'Superbug' Alert As Resistant Gene Hits UK

[TrueScotsman]

http://news.sky.com/skynews/Home/UK-News/Superbug-Enzyme-New-Delhi-Metallo-1-Detected-In-UK-Hospitals-Is-Resistant-To-Antibiotics/Article/201008215681024?lpos=UK_News_Carousel_Region_2&lid =ARTICLE_15681024_Superbug%3A_Enzyme_New_Delhi_Met allo_1_Detected_In_UK_Hospitals_Is_Resistant_To_An tibiotics

A 'superbug' that is resistant to the most powerful antibiotics has reached the UK.

Scientists are warning the bug, an enzyme called New Delhi-Metallo-1 (NDM-1), could spread across the world as nothing is being developed to treat it.

There has been 37 reported cases in the UK, mainly among patients who travelled to areas of Asia for cosmetic surgery, transplants and cancer treatment.

The bug can exist inside different bacteria, like E.coli, and cause infections in other parts of the body.

It can also move from one bacterium to another and experts are concerned it may attach itself to more dangerous diseases and cause them to become resistant to antibiotics.

The scientists, writing in the journal Lancet Infectious Diseases, said: "It has an alarming potential to spread and diversify."

Dr David Livermore, one of the researchers and who works for the UK's Health Protection Agency (HPA), said: "The NDM-1 problem is likely to get progressively worse in the foreseeable future.

"The potential for wider international spread and for NDM-1 to become endemic worldwide are clear and frightening."

Infections have already been passed from patient to patient in UK hospitals.

Researchers say the way to stop NDM-1 is to identify and isolate any patients who are infected.

snip

EDIT: Not sure if this should be in the E.Coli section or what? Apologies if so.

[TrueScotsman]

Re: 'Superbug' Alert As Resistant Gene Hits UK

http://www.bbc.co.uk/news/health-10925411

[quote]

A new superbug that is resistant to even the most powerful antibiotics has entered UK hospitals, experts warn.

They say bacteria that make an enzyme called NDM-1 have travelled back with NHS patients who went abroad to countries like India and Pakistan for treatments such as cosmetic surgery.

Although there have only been about 50 cases identified in the UK so far, scientists fear it will go global.

Tight surveillance and new drugs are needed says Lancet Infectious Diseases.

NDM-1 can exist inside different bacteria, like E.coli, and it makes them resistant to one of the most powerful groups of antibiotics - carbapenems.

These are generally reserved for use in emergencies and to combat hard-to-treat infections caused by other multi-resistant bacteria.

And experts fear NDM-1 could now jump to other strains of bacteria that are already resistant to many other antibiotics.

Ultimately, this could produce dangerous infections that would spread rapidly from person to person and be almost impossible to treat.

At least one of the NDM-1 infections the researchers analysed was resistant to all known antibiotics.

Similar infections have been seen in the US, Canada, Australia and the Netherlands and international researchers say that NDM-1 could become a major global health problem.

Infections have already been passed from patient to patient in UK hospitals.



The way to stop NDM-1, say researchers, is to rapidly identify and isolate any hospital patients who are infected.

Normal infection control measures, such as disinfecting hospital equipment and doctors and nurses washing their hands with antibacterial soap, can stop the spread.

And currently, most of the bacteria carrying NDM-1 have been treatable using a combination of different antibiotics.

But the potential of NDM-1 to become endemic worldwide is "clear and frightening", say the researchers in The Lancet infectious diseases paper.



National alert

[quote]


more.............

[cartski]

Re: 'Superbug' Alert As Resistant Gene Hits UK

Does NDM-1 herald the end of the antibiotic era?
10:30 12 August 2010
Health
Jessica Hamzelou, reporter

The spread of a drug-resistant bacterial gene could herald the end of antibiotics, researchers warned us yeterday. "In many ways this is it," Tim Walsh at Cardiff University, UK, told The Guardian newspaper. "This is potentially the end."

Walsh's bleak prediction follows his research into a drug-resistant bacterial gene called NDM-1, or New Delhi metallo-β-lactamase 1, which was first identified in India.

In the study, published in The Lancet Infectious Diseases, Walsh's team investigated cases of multi-drug resistant Enterobactericeae infections - which include E.Coli and Salmonella - in India, Pakistan and the UK from 2003-2009, to find out how many NDM-1 had a hand in. They identified 143 cases of NDM-1 across India and Pakistan, but 37 - a surprisingly high figure - in the UK.

more...........

http://www.newscientist.com/blogs/shortsharpscience/2010/08/does-ndm-1-herald-the-end-of-t.html

J.

[cartski]

Re: 'Superbug' Alert As Resistant Gene Hits UK

Lancet article is open source, but needs a registration. Note that they tend to follow up with lots of emails ads.

Abstract below.

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70143-2/fulltext#article_upsell

J.

Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

Original TextKarthikeyan K Kumarasamy MPhil a, Mark A Toleman PhD b, Prof Timothy R Walsh PhD b , Jay Bagaria MD c, Fafhana Butt MD d, Ravikumar Balakrishnan MD c, Uma Chaudhary MD e, Michel Doumith PhD c, Christian G Giske MD f, Seema Irfan MD g, Padma Krishnan PhD a, Anil V Kumar MD h, Sunil Maharjan MD c, Shazad Mushtaq MD c, Tabassum Noorie MD c, David L Paterson MD i, Andrew Pearson PhD c, Claire Perry PhD c, Rachel Pike PhD c, Bhargavi Rao MD c, Ujjwayini Ray MD j, Jayanta B Sarma MD k, Madhu Sharma MD e, Elizabeth Sheridan PhD c, Mandayam A Thirunarayan MD l, Jane Turton PhD c, Supriya Upadhyay PhD m, Marina Warner PhD c, William Welfare PhD c, David M Livermore PhD c, Neil Woodford PhD c

Summary
Background

Gram-negative Enterobacteriaceae with resistance to carbapenem conferred by New Delhi metallo-β-lactamase 1 (NDM-1) are potentially a major global health problem. We investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK.

Methods
Enterobacteriaceae isolates were studied from two major centres in India?Chennai (south India), Haryana (north India)?and those referred to the UK's national reference laboratory. Antibiotic susceptibilities were assessed, and the presence of the carbapenem resistance gene blaNDM-1 was established by PCR. Isolates were typed by pulsed-field gel electrophoresis of XbaI-restricted genomic DNA. Plasmids were analysed by S1 nuclease digestion and PCR typing. Case data for UK patients were reviewed for evidence of travel and recent admission to hospitals in India or Pakistan.

Findings
We identified 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan. NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin. K pneumoniae isolates from Haryana were clonal but NDM-1 producers from the UK and Chennai were clonally diverse. Most isolates carried the NDM-1 gene on plasmids: those from UK and Chennai were readily transferable whereas those from Haryana were not conjugative. Many of the UK NDM-1 positive patients had travelled to India or Pakistan within the past year, or had links with these countries.

Interpretation
The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed.

Funding
European Union, Wellcome Trust, and Wyeth.