Mumbai docs reported superbugs months before Lancet study

Mumbai: Researchers in a Mumbai hospital had
reported presence of a multi-drug resistant superbug in an
article published in an Indian medical journal, months before the Lancet study that has caused an outrage in the country`s medical fraternity and drawn criticism from the government.

A team of researchers from Department of Medicine at P D Hinduja National Hospital and Medical Research Centre -- Payal Deshpande, Camilla Rodrigues, Anjali Shetty, Farhad Kapadia, Ashit Hedge and Rajeev Soman -- had in March this year warned about the superbug in the Journal of the Association of Physicians of India (JAPI).

The Lancet article, however, did not cite this paper in
its issue and quoted only the editorial which appeared in

Hinduja researchers had come to the conclusion after
noticing 22 instances of New Delhi Metallo-lactamase-1 (NDM-1)
in 24 patients between August and November last year.

"This high number in a relatively short span is a
worrisome trend that compromises the treatment options with
carbapenems (a type of antibiotics used against multi-drug
resistant infections)," the article in JAPI said.

According to medical experts, superbugs or any other
microbes are present everywhere and are not specific to any
city, country or religion.

"Microbes develop resistance because of indiscriminate
use of antibiotics. Every hospital should have a rational
antibiotic or anti-microbial policy in place. Use of
antibiotics should be gradual and based on proper culture and
sensitivity tests so that such resistant strains do not
develop in future," a senior surgeon at Hinduja hospital said.

Shashank Joshi, eminent endocrinologist and editor of
JAPI, said since the 15th century microbes are known to be
present globally and it is time for the clinicians and
microbiologists to collaborate to implement a rational
antibiotic policy appropriately because what is grown
(microbes) in petri-dish may not be the same in human body.

Scientific theory behind superbugs and drug resistance is
fine, but it is preposterous and objectionable to blame New
Delhi or India for that, he said.

"Microbes cannot be named after a city or a country and
it is fundamentally wrong to name a microbe as New Delhi
metallo-lactamase-1 (NDM-1). We should have objected last year
when the British scientists gave the nomenclature," he said.

"Methicillin-resistant Staphylococcus aureus (MRSA), a
bacterium responsible for several difficult-to-treat
infections in humans, was discovered in the UK, but it was
not named after Kettering, UK," he said criticising the
tendency to blame any country for emergence of superbugs.

A study conducted by Dr Jean Louis Vincent and colleagues
of Erasme University Hospital in Brussels published in the
December 2009 edition of the Journal of the American Medical
Association said heavy use of antibiotics in ICUs can make
such units into epicentres for bacteria to mutate into drug-
resistant forms and spread.

Sanjay Borude, bariatric surgeon at the Breach Candy
Hospital, who performs weight loss procedures across the
country and abroad, stressed the need for exhaustive research
on this issue and termed the Lancet study as a haphazardly
done survey.

"Having personally operated on more than 200 patients
from various countries abroad, I can safely vouch for the fact
that not a single complication has ever occurred (due to
superbugs)," Bourde said. He called for adherence to a
rational antibiotic policy in all hospitals.

The Lancet study on NDM1 superbug came in for sharp
criticism by India which said there was the need to find out
whether there were "ulterior motives" behind the claim as it
had been funded by a pharmaceutical major.

"The study was funded by a pharmaceutical company which
is one of the biggest antibiotics makers in the world," Union
Health Minister Ghulam Nabi Azad had said yesterday reacting
to the report.


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