Times of India
12 August 2010
By Pushpa Narayan
Chennai, India

Scientists have tracked down a drug–resistant superbug that infects patients and causes multipleorgan failure to Indian hospitals, but doctors here see in it the germ of a move to damage the country’s booming medical tourism industry.

The superbug, resistant to almost all known antibiotics, has been found in British patients treated in Indian hospitals. Named after the Indian capital, it is a gene carried by bacteria that causes gastric problems, enters the blood stream and may cause multipleorgan failure, leading to death.

"India also provides cosmetic surgery for Europeans and Americans, and it is likely the bacteria will spread worldwide," scientists reported in The Lancet Infectious Diseases Journal on Wednesday. While the study has the medical world turning its focus to infection control policies in Indian hospitals, the Indian Council of Medical Research (ICMR) has alleged a bias in the report and said it is an attempt to hurt medical tourism in the country that is taking away a huge number of customers from hospitals in the West. "Such infections can flow in from any part of the world. It’s unfair to say it originated from India," ICMR director Dr V M Katoch said.

Katoch has reasons to fume, as the superbug NDM–1 (New Delhi metallo–beta–lactamase) is named after the capital where a Swedish patient was reportedly infected after undergoing a surgery in 2008.

DEADLY STRAIN

• Superbug New Delhi metallo–beta–lactamase (NDM–1) was first reported in a Swedish patient who received treatment in New Delhi in 2008
• What makes the superbug more dangerous is its ability to copy itself and jump from one bacteria to another
• UK, which reported 8 cases of antibiotic resistance in 2007, saw 21 such cases in ’08
• In 2009, the Health Protection Agency of UK issued an alert reporting that NDM–1 was resistant to most antibiotics
• Doctors found 12 of 18 cases linked to the Indian subcontinent. At least 8 have had medical contact in India or Pakistan

India cannot fight superbug charges: Doctors
Chennai: Several cases of the drug–resistant superbug, traced to Indian hospitals, have been reported in the UK, and in 2009, the British health protection agency issued an alert on the ‘gram negative’ bacterial infection that was resistant to even the most powerful and reserved class antibiotics called carbapenems.

In a joint study led by Chennai–based Karthikeyan Kumarasamy, pursuing his PhD at the University of Madras, and UK–based Timothy Walsh from Cardiff University researchers sought to examine whether NDM–1–producing bacteria was prevalent in South Asia and Britain.

"We saw them in most of the hospitals in Chennai and Haryana. We estimate that the prevalence of this infection would be as high as 1.5%," Kumarasamy said. "We found the superbug in 44 patients in Chennai and 26 in Haryana, besides 37 in the UK and 73 in other places across India, Pakistan and Bangladesh.”

What makes the superbug more dangerous is its ability to jump across species. "We have found that the superbug has the potential to get copied and transferred between bacteria, allowing rapid spread," Kumarasamy said.

Doctors said India lacked policies on antibiotics, infection control and registries for hospital–acquired infections. By the ICMR director’s own admission, India cannot scientifically fight back allegations of being the source of such superbugs, as the country does not have a registry of such hospital–acquired infections.

Small–town lad makes it big
It has been a long journey for Kumarasamy, from a Tamil school in TN’s Erode to Cardiff University. "I owe it all to my parents and teachers," he said. As a student, who was always keen on microorganisms, he did his Bsc from Navarasam College of Arts and Science, Narachalur. His interest in bacterial infections grew when he joined a hospital in Erode. "I tracked the bacterial strains that caused a common hospital–acquired infection. I was thrilled to see them under the microscope," he said.