answer to anyone who wants to understand why the NDM-1 (New Delhi metallobeta-lactamase-1) is creating ripples ² both within India and in the rest of the world. Canada. the Netherlands. the data from all the Indian hospitals. Canada. The researchers said that since many Americans and Europeans travel to India and Pakistan for elective procedures like cosmetic surgery." the authors wrote. and coordinated international surveillance is needed. It has been seen largely in E.K. "The spread of these multi-resistant bacteria merits very close monitoring. Pitout called for international surveillance of the bacteria. the resistant gene has also been detected in Australia. the most common cause of urinary tract infections.. particularly in countries that actively promote medical tourism. called NDM-1. The gene alters bacteria. "If a single hospital can isolate such a significant number of bacteria with a new resistance gene in a short period of time.
" wrote Dr Abdul Ghafar K. Chennai. Q: Can it be treated? Other treatment options are available to fight these infections but they present major challenges for clinicians and will often demand combinations of antibiotics are used." Read more: 22 superbug cases in just one hospital. . Ultimately. Q: Why is this a problem? NDM-1 (or more precisely the DNA code for this enzyme) can easily now jump from one strain of bacteria to another. in an editorial in JAPI. This is concerning because these antibiotics are some of the most powerful ones." he said. it could produce dangerous infections that would spread rapidly from person to person and be almost impossible to treat. is the world leader in antibiotic resistance.com/india/22-superbug-cases-in-just-onehospital/articleshow/6313069. Q: What is NDM-1? New Delhi metallo-ß-lactamase-1. in no other country antibiotics been misused to such an extent.considered as a discovery more important than the moon landing itself. or NDM-1 for short. used on hard-to-treat infections that evade other drugs.. But Dr Abhay Chaudhary. In his JAPI article in March. consultant in infectious diseases at Apollo Hospital.cms#ixzz0xLcaqdkK Experts have warned that a new type of drug-resistant superbug is emerging in UK hospitals. India. "Some of the extrapolations in the study which appeared in the study that appeared in the Lancet Infectious Diseases journal are inappropriate..indiatimes. A senior microbiologist from Mumbai who doesn't want to be named believes that mutations in bugs ² to create superbugs ² can only occur in countries like India where antibiotics are routinely overused or abused. is a gene carried by bacteria that makes the strain resistant to carbapenem antibiotics. there are few things most Indian doctors agree upon: widespread abuse and overuse of antibiotics and the subsequent resistance in the community. Dr Ghafur wrote. While the truth about NDM-1's origins remain debatable. . Experts are worried that it may end up in another bacterium which is already resistant to many other antibiotics. president of the Indian Association of Medical Microbiologists believes that the European conclusion that it originated from the Indian subcontinent is not substantiated.India .The Times of India http://timesofindia. "Our country. one of the leading Indian research journals.
Q: Are there new antibiotics that could help? While there is a great deal of investment in research to find new antibiotics. And they say we now need new drugs to treat resistant strains. But. Australia and the Netherlands. This is because the bacteria that carry NDM-1 are Gram-negative. NDM-1 is already widespread in the Indian subcontinent and has also reached countries including the US. experts say that most of the drugs currently in the pipeline will be useless for treating NDM-1 positive patients. Normal infection control measures.Scientists have identified some strains that have been resistant to all known antibiotics. The infections have ranged from mild to severe . Q: Can its spread be stopped? Experts say the way to stop it is through surveillance.and some have been fatal. Canada. The Department of Health said it was investigating ways of encouraging the development of new antibiotics with European colleagues. Q: What will happen now? . Q: How would I know if I had it? So far. such as disinfecting hospital equipment and doctors and nurses washing their hands with antibacterial soap. many of the UK cases have been in patients who have recently travelled to India or Pakistan for medical treatment and who caught the infection while there.coli and another that can invade the lungs called Klebsiella pneumonia. Scientists believe it has the potential to become a global public health issue. The Health Protection Agency says "multi-resistant Gram-negative bacteria pose a notable public health risk and it remains important that the pharmaceutical industry continues to work towards developing new treatment options". Both can lead to urinary tract infections and blood poisoning. rapid identification and isolation of any hospital patients who are infected. Infections such as these would usually be spotted in patients by medics. can stop the spread. while most of the work is being carried out for Gram-positive bugs like MRSA. some of these patients have passed the infection on to others in UK hospitals upon their return. Two types of bacteria have been host to NDM-1: the gut bacterium E.
In the meantime.The government said HPA would continue to monitor the situation and would regularly review the data and the need for further action. . and consider whether patients have recently been treated abroad and send samples to HPA for testing if necessary. hospitals should ensure they continue to provide good infection control to prevent any spread.
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