Superbug alert came in 5 months ago

The bug story: A single Mumbai hospital had recorded 22 cases

Besides alerting the medical community, doctors from the P D Hinduja National Hospital and Medical Research Centre, too, suggested that if the superbug spread in the community, “it may endanger patients undergoing major treatment at Indian centres and might have adverse implications for medical tourism”.

While the Hinduja study, published in the Journal of the Association of Physicians in India (JAPI) went virtually unnoticed, all hell broke loose when a second study by a big team involving scientists from India and the UK found the super bug in many Indian and Pakistani cities and advised patients against visiting the subcontinent for surgeries to reduce the risk of acquiring the infection.

The Hinduja group took up the study after the UK issued an alert in 2009. The antibiotic resistance monitoring programme in the UK spotted carbapenem-resistant bugs in patients, many of whom were recently hospitalised in India and Pakistan in recent months.

Carbapenem is the last-option antibiotic against ‘gram negative’ bacteria like the NDM-1 till date. These bacteria have an additional membrane outside their cell wall, which makes them more difficult to treat.

That is why resistance against carbapenem means the end of road for patients as other drugs for treating the infection are not safe for human use. The Hinduja team found the NDM-1 mutation—a tiny genetic change that turns ordinary hospital microbes into superbug—in 24 samples, out of which 22 gave positive results. 

Five common microbes carry the NDM-1 genes and the bugs were found in swab, urine, blood, sputum and pus of patients either in ICUs or wards.

“This is the first Indian study and an eye opener on how deep a trouble we are in,” said K Abdul Ghafur, a former National Health Services (UK) doctor, who is now a consultant with Apollo Hospital in Chennai.

In an editorial in the same issue of JAPI, he said Indian medical community remained in a state of denial as it had not taken the issue of antibiotic resistance seriously. Ghafur said the easiest way of tackling the superbug problem was to use the “notorious ostrich strategy”, which denied the problem’s existence. The health ministry so far does not have an antibiotics resistance monitoring programme.