New drug-resistant superbugs found in 3 states
Gene can spread person-to-person; all patients had
been treated in India:
MARILYNN MARCHIONE
An infectious-disease nightmare is unfolding. A new gene that can
turn many types of bacteria into superbugs resistant to nearly all
antibiotics has sickened people in three states and is popping up all
over the world, health officials reported Monday.
An uncontrolable superbug affecting people |
The US cases and two others in Canada all involve people who had
recently received medical care in India, where the problem is
widespread. A British medical journal revealed the risk last month in an
article describing dozens of cases in Britain in people who had gone to
India for medical procedures.
How many deaths the gene may have caused is unknown; there is no
central tracking of such cases. So far, the gene has mostly been found
in bacteria that cause gut or urinary infections.
Scientists have long feared this - a very adaptable gene that hitches
onto many types of common germs and confers broad drug resistance.
“It’s a great concern,” because drug resistance has been rising and
few new antibiotics are in development, Director of infectious diseases
at the University of Melbourne in Australia Dr. M. Lindsay Grayson siad.
“It’s just a matter of time” until the gene spreads more widely
person-to-person, he said. Grayson heads an American Society for
Microbiology conference in Boston, which was buzzing with reports of the
gene, called NDM-1 and named for New Delhi.
The US cases occurred this year in people from California,
Massachusetts and Illinois, lab chief at the Centers for Disease Control
and Prevention Brandi Limbago said. Three types of bacteria were
involved, and three different mechanisms let the gene become part of
them.
“We want physicians to look for it,” especially in patients who have
traveled recently to India or Pakistan, she said.
What can people do?
Don’t add to the drug resistance problem, experts say. Don’t pressure
your doctors for antibiotics if they say they aren’t needed, use the
ones you are given properly, and try to avoid infections by washing your
hands.
The gene can spread hand-to-mouth, which makes good hygiene very
important.
It’s also why health officials are so concerned about where the
threat is coming from, microbiology professor at South-Paris Medical
School Dr. Patrice Nordmann said. India is an overpopulated country that
overuses antibiotics and has widespread diarrheal disease and many
people without clean water.
“The ingredients are there” for widespread transmission, he said.
“It’s going to spread by plane all over the world.”
The US patients were not related. The California woman needed
hospital care after being in a car accident in India. The Illinois man
had pre-existing medical problems and a urinary catheter, and is thought
to have contracted an infection with the gene while traveling in India.
The case from Massachusetts involved a woman from India who had surgery
and chemotherapy for cancer there and then traveled to the US.
Lab tests showed their germs were not killed by the types of drugs
normally used to treat drug-resistant infections, including “the
last-resort class of antibiotics that physicians go to,” Limbago said.
She did not know how the three patients were treated, but all
survived.
Repeated antibiotics alter beneficial gut germs
Doctors have tried treating some of these cases with combinations of
antibiotics, hoping that will be more effective than individual ones
are. Some have resorted to using polymyxins - antibiotics used in the
1950s and ‘60s that were unpopular because they can harm the kidneys.
The two Canadian cases were treated with a combination of
antibiotics, said Dr. Johann Pitout of the University of Calgary in
Alberta, Canada. One case was in Alberta, the other in British Columbia.
Both patients had medical emergencies while traveling in India. They
developed urinary infections that were discovered to have the resistance
gene once they returned home to Canada, Pitout said.
The CDC advises any hospitals that find such cases to put the patient
in medical isolation, check the patient’s close contacts for possible
infection, and look for more infections in the hospital.
Any case “should raise an alarm,” Limbago said.
AP
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