What is the new superbug with the NDM - 1 gene all about?
Aravind Menon
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Aravind R Menon
MBBS, MPH
Health Systems Research India Initiative
Super-bugged, Govt trashes study by own scientists
What all of them seemingly glossed over is the fact that six Indian institutes, including the Department of Microbiology at Banaras Hindu University’s Institute of Medical Sciences and the Microbiology Department at the University of Madras in Chennai, participated in the study in collaboration with Cardiff University, UK, and Stockholm’s prestigious Karolinska University Hospital.
The study was funded by the European Union; Wellcome Trust, a charity that sponsors medical research, and Wyeth, a pharma company now part of Pfizer.
“It is the most unscientific article and I am shocked that Lancet has published it. There is a conflict of interest and there is clearly no science behind it,” K Sujatha Rao, Health Secretary told The Indian Express.
Late in 2008, the Antibiotic Resistance Monitoring and Reference Lab of the UK-based Health Protection Agency (HPA) sounded an alarm across the world about the New Delhi metallo-ß-lactamase 1 (NDM-1) gene.
“We found cases of drug-resistant patients in Sir Sunderlal Hospital and we started a study on our own when we found the information about this gene on the net,” said Dr M R Sen, professor at the Department of Microbiology of BHU’s Institute of Medical Sciences, one of the participating institutions.
Sen said they contacted HPA and decided to test patients for NDM-1. About 300 to 400 patients were screened and 17 samples were selected for genetic analysis. Of these, 13 tested positive for the drug-resistant gene. Since facilities of genetic analysis were then not available in Varanasi, a research scholar Supriya Upadhyay took the samples to the P D Hinduja Hospital and Medical Research Centre in Mumbai. Amitabh Bhattacharya was another researcher involved in the study, said Sen.
At that time, Cardiff University, which had been in touch with HPA, was also working on the gene along with some other Indian institutions. “The British researchers found that the patients had a recent travel history to India and Pakistan. The study was conducted almost simultaneously at various other centres in India,” said Dr Sen.
These were: the University of Madras and Apollo Hospital, Chennai; Pandit B D Sharma PG Institute of Medical Sciences, Rohtak, Haryana; Amrita Institute of Medical Sciences, Kerala; Apollo Gleneagles Hospital, Kolkata, and BHU, Varanasi.
Sen said the existence of this gene is common in bacteria like E. Coli (which causes urinary tract infections) and K. Peumoniae (which causes pneumonia). “Though the detection of E. Coli and K. Peumoniae is easy, and even their resistance against common drugs can be tested in a routine way, the trick is to test whether the bacteria is resistant to all antibiotics like carbapenems which is one of the latest antibiotics effective on most of the bacteria”, said Sen.
This drug-resistant bacteria first spreads in hospitals and strikes at the community level only at a very later stage, Sen said. He added that if detected early in a patient, the bacteria can be tackled medically. But once the infection spreads, it is difficult to contain it and may cause septicemia in patients, he said.
The DGHS today held a meeting with the Secretary, Health Research, V M Katoch and Director of National Centre for Disease Control Dr R L Ichhpujani.
“This (the conclusion) is not supported by any scientific data. This occurs in nature and in the intestines of animals and humans universally. Similar strains are found in the US and UK,” said Ichhpujani.
Some experts said that such organisms may be circulating more commonly in the world due to international travel and to link this with the safety of surgery in hospitals in India is wrong.
But Dr Anoop Misra of Fortis hospital said he would be careful before trashing the Lancet study. “This is a serious thing and I see no reason for the Lancet to mislead. If the government is of the view that there is no basis to it, the best thing is to independently investigate the matter rather than just rubbishing it,” he said.
Adding that the study should be an eye opener as regulations are needed on the use of antibiotics anyways, he said, “There should be an independent policy by each policy on the use of antibiotics.”
The Government said the study was funded by the European Union and a pharma company, Wyeth, that produces antibiotics. Said Dr Misra: “The study does no good to the pharma companies as well and Lancet is very strict about these issues. They definitely take in account the funding. I know how professional they are. It is unfair to say there is a conflict of interest.”
Source:http://www.indianexpress.com/story-print/659701/
Aarti Dhar
NEW DELHI: 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.
It said Indian hospitals were safe as a number of such bacteria survived in nature and were reported from several other countries.
The conclusions of the study are “loaded with inference'' that the antibiotic-resistant organism possibly originated in India, an official statement by the Ministry of Health and Family Welfare said here on Thursday.
“While such organisms may be circulating more commonly in the world due to international travel, 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,” V.M. Katoch, Director-General, Indian Council of Medical Research, said here.
Several authors had declared a conflict of interest in the publication of the study. The study was funded by the European Union and two pharmaceutical companies — Wellcome Trust and Wyeth — that produce antibiotics for treatment of such cases, the statement said.
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.
Admitting that such news reports were likely to dent the prospects of medical tourism in the country, Dr. Katoch said correct reporting by the media should inform the people and set the matter right. “Indian hospitals are world class and follow the best practices,” Dr. Katoch said.
Though not disputing the validity of the study, he said the conclusions were “unfair” and “scary.” The conclusions and interpretations of the study were wrong, scientifically invalid and aimed at creating a scare.
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