New Delhi Metallo beta lactamase-1: Superbug may turn ordinary bacteria more potent
Syed Akbar Hyderabad: With the NDM-1 gene being capable of changing the genetic code ofpathogens causing cholera and gastroenteritis, doctors will now have to look much morebeyond uncontrollable loose motions and vomiting while treating patients. Doctors warn that cholera and gastroenteritis patients may suffer from infection of theblood, bone, kidney, lung and heart if the pathogens they carry have mutated, harbouringthe NDM-1 gene. These infections are likely to turn more serious than the common symptomsof vomiting and diarrhoea. "Forget about the common symptoms like loose motions and vomiting. Doctors will have tolook beyond these symptoms for treating cholera and gastroenteritis patients. Since theNDM-1 or New Delhi Metallobeta lactamase has been found in bacteria like Vibrio choleraeand Escherasia coli, these pathogens will become more powerful and can infect body organslike kidney, lung and heart, besides bones and blood. Doctors will now have to treatthese problems too," said infectious diseases expert Dr Suneetha Narreddy. The report that the NDM-1 gene has been found across more than a dozen bacteria will notaugur well for people infected by them. These pathogens will emerge more powerful andpotent and will not respond to many antibiotics including the most powerful ones calledcarbapenems. "At present there are only two antibiotics that will fight the NDM-1 influenced superbugs. They respond to colistin/polymixin and tigecyclin. If the pathogens becomeresistant to these antibiotics too, we will have to search for newer medicines," shewarned. Senior physician Dr Aftab Ahmad said it would be difficult in a clinical setting to findout whether the pathogen carries the NDM-1 gene. "First we have to rule out throughculture tests whether the bacteria is resistant to common antibiotics. If it isresistant, then we will have to go in for more tests to determine whether the patient isaffected by NDM-1 gene. But during the process precious time is lost and the infectionspreads to other areas," he said. Ironically most the hospitals in the country are ill-equipped to identify the presence orabsence of NDM-1 gene. Only a few high-end research laboratories have the facility. Watersamples collected by municipal and public health authorities simply test them for thepresence of certain bacteria, but they do not test whether the bacteria are carrying theNDM-1 gene. This makes the identification of the gene even more difficult. "If the NDM-gene is really found in the common bacteria, then one has to take extraprecautionary measures like using good water filters, boiling water and sufficient doseof chlorination. The best way to fight super bugs is prevention," he added.