Saturday, 16 April 2011

Super bug scarce: There are more powerful superbugs in Europe than NDM-1

Syed Akbar
Hyderabad: The Lancet study on NDM-1 in India notwithstanding, different types of metallo beta lactamase, the protein that makes an ordinary bacteria a drug resistant superbug, exist 10 to100 times more in Europe.
According to Dr Niyaz Ahmed, editor of PLoS ONE, a leading biomedical journal published from the USA, various types of metallo beta lactamases like bla-VIM, bla-KPC and some OXA types have been in circulation around the world for many years. Type OXA-48 is found in Germany and Europe. The world-wide distribution of these types is much higher than that of the New Delhi Metallo beta lactamase, allegedly found in drinking water samples in India.
The estimated prevalence of NDM is less than 0.1 per cent in Germany and other European countries, as against other metallo beta lactamase types whose occurrence is about 10 to 100 times higher in countries
like Cyprus and Greece.
Dr Niyaz Ahmed, who is also professor of bacterial genomics at the Institute of Life Sciences, University of Hyderabad, told this correspondent that other metallo beta lactamases are also present in other developed countries like Japan and the United States.
"NDM-1 is a world-wide problem although much caution is warranted as it is a worrisome situation for India due to the current stigmatisation by the Lancet studies. But, what about all other metallo beta-lactamases
circulating around the world since many years - why didn’t these carbapenemases evoke such a hype," he wondered.
Dr Niyaz Ahmed allayed the fears saying that bacteria living outside the body do not necessarily cause health problems or diseases. "Bacterial pathogenic behaviour is not 100 per cent guaranteed when it is free living (outside the host body) due to the dynamic evolutionary events taking place to ensure adaptation," he said adding that mobilisation and sharing of drug resistance encoding apparatuses among different species of bacteria is again not as straightforward as it is assumed.
According to him, environment has a great deal of regulatory role in this case. Moreover, resistance phenotypes are not permanent and the mutants could revert back and become sensitive to drugs.  It all
depends on the evolutionary dynamics of bacteria that are dictated by the environment and the host immune status.
Asked if drug resistant bacteria are found in major cities like Hyderabad too, he said "when these phenotypes are seen in Germany, Japan, China and Taiwan, Hyderabad can’t remain an exception. He however, said culture or PCR positivity does not mean that a potential epidemic is brewing.
"I think the situation demands an improvement in our community hygiene technology and infrastructure, although, the present campaign of the British microbiologists and their pharma sponsors is entirely
directed at denting the medical and health services industry in India,", he said.

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