Thursday, August 12, 2010

Public Health Agencies On NDM-1

 

 

UPDATE: 8/14/10    This has turned into a rapidly evolving story.  To see a list of the latest blog entries on NDM-1 click this link.

 

# 4802

 

 

A number of public health agencies from around the world have been weighing in on yesterday’s Lancet study on an emerging antibiotic resistance being seen in some types of bacteria (see NDM-1: A New Acronym To Memorize).

 

The UK’s Health Protection Agency released this statement yesterday:

 

Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

 

11 August 2010

Study co-author, Dr David Livermore, director of antibiotic resistance monitoring at HPA said: "The findings of this paper show that resistance to one of the major groups of antibiotics, the carbapenems, is widespread in India. This is important because carbapenems were often the last 'good' antibiotics active against bacteria that already were resistant to more standard drugs.

 

"We have now also identified bacteria with this type of resistance - NDM - in around 50 patients in the UK.  Most, not all, had previously travelled to the Indian subcontinent, and many had received hospital treatment there.  International travel gives a great potential for spread of resistant bacteria between countries.

 

"Few antibiotics remain active against these bacteria.  Their spread underscores the need for good infection control in hospitals both in the UK and overseas, and the need for new antibiotic development." 

 

In June of this year, the UK’s HPA released a National Resistance Alert on Carbapenemase-producing Enterobacteriaceae in the UK.

 

Also in late June, the CDC’s MMWR released a report detailing 3 cases of NDM-1 detected in the United States in:

 

Detection of Enterobacteriaceae Isolates Carrying Metallo-Beta-Lactamase --- United States, 2010

Weekly

June 25, 2010 / 59(24);750

 

 

And today, Hong Hong’s Centre for Health Protection released the following statement (h/t Ironorehopper on FluTrackers)

 

CHP attaches great importance to antibiotic resistant bacteria
******************************************************

A spokesman for the Centre for Health Department (CHP) of the Department of Health today (August 12) said CHP attached great importance to an overseas report concerning the emergence of new antibiotic resistant organisms harbouring New Delhi metallo-β-lactamase 1 (NDM-1).

 

NDM-1 is an enzyme which can inactivate certain groups of antibiotics (e.g., carbapenems, beta-lactams), thus conferring multi-drug resistance to bacteria bearing this enzyme.

 

"We are following up with the World Health Organization and the respective health authorities to understand more of the situation," a CHP spokesman said.

 

"We are also liaising with hospital laboratories to formalise an enhanced surveillance arrangement for such organisms.

 

The spokesman noted that CHP's Public Health Laboratory Services Branch (PHLSB) had all along been monitoring the antibiotic resistance pattern of bacteria.

 

"According to test results of PHLSB, there was one isolate of E. coli harbouring NDM-1 in a 66-year-old male patient attending a government out-patient clinic in October 2009.

 

"The organism was however susceptible to oral antibiotic agents commonly used to treat urinary tract infection," the spokesman said.

 

The patient fully recovered.

 

CHP will issue letters to doctors to alert them of the situation and will remain vigilant for changes in antibiotic resistance that may have public health significance, he added.

Ends/Thursday, August 12, 2010
Issued at HKT 21:13

 

 

Although I’ve already heard some public skepticism voiced regarding this threat, quite obviously the emergence of this resistant enzyme has many doctors and scientists watchful and justifiably concerned. 

 

Unlike a pandemic, this is a much slower evolving health crisis . . .  but over time, it has the potential to have a huge impact. 

 

While a number of talented journalists and bloggers have written on this issue, probably the best I’ve read comes from the pen of  Maryn McKenna who posted NDM-1: Novel, global, complex and a serious threat on her Superbug Blog last night.

 

No doubt this is a subject that we’ll be hearing more about in the coming days, months, and years.

 

And for another twist in this evolving story, Crof  at Crofsblog has a BBC story that officials from India are taking umbrage over the association of this resistant enzyme to their nation, calling it a `conspiracy’.

 

NDM-1: India rejects UK scientists' 'superbug' claim