NDM-1 (New Delhi Metallo-1) is the hard talk now in the global medicine industry. NDM-1 is a new MBL (metallo beta lactamase, enzyme that can help bacteria from being killed by beta lactum antibiotics like penicillin) which has been reported from India (ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Dec. 2009, p. 5046–5054). This new trait doesn’t show a lot of similarity with the already known MBLs. Some quote this as “super bug”, next to MRSA (Methicilin Resistant Staphylococcus Aureus); am not convinced with terming it as a superbug rather it might infact make a bacteria, a super bug which will be resistant to ‘most’antibiotics’, as the media says.
Am sceptical too about the phrase “most antibiotics” as what includes the ‘most’? The article which reported the NDM-1 containing plasmids in two different organisms (Klebsiella pneumoniae and Escherichia coli) present data for their susseptibility to fluoroquinolones and colistin. Chromosomally encoded MBL was first reported in 1991 in Japan (http://www.alfred.org.au/Assets/Files/MBLsFactSheet2007.pdf). Often the MBL genes are associated with integrons (Clin Microbiol Rev. 2005 Apr;18(2):306-25) which are mobile genetic elements known to contribute the dissimination of antibiotic resistance. I have not gone in to probing the nature and origin of already known MBLs, but the new one is plasmid encoded and is reported from India.
Being the first of its kind the UK government has instructed their people to restrict ‘medical tourism’ in India, which is one among the glowing industries in the country. The Indian health ministry has expressed its strong disappointment over this move and tagging the issue with a country, in this case India. I dont know if this has happened before whenever there were new antibiotic resistant genes or bugs reported. Did it happened in the case of MRSA which was originally accredited as the ‘super bug’ when it was first reported in UK (1961)? I dont find a clue for it. Later the US reported its first case in 1981. To-date, MRSA is widespread. Is it acceptable to say, the MRSA originated from the UK and spread across the world?
The more important concern is the media. Needless to say, the media is amplifying the facts as they always do. One news media has made an extra effort saying “it may cause death by multiple organ failure”!! I wish the usage “may” should be forbidden from being used in the news media. They just want to make money out of public’s ignorance. The news media has a very important role and responsibility to play in the society. But its a pity that the media has turned in to a pure business where they have to sell their story with better thrills and turning points while competing with others of their kind.
The government of India and the news media has already launched the campign against the NDM-1 stamp on the country and it is going to delay the process of finding a better solution for the problem. The designation of the name ‘NDM-1’ itself is being debated. It is very obvious to label the trait after the place where it was isolated. But the politics argue that this is very intentional to defame the billion-dollar business, ‘medical tourism’ in India. The country backs-up its defence with the fact that the research which revealed the NDM-1 is being funded by industries who themselves are antibiotic produces and will be benifited by the propaganda.
We dont know what the fact is but the only way to handle the issue should be purely scientific. If I would philosophize this very matter; antibiotic resistance among the microbes is a war between two organisms, microbes and man. If business and politics is going to take a ride over science, the looser here will be the MAN.
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