The antibiotic-resistant gene, NDM-1, was first identified in 2008 a Swedish patient that had received hospital care in New Delhi. NDM-1 produces an enzyme that allows bacteria to destroy most antibiotics. It exists on plasmids, which are pieces of genetic material that are easily shared between bacteria including E coli and other species that can cause pneumonia, urinary tract infections, and blood stream infections.
NDM-1 probably evolved in parts of India where poor sanitation and overutilization of antibiotics provide a perfect environment for the creation of antibiotic-resistant bacteria.
The gene has been identified in three U.S. patients. All had received medical treatment in India, and all recovered from their infections. It has been found sporadically in Britain, Australia and nearly a dozen other countries as well. Most affected patients were “medical tourists” — that is, people seeking less expensive medical care in India.
“We need to be vigilant about this,” said Arjun Srinivasan, an epidemiologist at the CDC told the Washington Post. “This should not be a call to panic, but it should be a call to action. There are effective strategies we can take that will prevent the spread of these organisms.”
The NDM-1 gene does not appear to be transmitted by coughing or sneezing, but rather through exposure to contaminated sewage, water and medical equipment. Inadequate handwashing also likely plays a role. The CDC has advised doctors to look for it and isolate patients that have it.
The scientists who discovered NDM-1 warned that it had become endemic in many areas of India and Pakistan.
“What we saw (in south-Asian hospitalized patients) is the tip of the iceberg,” Timothy Walsh, a Cardiff University professor of microbiology told the Post. “For every person in the hospital, you can imagine there are a vast majority of people out there carrying NDM around.”
Meanwhile, the Indian government denounced the news as a scare tactic designed to discredit the nation’s exploding medical tourism industry. That industry attracts 450,000 patients per year and will likely generate $2.4 billion in revenue in 2012.
*This blog post was originally published at Pizaazz*