Is New Delhi the Capital of Super Bugs?

April 7th, 2011
in econ_news

bacteria Econintersect, reported by Sanjeev Kulkarni  (last update 7:31 pm GMT, April 7, 2011):

New Delhi, the capital of one of the world's largest growing economies, seems to be the biggest breeding ground of "super bugs", primarily due to poor sanitation.  According a report in The Lancet,  different species of bacteria with the deadly NDM1 gene have been found in tap water meant for drinking.

Follow up:

Super bugs refer to bacteria that carry genes that make bacteria resistant to known antibiotics.  According to World Bank report cited in Bloomberg, "lack of sanitation is holding back India’s economic development".

NDM-1 is an acronym for New Delhi metallo-beta-lactamase an enzyme that makes bacteria resistant to broad range of antibiotics. In the popular press bacteria with NDM-1 producing genes are referred as super bugs.

According to Wikipedia

"NDM-1 was first detected in a Klebsiella pneumoniae isolate from a Swedish patient of Indian origin in 2008.  It was later detected in bacteria in India, Pakistan, the United Kingdom, the United States, Canada, Japan and Brazil. The most common bacteria that make this enzyme are Gram-negative such as Escherichia coli and Klebsiella pneumoniae, but the gene for NDM-1 can spread from one strain of bacteria to another by horizontal gene transfer."

The Lancet report indicates is cautious about drawing conclusions of mass sickness due to these deadly species of bacteria. 

"Not all patients infected with NDM-1-positive bacteria have a history of hospital admission in India, and extended-spectrum â-lactamases are known to be circulating in the Indian community"

According to Bloomberg

"More than 100 million Indians may possibly harbor bacteria with the NDM-1 resistance gene if the study’s findings reflect community-wide dissemination, Walsh said in an interview."
"Eighteen percent of public water samples tested at more than 600 sites in New Delhi were tainted by E. coli, Salmonella, or some other disease-causing bacteria found in human excreta that made the water unfit for drinking, according to a survey this year by the Municipal Corporation of Delhi."
The findings expose the extent to which a lack of sanitation is holding back India’s economic development. A shortage of toilets and inadequate sewage treatment trimmed 6.4 percent from India’s gross domestic product in 2006, or the equivalent of $53.8 billion, a study by the World Bank’s Water and Sanitation Program found."
The government has gone into denial mode.  According to story published in Hindustan Times:  
"The health ministry on Thursday said the environmental presence of superbug NDM-1 gene in Delhi does not pose a public health risk. "The environmental presence of NDM-1 gene carrying bacteria is not a significant finding since there is no clinical or epidemiological linkage of this finding in the study area."
Experts disagree. According to Peter Collignon an infectious diseases doctor who teaches at the Australian National University in Canberraas quoted  in Bloomberg

“There is not even a light you can see at the end of this dark tunnel; people are dying from infections that are no longer treatable with available antibiotics.”

The growth in antibiotic resistant microbes has been a concern of health experts for decades.  Frank Swain, writing at the Guardian:

The insidious spread of the latest form of antibiotic resistance is just one more sign that governments haven't grasped the gravity of the situation.
After a torrent of dramatic headlines, interest in NDM-1 fell away. After all, in a world well-stocked with superbugs – MRSA, MDRTB, C diff – what was another acronym? The media tend to train their spotlight on highly pathogenic diseases – those that kill in no time flat – at the expense of untreatable diseases, which are far less dramatic. The trouble with superbugs like NDM-1 is that once they gain a foothold in hospitals, even minor surgerical procedures are burdened with a much higher risk of serious postoperative complications."

NDM-1 is here to stay. Perhaps that will be enough to prompt the action called for by health practitioners 50 years ago, but it's hard to shake the feeling that the microbes have us in checkmate.

Sources: Antibiotic Resistance - Wikipedia, NDM-1 positive bacteria in  New Delhi - The Lancet, New Delhi metallo-beta-lactamase - WikipediaBloomberg, Guardian and  Hindustan Times

Sanjeev Kulkarni Sanjeev Kulkarni is an entrepreneur based in Pune, India. He worked for large organizations in board level position before venturing on his own. He is currently involved as an investor in health care software company and as an investor, mentor in an automation company. Very widely traveled, he has experience of working in different geographical areas with people of varying nationalities. He did his BS from Indian Institute of Technology, Delhi.

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