Superbug Fight Sparks ‘Scaremonger’ Charges

India’s health authorities have angrily accused British researchers and the medical journal The Lancet that published their work of scaremongering over a new multi-drug-resistant superbug that first appeared in India.

They say doctors at a leading private hospital in Mumbai warned earlier this year about the threat, months before a British study produced the same conclusions.

The Mumbai research team had warned that that foreigners coming to India for cut-price surgery could pick up the new bug, NDM-1, and spread it worldwide.

The row has acquired a political dimension with some Indian politicians saying the British warning is a conspiracy designed to scupper India’s booming health tourism industry.

But Indian researchers themselves had said in March that they found 22 incidences of “New Delhi metallo-lactamase-1” producing bacteria in 24 infection cases between August and November last year.

“This high number in a relatively short span is a worrisome trend,” the team from the Hinduja hospital said in the Journal of the Association of Physicians of India.

Equally worrying is the fact that NDM-1-carrying bacteria are resistant even to carbapenems, a group of antibiotics often reserved as a last resort for emergency treatment for multi-drug resistant bugs.

“The growing incidence and also the diversity of carbapenemase-producing strains is therefore of major concern,” the researchers said. They also warned that the superbug had “potential for further dissemination in the community.”

The Indian team said they did not know the exact prevalence of NDM-1 but added that its spread might endanger patients having major treatment at centres in India and this may have adverse implications for medical tourism.

An Australian infectious diseases specialist said last week three people who had travelled to India for treatment had contracted the infection and the cases could be just the “tip of the iceberg”, amid concern about its global spread.

Professor Peter Collignon, head of the infectious diseases department at Canberra Hospital, said the cases – including one patient who had plastic surgery in Mumbai – were just the “tip of the iceberg.”

“We found this multi-resistant, untreatable bug in their urine, luckily not causing too many problems to that person. But it’s a real problem if it spreads to others,” he said.

“The germ we had was untreatable — there were no drugs we had that could treat it,” he added.

Collignon said one of the patients caught the bug in intensive care in an Indian hospital after plastic surgery went wrong. But he said another picked it up in the general community, indicating the extent of the problem.

Critics of Indian complacency are also found in India itself. Dr K. Abdul Gharfur, a consultant on infectious diseases in Chennai, says India’s medical authorities are in denial about the extent of multi-drug resistant infections.

He said last week no country was immune to the problem, but it was likely to be more acute in places like India because of a lack of effective controls on the prescription of antibiotics.

“This bacteria, NDM-1, is increasing. It’s true it’s spreading in India. I’m sure it exists in almost every major hospital in India. But we have limited data,” Gharfur said.

He said few Indian hospitals, including in the private sector, have specialist infection control departments and there was a general lack of awareness among doctors about the spread of drug-resistant infections, he added.

“The responsible authorities should only allow the use of antibiotics by qualified people,” he said. Proper monitoring of infections should be carried out because antibiotic-resistant infections were increasing.

* The South Asian superbug has already claimed its first western fatality, doctors in Belgium said last weekend. The victim, a man who had been in a car accident in Pakistan and had initial surgery there, died in a Belgian hospital in June. A second Belgian who contracted the disease recovered.

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