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Thursday, August 12, 2010

NEW SUPER BUG TO HIT MEDICAL TOURISM-A NEW PUZZLE FOR MICROBIOLOGISTS!


India bashing is a popular game for some people and the latest salvo against the country comes from the UK, India's past colonial masters. According to some reports emanating from this country it is dangerous to go to India for surgical procedures as the country is "host" to a new "super bug" that is the most drug resistant variety in the world! The report gains some credibility because the findings have been reported in a prestigious international journal and probably scientific content has been peer reviewed. To add insult to injury the new pathogen has been named after the Indian capital to remind future tourists about the dangers of going to India for any surgery. It was only recently that international media showered praise on India for low cost medical treatments which often cost less than 20% of that charged in advanced countries. Here is a take on that.


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. He said the 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.


According to a paper published in scientific journal 'Lancet, t
he 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.These are generally reserved for use in emergencies and to combat hard-to-treat infections caused by other multi-resistant bacteria. At least one of the NDM-1 infections the researchers analysed was resistant to all known antibiotics. Similar infections have been seen in the US, Canada, Australia and the Netherlands and international researchers say that NDM-1 could become a major global health problem. Infections have already been passed from patient to patient in UK hospitals.


What is urgently needed is for the government of India to get into the act, organize a team of pathologists and infectious disease experts to bring out the facts. Most probably the report emanating from UK could be without any solid proof and only a national task force as suggested here would bring out the truth. This is necessary to clear India's name tarnished by the Lancet report.

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