Times of India
07 April 2010
By Nirmala M Nagaraj
Bangalore, India

Overuse Of These Strong Pills Could Kill Your Resistance To Bacterial Infections
When our defences are down, attacks are imminent: in today’s smoggy world, when even simple bacterial infections are increasingly becoming life–threatening, it is dismaying to note that antibiotics are just not enough for some strains of bacteria.

And that’s because popping antibiotics is common, at least in the sub–continent; but this trend is slowly killing resistance.

According to D Raghunath from the Sir Dorabji Tata Centre for Research in Tropical Disease, Innovation Centre, Indian Institute of Science (IISc): “With the increase in antibiotics resistance, bacterial infections are becoming difficult to treat.”

A study published in the March edition of the Journal of the Association of Physicians of India (JAPI) says that due to increasing antibiotics resistance to bacterial infections, we are left without a single effective antibiotics option. Especially among the immuno–compromised, transplant and cancer patients on chemotherapy are prone to develop infections, and known to have a high mortality rate.

What is New Delhi Metallo–1?
Interestingly, a National Resistance Alert in UK was issued in January 2009 to warn of an increasing number of carbapenem–resistant strains of Enterobacteriaceae being identified in UK hospital patients. Not surprisingly, a significant proportion of them had received medical treatment in India and Pakistan. Now, this new resistance mechanism is named ‘New Delhi Metallo–1’ (NDM–1).

A recent study published in JAPI shows that within a span of three months at Hinduja National Hospital, Mumbai, 22 NDM–1 producing Enterobacteriaceae have been isolated, and from a single hospital.

Causes for Resistance

• Public health experts blame overprescribing of antibiotics in India. Without proper diagnosis, therapy with anti–microbial combinations is usually started even before culture specimens are sent to the laboratory.
  
  Though upper respiratory tract infections are usually due to viruses, and in the absence of a culture, patients receive antibiotics, resulting in development of bacterial resistance.
  
  Surprisingly, in India, there is no restriction on the usage of high–end antibiotics. Without proper monitoring and surveillance, doctors here don’t have to justify the prescription.
• Other reasons are: over–the–counter access to antibiotics, primitive injections control in hospitals, self–medication is common and often incomplete. Secondly, deficient sanitation conditions have contributed to the transmission and acquisition of antibiotic resistance to bacterial infections.
  
  Infectious diseases expert Dr Sunitha Desikan says: “By the time a flu patient reaches hospital, he/she develops resistance with multiple course of different antibiotics. And, without proper diagnosis even for viral infections, antibiotics are prescribed, leading to drug resistance.’ Some of the bacteria we have already developed resistance to are – E Coli, Tseudomonas, Kledsiella etc., because of which patients are succumbing to even common problems like urinary, respiratory and abdominal infections.

H1N1 Double Trouble
During the recent H1N1 flu pandemic, due to bad viral infections, the lungs of flu patients were damaged, and they were put on ventilators and spent some days in the ICU, developing secondary bacterial infections. As some of them had already developed resistance to antibiotics, it was difficult to treat the secondary infection, leading to death. “Due to the long stay of patients for treatment, hospital–acquired infections are also common, and tackling them with increasing antibiotics resistance has been a challenge,’ said Dr Desikan.

What’s Antibiotic Stewardship?
It is mandatory in western countries that hospitals implement an antibiotic stewardship programme. It is a basic surveillance method used to monitor antibiotics prescription in hospital – all antibiotics prescribed to the patient are reviewed, and doctors have to justify the usage of antibiotics.

Day’s Events
Manipal Cure and Care (MCC) will launch ‘how stressed is Bangalore’ campaign on World Health Day. It’s an attempt to understand the effects of urbanization on Bangaloreans, with focus on stress levels, obesity and overall health. Through the campaign, MCC aims to reach out to 1,000 corporate and residential societies starting from Wednesday. Trained medical practitioners will visit business houses and residential societies to conduct simple noninvasive procedures– height, weight and BP checks – that does not take more than couple of minutes.
Contact: 919611896540

HealthCare Global Enterprises (HCG)
will conduct a free cancer detection camp between 10 am and 3 pm. The camp will be held simultaneously at HCG Towers, P Kalinga Rao Road, Sampangi Ram Nagar and Bangalore Institute of Oncology, off Lalbagh Double Road. Clinical examinations like history taking, pulse, BP, temperature and systematic examinations will be done free of cost. Contact: 22129829

M S Ramaiah Hospital will organize a public health awareness programme on ‘healthy lifestyle’. Eminent doctors will discuss topics like health, nutrition, importance of exercise etc. An interactive session will follow the discussion.
Contact: 22183060.

HOSMAT Hospital along with Association of People with Disability (APD) will conduct a free screening camp for people suffering from orthopedic problems between 9.30 am and 1.30 pm on Wednesday at the HOSMAT Super Specialty Hospital. Hand–crafted items made by the disabled people of APD will be on sale at the venue. Contact: 9845266023

FPA India, Bangalore Branch and Field Service and Inter–cultural Learning India (FSL India) will jointly organise an event on the theme – urbanization and health for adolescents, between 10 am and 4 pm, Wednesday. Venue: FPA India Bangalore Branch, 1st Floor, City Corporation Maternity Hospital, Palace Guttahalli. Contact : 080–23360205.

BGS Global Hospitals will conduct a free health check–up camp at the hospital. Patients can avail of free consultation, BP check and ECG on Wednesday. Venue: 67, Uttarahalli Main Road, Kengeri. 2625 5555

Department of public health dentistry, M R Ambedkar Dental College will organize a CDE programme on the theme – to raise awareness about health challenges associated with urbanization. Venue: M R Ambedkar Dental College Auditorium, Cline Road, Cooke Town. 080–2546 3097