Monday, 16 August 2010

New Delhi Metallobeta Lactamase-1: NDM-1 superbug survives thanks to abuse of antibiotics

By Syed Akbar
Hyderabad, August 15: As they cruise infor mation super-high ways, being super heroes at their nascent careers, a whole generation of teens, university students and the young workforce are making themselves super susceptible to superbugs.
Stuck for long hours in air-conditioned offices, breathing recycled germs, nourished by re-heated food from dubious take-aways when their compromised immune systems fall apart, they usually self-diagnose or pop OTC quick-fixes putting them at serious risk of bigger illnesses.

Whether for a simple cold or a fever, these quick-fixes to deal with the `symptoms' of illness are very much part of the lifestyle mantra for the young whose rat-race has gotten faster and harsher. But scientists and health experts warn that inappropriate use of antibiotics is creating resistance in simple disease causing germs. Doctors suggest, the latest superbug, New Delhi Metallobeta-lactamase (NDM)-1, has been allowed to evolve because of a rampant overuse or rather abuse of antibiotic pills.
Indiscriminate use of antibiotics has turned into a major health nuisance. Doctors have to deal with the diseases resistant to regular drugs while researchers and scien tists are watching the emergence of a generation of superbugs. NDM-1 is capable of causing multi-organ failure and eventually death.
Dr V.K. Bhargava, senior physician, Apollo Hospitals explains, "Any drug or antibiotic has to be used only against the indication. Each fever is not bacterial.Antibiotics are only for bacterial and some fungal or viral infections. Wrong use of antibiotics for infection will lead to resistance, the antibiotic rendered ineffective."
Bacteria that develop resistance to more than one drug are called multi-drug resistant bacteria, or superbugs.
The resistant gene in a superbug is capable of spreading across bacterial species making even harmless bacteria a new superbug. Several superbugs already exist including the notorious multi-drug resistant tuberculosis bacteria and Pseudomonas which are capable of thriving even in a bottle containing antibiotic solution.

Escherichia or E. coli which causes food poisoning and gastroenteritis, has already developed a 70 per cent resistance to available drugs. The presence of the NDM-1 gene in E coli will make the bacteria even more drug resistant turning the fight against gastroenteritis into a Herculean task. India ranks high amongst countries where antibiotics use is quite high and young patients who go to doctors can be blamed.
"Bacteria are developing resistance to existing drugs, the cause of very high morbidity and mortality. Patients should not pressurise doctors to prescribe antibiotics," warns Dr Bhargava, adding that doctors must prescribe the appropriate drug for specific indication and the right dosage for the right length of time.

Infectious diseases expert Dr Suneetha Narreddy feels that doctors share the blame, "When a person develops cold/cough with or without fever and visits a doctor; the doctor may correctly diagnose a viral infection but in spite of this, the doctor prescribes an antibiotic.
Patients expect doctors to give them antibiotics for even minor symptoms and the doctor fears losing a potential client."

The situation is compounded when you consider that India faces the major challenge of veterinary drug misuse. Traces of veterinary drugs are found in dairy milk, meat and eggs, thanks to administration of large doses of antibiotics in milch cattle and poultry birds.
"A single dose of antibiotics will provide resistance in an individual for up to 12 months. Considering the fact that a person is subjected to several such doses of antibiotics in a short span of time, it's no wonder that new superbugs continue to emerge," points out senior geneti cist Dr M.N. Khaja.
Dr Suneetha says, in India antibiotic abuse is more of a problem for several reasons increase in prescriptions where not indicated, availability of antibiotics over the counter with out prescription, availability of generics which are very often substandard and may not contain the right medication in the right quantity and quality, antibiotics prescribed without diagnostic facilities and empiric treatment or treating without diagnosis.
It's time for the next generation to bolster their immunities naturally, build resistance and restrain against arbitrary pill-popping.

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