Scientists find superbugs in Delhi drinking water

[Ronan Kelly]

Scientists find superbugs in Delhi drinking water
KATE KELLAND
LONDON? Reuters
Published Wednesday, Apr. 06, 2011 7:31PM EDT
Last updated Wednesday, Apr. 06, 2011 7:32PM EDT

A gene that makes bugs highly resistant to almost all known antibiotics has been found in bacteria in water supplies in New Delhi used by local people for drinking, washing and cooking, scientists said on Thursday.

The NDM 1 gene, which creates what some experts describe as ?super superbugs?, has spread to germs that cause cholera and dysentery, and is circulating freely in other bacteria in the Indian city capital of 14 million people, the researchers said.

?The inhabitants of New Delhi are continually being exposed to multidrug-resistant and NDM 1-positive bacteria?, said Mark Toleman of Britain?s Cardiff University School of Medicine, who published the findings in a study on Thursday.

...

http://www.theglobeandmail.com/news...rbugs-in-delhi-drinking-water/article1974039/

 

[Ronan Kelly]

Re: Scientists find superbugs in Delhi drinking water

Public release date: 6-Apr-2011
[ Print | E-mail | Share ] [ Close Window ]

Contact: Stephen Rouse
RouseS@cardiff.ac.uk
44-292-087-5596
Cardiff University

Antibiotic-resistant bacteria in Indian public water supply
Disease-causing bacteria carrying the new genetic resistance to antibiotics, NDM-1, have been discovered in New Delhi's drinking water supply.

A Cardiff University-led team found new strains of resistant bacteria in the Indian capital, including species which cause cholera and dysentery. The findings are the first evidence of the environmental spread of NDM-1, which had previously only been found in hospitals.

The scientists are calling for urgent action by health authorities worldwide to tackle the new strains and prevent their global spread. The Cardiff scientists also highlight the all-round benefits of preventative measures such as better sanitation and appropriate drinking water.

Cardiff scientists were the first to identify the NDM-1 gene which makes bacteria resistant to a large range of antibiotics. Moreover, the NDM-1 gene is carried on mobile DNA called plasmids which can carry up to 13 other antibiotic resistance genes. While most patients with the bacteria have recently been hospitalised in India, some cases have occurred there without recent hospital treatment, prompting the team to test the wider environment.

Samples were taken in New Delhi from public water taps and from waste seepage, such as water pools in the street. Resistant bacteria were found in 4 per cent of the water supplies and 30 per cent of the seepage sites. The researchers identified 11 new species of bacteria carrying the NDM-1 gene, including strains which cause cholera and dysentry. Antibiotics are used to reduce excretion of bacteria in cholera patients, and to reduce the duration and severity of dysentery. Worryingly, the identified Shigella isolate, which can carry dysentery, is resistant to all appropriate antibiotics.

Study leader Professor Tim Walsh, of Cardiff University's School of Medicine, said: "These are extremely worrying results. We found resistant bacteria in public water used for drinking, washing and food preparation and also in pools and rivulets in heavily-populated areas where children play. The spread of resistance to cholera and to a potentially-untreatable strain of dysentery is also a cause for extreme concern."

A recent UN report showed that 650 million Indian citizens do not have access to a flush toilet and even more probably have no clean water. The New Delhi sewage system itself is reported to be unable to cater for the city's population. The research team also believes that temperatures and monsoon flooding make New Delhi ideal for the spread of NDM-1.

Professor Walsh said: "This is an urgent matter of public health. We need similar environmental studies in cities throughout India, Pakistan and Bangaldesh to establish how widespread resistant bacteria are. If we are to maintain our ability to treat severe infection in vulnerable patients, this action is vital."

"The environmental spread of bacteria is also an international issue. We have discovered patients in the UK and Europe carrying NDM-1 who did not visit hospitals while in India. Our research team at Cardiff would be happy to advise the World Health Organisation and the Asian health authorities on the action that needs to be taken."

The team's findings are published today in The Lancet Infectious Diseases

http://www.eurekalert.org/pub_releases/2011-04/cu-abi040611.php

 

[Ronan Kelly]

Re: Scientists find superbugs in Delhi drinking water

The Lancet Infectious Diseases, Early Online Publication, 7 April 2011doi:10.1016/S1473-3099(11)70059-7Cite or Link Using DOI

Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study

Original Text
Prof Timothy R Walsh PhD a b , Janis Weeks BSc a, David M Livermore PhD c, Mark A Toleman PhD a
Summary

Background
Not all patients infected with NDM-1-positive bacteria have a history of hospital admission in India, and extended-spectrum β-lactamases are known to be circulating in the Indian community. We therefore measured the prevalence of the NDM-1 gene in drinking water and seepage samples in New Delhi.

Methods
Swabs absorbing about 100 μL of seepage water (ie, water pools in streets or rivulets) and 15 mL samples of public tap water were collected from sites within a 12 km radius of central New Delhi, with each site photographed and documented. Samples were transported to the UK and tested for the presence of the NDM-1 gene, blaNDM-1, by PCR and DNA probing. As a control group, 100 μL sewage effluent samples were taken from the Cardiff Wastewater Treatment Works, Tremorfa, Wales. Bacteria from all samples were recovered and examined for blaNDM-1 by PCR and sequencing. We identified NDM-1-positive isolates, undertook susceptibility testing, and, where appropriate, typed the isolates. We undertook Inc typing on blaNDM-1-positive plasmids. Transconjugants were created to assess plasmid transfer frequency and its relation to temperature.

Findings
From Sept 26 to Oct 10, 2010, 171 seepage samples and 50 tap water samples from New Delhi and 70 sewage effluent samples from Cardiff Wastewater Treatment Works were collected. We detected blaNDM-1 in two of 50 drinking-water samples and 51 of 171 seepage samples from New Delhi; the gene was not found in any sample from Cardiff. Bacteria with blaNDM-1 were grown from 12 of 171 seepage samples and two of 50 water samples, and included 11 species in which NDM-1 has not previously been reported, including Shigella boydii and Vibrio cholerae. Carriage by enterobacteria, aeromonads, and V cholera was stable, generally transmissible, and associated with resistance patterns typical for NDM-1; carriage by non-fermenters was unstable in many cases and not associated with typical resistance. 20 strains of bacteria were found in the samples, 12 of which carried blaNDM-1 on plasmids, which ranged in size from 140 to 400 kb. Isolates of Aeromonas caviae and V cholerae carried blaNDM-1 on chromosomes. Conjugative transfer was more common at 30?C than at 25?C or 37?C.

Interpretation
The presence of NDM-1 β-lactamase-producing bacteria in environmental samples in New Delhi has important implications for people living in the city who are reliant on public water and sanitation facilities. International surveillance of resistance, incorporating environmental sampling as well as examination of clinical isolates, needs to be established as a priority.

Funding
European Union.

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70059-7/abstract

 

[Ronan Kelly]

Re: Scientists find superbugs in Delhi drinking water

British findings on germ?s resistance dismissed as ?non-scientific?
Experts allay fear on superbug
New Delhi, April 7, DHNS:

The discovery of the NDM-1 superbug in Delhi?s water system does not pose any public health threat, government experts asserted here on Thursday.


UK researchers had earlier discovered NDM-1 superbug in the public water systems in Delhi, which is the first study to find out the reservoirs of these bugs in the wild. The germ is resistant to almost all antibiotics including the strongest ones like carbapenems.
The Union Health Ministry while acknowledging the presence of the bug in the environment denied it being a cause of worry.

?There is no evidence to suggest any public health threat from the NDM-1 in the environment. Some people want to keep the heat on India,? said V M Katoch, director general of Indian Council of Medical Research.

If the hospitals follow good infection control practices, the chances of transmission of the drug-resistant strain is negligible, said R K Srivastava, director general of health services at the Ministry.


...

http://www.deccanherald.com/content/151860/india-slams-reports-superbug-delhi.html

 

[Ronan Kelly]

Re: Scientists find superbugs in Delhi drinking water

Reported NDM-1 not A Significant Problem: Min of H
Regarding LANCET Article ?Dissemination of NDM-1 Positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence? published online on 6.04.2011, the official statement by Ministry of Health and Family Welfare, Government of India, is as follows:

? ?The environmental presence of NDM-1 gene carrying bacteria is not a significant finding since there is no clinical or epidemiological linkage of this finding in the study area as given in the publication. The fact that patients respond well to medical & postsurgical antibiotic treatment indicates that NDM-1 is not a significant problem in the country.

? Infact in the same area the study carried out by Sir Ganga Ram Hospital, New Delhi shows that Esch.coli isolated from the gut of a large randomly selected sample of pregnant women did not show any carbapenem resistant Esch.coli in the stool samples indicating no presence of NDM1 .

? The carbapenem antibiotic is not required to be used in the treatment of Cholera & shigella dysentery as these cases respond to commonly used antibiotics.

? The publication itself mentions that NDM 1 gene is not a stable character in most of the isolates indicating that any time it can revert back to a sensitive state.

? Carbapenem resistance develops mainly in patients who are on carbapenem therapy. However Carbapenem is sparingly used under the supervision of doctor.

? The chlorination carried out for making water safe for drinking inactivates sensitive & drug resistant bacteria alike.

? Drug resistance surveillance is an ongoing activity in all major hospitals providing sentinel data.

The study is unsupported by any clinical & epidemiological evidence and also does not highlight the unstable character of the isolates.?

SBS
(Release ID :71532)

http://pib.nic.in/newsite/erelease.aspx?relid=71532