Posting in Government
MRSA infections might be down, but there's another bug that is spreading from India. The NDM-1 gene in bacteria is prevalent in India, but is spreading to other parts of the world through medical tourism.
An antibiotic resistant gene has been identified in India and patients who traveled there for medical tourism are picking up the bug too. Does this really hint at a gloomy future for us?
When I read The Guardian article called "Are you ready for a world without antibiotics," I got chills. I keep hearing this concern echoed.
When I was in San Francisco, I spoke with Kevin Judice, the CEO of Achaogen, about his company's mission to discover new ways to treat drug-resistant pathogens. He warned me of these gram-negative resistant bacteria that might launch us into an era without antibiotics. But that's also why his company is focused on developing drugs to combat multi-drug resistant gram negative bacteria and Methicillin-resistant Staphylococcus aureus, or MRSA.
Doctors and the government prepared for the fight against the gram-positive superbug MRSA and the outbreaks appear to be more controlled. Infection of MRSA in the hospital has dropped.
But Darwinian evolution is part of life — and bacteria will continue to evade the drug weapons we throw at it. The bacteria will find some way to survive.
Meet NDM-1 gene. Cardiff University professor Tim Walsh discovered the NDM-1 gene in Klebsiella pneumoniae and Escherichia coli bacteria. It was first identified in a Swedish patient who was infected after undergoing a procedure at an Indian hospital in 2009.
The bug has been found in the UK, US, Australia, and in a number of other countries. Some fear that it will spread throughout the world as medical tourism remains a popular and cheap alternative.
What's worse, the mutation makes bacteria resistant to nearly all antibiotics — even the ones that are supposed to act as our last line of defense.
They identified 44 (1.5%) NDM-1-positive bacteria in Chennai, 26 (8%) in Haryana, 37 in the UK, and 73 in other sites in Bangladesh, India, and Pakistan. NDM-1 was mostly found in E coli (36), the most common cause of community-associated urinary tract infections, and K pneumoniae (111).
The gene can hop from one strain of bacteria to another because it is found on plasmids in the bacterial nuclei. Its location on the plasmid makes the mutant gene pretty promiscuous. While the infection has been found in a small number of people, experts worry that it transfers between different types of bacteria, which makes it harder to contain.
The fact that it exists in gram-negative bacteria, limits the number of drugs in the pipeline that can treat it.
Drug-resistant bacteria like the NDM-1 mutation are typically a problem in hospitals. Not only do the patients have welcoming open wounds, their immune systems are weaker, and the antibiotics they are on kill off healthy bacteria and let the drug-resistant ones flourish.
The growing trend for medical tourism will enable this bug to spread throughout the world. We are seeing what some experts believe, is the tip of the iceberg, in our inability to treat infections.
It only took this mutant three years to rise from obscurity to infect up to 3 percent of the population in India and Pakistan. The gram-negative bacteria resides in the gut and the fact that only two drugs can treat this infection (if at all) has some experts worried about the potential public health risk.
“The rapid emergence of these multi-drug resistant NDM-1 producing bacteria and their potential worldwide spread could herald a period in which antibiotics become redundant and demands very close international monitoring and surveillance," Walsh says in a statement.
The Guardian paints a dark picture of what the world would be like if antibiotics couldn't kill infectious bacteria: Transplant surgery can't be done without running the risk of infection from life-threatening bacteria, routine appendix operation becomes dangerous once again, pneumonia will return as big-time killer, gonorrhea will become resistant, and there's really going to be no way to treat tuberculosis.
The best thing doctors can do is practice better hygiene and take extra precaution in the hospital. Unfortunately the NDM-1 doesn't discriminate. It has been found in the Asian community, spread through contaminated water — and can be spread to other parts of the world through travel.
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Aug 13, 2010
@wizo & mejo: Very cool stuff, but of course our media wants to focus on the scare tactics. We will find a way, and hopefully stop allowing our food to be pumped full of antibiotics. Meanwhile, corporations will continue to take over companies creating solutions so that they can capitalize on our well-being. Bacteria will find ways to become immune as long as they have the ability to evolve, and humans will find ways to look outside for answers, as usual. Why aren't we taking into account that viruses have become a part of our own DNA, and considering the possibility that our own immune systems have a lot of potential for creating immunity? Common sense, you would think.
A "Medical Tourist" from Scandanavia going to India for treatment? Scandanavia has the best health care systems in the world. That tourist must be a dangerous idiot to think s/he could find better treatment in India. Or is s/he a hippie who thought it would be cool to try an Ayurvedic hospital? There is a sort of "medical tourism" that offers a better hope for a world without antibiotics: the bacteriophage therapy of the Eliava Institute in Tbilisi, Georgia. The main problem with that now is just that some stupid American company took over and is now demanding outrageously high prices where before they had incredibly low prices.
Darwinian Evolution is a crock, it is not science. It is just a case of micro evolution, not some huge change.
This is just another reason to begin to enhance the bodies natural immune system. We Americans are already sterilizing our lives to the point that we do not have an immunity. Will WellMune help us? Canadian research is interesting.
Don't freak-out ... check-out ...Phage Therapy. Developed in Russia during the last century bacteria is used to fight bacteria. They couldn't afford antibiotics and developed this.
Don't freak-out. Check-out Phage Therapy. Developed in Russia in the last century it is using bacteria to fight bacteria.
We treat our existing antibiotics so carelessly. By over-prescribing and using them inappropriately. Times past, if you went to the doctor with a cold. You were given antibiotics, which was useless, since a cold is caused by a virus. Or giving antibiotics to animals, in order to make them grow faster.
Oh Boonsri! Accurate reporting? Surely the tourists are picking up whole bacteria not just one gene consisting of the cistrons collectively responsible for the expression of the enzyme NDM (New Delhi Metallo)-b-lactamase (a type of carbapenemase)???
Indian author says superbug report is fudged - http://timesofindia.indiatimes.com/city/chennai/Indian-author-says-superbug-report-is-fudged/articleshow/6302479.cms
I don't think medical tourism is as much as a problem as the out of control Work Visa programs we have here in the US. With several hundred thousand perrmit workers and their familes traveling back and forth from areas in the middle east where these viruses are prevalent while companies like Cisco, Microsoft, Verizon vigourously lobby for even more visas, with even fewer restrictions, it is just a matter of time before more virulent strains hit the US. Like most facets of programs like NAFTA, WTO, etc. that surround the outsourcing & insourcing of US jobs and education, innocent Americans who built this country from the ground up are the ultimate victims of the corruption that has invaded Washington in the name of international profits and polarized partisonship between our 2 current political parties. Not "We the people", but "We the victims"! We the People of the United States, in Order to form a more perfect Union, establish Justice, "insure domestic Tranquility", provide for the common defence, "promote the general Welfare", and "secure the Blessings of Liberty to ourselves and our Posterity", do ordain and establish this Constitution for the United States of America. Insure DOMESTIC TRANQUILTY, promote the GENERAL TRANQUILITY and SECURE the BLESSINGS OF LIBERTY to "OURSELVES" and "OUR" our PROSPERITY. What free trade program has insured Our Tranquility and OUR Prosperity in the last 30 years. Our economy is shot, our unemployment at 58% and we have basically opened the borders allowing non-Americans to manage our checkbooks from sea to shining sea.
The obvious thing to do is to intentionally introduce this into the best strains of normal useful bacteria within our bodies. We will be unable to suppress the trait and even if we did, bacteria are guaranteed to develop another method of resisting. 3 years is nearly 80,000 bacterial generations.... We do far too little study of the beneficial organisms which are part of us.
I understand that NDM-1is not a bacterium but an enzyme. Is this true, and if so, do enzymes have DNA?
Bacteria are prokaryotes (they lack organelles with membranes). Therefore they don't have a cell nucleus. Their genetic material, both long-strand DNA and plasmid DNA loops are dispersed throughout the cell. The fact that the plasmids aren't "hidden" in a cell's nucleus is what makes it so easy for bacteria to exchange them, thus quickly spreading advantageous genes, like drug resistance, even to bacteria of differing species. So this genetically based drug resistance doesn?t just spread to a single cell?s progeny, it can potentially spread to any other bacteria that the resistant cell comes into contact with.