Tuesday, September 07, 2010

NDM-1 Surveillance

 

 


# 4880

 

 

 

Just short of a month ago a new form of antibiotic resistance called New Delhi metallo-ß-lactamase-1, or NDM-1 for short, made headlines in the wake of the release of a Lancet study called:

 

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

 

Like many health bloggers, I wrote several times on this mutated gene that can confer resistance to some types of gram negative bacteria against our most powerful antibiotics.

 

NDM-1: A New Acronym To Memorize
Public Health Agencies On NDM-1

Denialism and NDM-1

 

But arguably the best coverage came from Maryn McKenna on her Superbug Blog  here and here

 

Since then, we’ve seen a few scattered media reports of cases of NDM-1 that have been detected in nations around the world, some political outrage and posturing from India regarding the naming of the gene, and little else of note.

 

Unlike a pandemic, which can explode around the world in a matter of weeks or months - this is going to be a slower evolving story.

 

It may take years for NDM-1 to become widespread – so news stories right now are mostly about the potential threat. 

 

Which brings us to a pair of reports today, one out of Japan and the other out of Taiwan, regarding surveillance for this new health threat.

 

 

First, from  Agence France Presse we get a report on Japan’s intention to conduct a nationwide survey on NDM-1, after their Health Ministry confirmed their first case last week.


The Health Minister also announced a tightening of hospital reporting requirements.

 

Japan plans nationwide survey for NDM-1 superbug

(AFP)

 

 

Although Taiwan has yet to identify any residents with NDM-1, their CDC (Center for Disease Control) announced today that they have classified this newly identified form of antibacterial resistance as a reportable communicable disease.

 

Doctors and hospitals are now required to notify the Taiwanese CDC if they encounter any suspected NDM-1 cases, particularly if a patient has returned from Pakistan or India.

 

More details are available from this Focus Taiwan news article.

 

CDC to list new superbug NDM-1 as communicable disease

2010/09/07 15:56:59

 

 

It should be noted that Japan’s only known case of NDM-1 resistance came from a man in his 50’s who was hospitalized in April 2009 after returning from India with a high fever.

 

He remained hospitalized until October of last year, and then was discharged.  

 

After The Lancet article was published last month, staff at the Dokkyo Medical University Hospital went back and examined a preserved sample from the patient, and identified the NDM-1 gene.

 

Media reports indicate the patient has since been tested for the NDM-1 gene, and found clear. The hospital also states that the infection did not spread within their facility.

 

While `breaking news’ stories are few and far between regarding NDM-1, the evidence suggests that the gene is spreading slowly, but insidiously around the world.

 

Over time, a combination of good surveillance and solid scientific analysis should give us a much better idea about the scope of the threat posed by this newly emerging antibiotic resistant gene.