Superbug: Health experts concerned over global threat

Updated: Sep 14, 2010, 00:00 AM IST

Boston: Health experts have voiced
concern over the spread of antibiotic-resistant `Superbug`,
particularly in countries like India where poor sanitation
conditions can further spread the germ, posing a global health
threat.

The three confirmed US cases - one in Massachusetts,
California and Illinois - all involved people who had received
medical care in India. Experts said poor sanitation can
further spread the superbug, also known as NDM-1, which
thrives in germs that proliferate in the gut.

"There are certain factors in the Indian subcontinent
that are going to make this spread quite widely," Cardiff
University scientist Timothy Walsh said.

"It is very easy for us to forget in the western world
how desperate the conditions are in some of these countries."

Germs with NDM-1 are typically spread through poor
hygiene and not by coughing or sneezing, Walsh added.

Walsh and other global health specialists attending a
microbiologists and infectious disease doctors conference here
said they are "particularly concerned about NDM-1 because of
its emergence in India."

"Antibiotics are cheap and available over the counter
in South Asia, fuelling inappropriate use and consequently,
the development of drug resistance," the Boston Globe quoted
the specialists as saying.

French germ specialist Patrice Nordmann said it is
only a "question of time" before the bug spreads to other
countries. "Slowly, it is going to be a problem worldwide,"
Nordmann said.

Threat posed by the germs in the US is most acute in
hospitals. "They do not cause infection in people walking down
the street," said Dr Alfred DeMaria, top disease tracker for
the Massachusetts Department of Public Health.

"If somebody is in an intensive care unit on a
ventilator with a tube in their trachea, they are at risk for
these organisms. If someone has had extensive abdominal
surgery with lots of open wounds, they are at risk."

Chief of Massachusetts General Hospital`s infection
control unit Dr David Hooper said people have to be vigilant
since with proper infection control measures, spread of the
superbug can be controlled.

"We are concerned, not alarmed. With good infection
control and following guidelines, they (superbugs) can be held
at bay."

The three US patients infected with the bug developed
urinary tract infections that carried a genetic feature that
made their cases harder to treat.

"It leaves treating physicians with few treatment
options," said Dr Alex Kallen, a medical officer at US Centers
for Disease Control and Prevention.

All three had been in India and two underwent medical
procedures in hospitals while they were there, Kallen said.

The patient treated in Boston was an Indian citizen
with cancer who had undergone surgery and chemotherapy in that
country before coming to Massachusetts, Kallen added.

Only two antibiotics - a drug called colistin and
tigecycline - possess a measure of effectiveness against
bacteria riddled with NDM-1.

Paucity of drugs to treat these multi-drug resistant
germs is also adding to the problem. "There are some
antibiotics that have been talked about... trouble is we have
got one or two that look promising and what we need are six to
eight to cover our options," Walsh said.

PTI