NDM-1

Press reports in August 2010 predicted the end of the antibiotic era if bacteria that generate an enzyme that’s known as NDM-1 (“New Delhi metallo-β-lactamase-1”) spread widely. The enzyme is able to counter all known antibiotics. Bacteria containing it are potentially a more serious threat to public health than the most resistant kind currently known, MRSA (methicillin-resistant staphylococcus aureus).

As its full name suggests, NDM-1 is linked to India, first being identified in a Swedish patient who received medical treatment in New Delhi in December 2009. It is spreading to other countries as a result of medical tourism, in which people travel to the Indian subcontinent to get less expensive medical treatment. The gene that generates NDM-1 is at the moment known to exist in two species of bacteria, which can respectively cause fatal pneumonia and urinary tract infections. However, in common with other bacterial genes it can transfer to other species, so potentially widening its impact.

The threat was reported in the journal Lancet Infectious Diseases on 11 August, which concluded that NDM-1 is “potentially a major global health problem” and that “co-ordinated international surveillance is needed”. The Indian government has responded angrily to the claim that it originated in India and in particular to its name.

NDM-1-producing bacteria are resistant to many existing antibiotics including carbapenems — a class of drugs often reserved for emergency use and ‘last resort’ treatment.

Daily Mail, 12 Aug. 2010.

A team of researchers from a leading private hospital in Mumbai came to similar conclusions as the British study, which warned that foreigners coming to India for cut-price treatment could pick up NDM-1 and spread it worldwide.

Vancouver Sun, 13 Aug. 2010.