Health authorities on alert for drug-resistant bacteria

THE EMERGENCE of a new class of drug-resistant bacteria, recently identified in Britain and India, is being closely monitored…

THE EMERGENCE of a new class of drug-resistant bacteria, recently identified in Britain and India, is being closely monitored by Irish health authorities.

The national Health Protection Surveillance Centre (HPSC) said yesterday it had been notified of the existence of bacteria with the NDM-1 antibiotic resistant gene by the UK health authorities last year.

The centre, which monitors the spread and prevalence of antibiotic resistant bugs through its antimicrobial resistance surveillance system, said no cases of the bacteria had so far been detected in the Republic.

The UK health authorities have identified 37 NDM-1 cases, mainly in patients who had travelled to India or Pakistan within the past year, including one in Northern Ireland.

READ MORE

The NDM-1 gene makes common bacteria, such as E.coli, highly resistant to almost all antibiotics, including the most powerful class called carbapenems, which are reserved for use in hospitals to combat hard-to-treat infections.

Some bacteria susceptible to NDM-1 invasion can result in serious forms of pneumonia and urinary tract infections. Experts fear NDM-1 could now jump to other potentially more infectious strains of bacteria which could spread rapidly.

A study, published in the Lancet Infectious Diseases journal yesterday, said bacteria containing the NDM-1 gene were becoming more common in India and Pakistan, and had now been imported to Britain by people returning from these countries.

It also warned such comprehensive antibiotic resistance had the potential to cause a worldwide public health problem.

Dr Fidelma Fitzpatrick, consultant microbiologist with the HPSC, said the widespread use of non-prescription, over-the-counter antibiotics in India had led to the emergence of more drug-resistant bugs.

“The more and more antibiotics that are used, the more likely the bugs are going to develop resistance in their quest to survive,” she added.

The discovery of the NDM-1 gene, Dr Fitzpatrick said, underlined the need for more responsible antibiotic use.

“Good antibiotic prescribing along with basic hygiene control measures like hand washing and sterilisation remains the most effective way of preventing the spread of such bacteria,” she said.

The Lancet study suggested the spread of NDM-1 bugs was being fuelled by people embarking on so called health tourism trips to India and Pakistan to get cheaper medical treatments.

The Department of Health said the National Treatment Purchase Fund no longer sent patients abroad for treatment. The department said it did, where convenient, arrange for patients living in Border counties to be treated in private facilities in Northern Ireland.

Northern Ireland’s Public Health Agency said yesterday one case of NDM-1 associated infection had been detected in the North last year. The spread of NDM-1 producing bacteria would have serious implications for the treatment of infections such as E.coli, it added.

Bacteria Briefing What, Where Why Of Ndm-1

What is NDM-1?

Wrongly described in some reports as a new superbug, NDM-1, or New Delhi metallo-beta-lactamase-1, is a gene found inside common bacteria such as E. coli, which makes them highly resistant to antibiotics.

Where did NDM-1 originate?

It is thought to have developed in India and Pakistan where there is chronic overuse of antibiotics.

Why is it a problem?

Infections caused by the bacteria can, in some cases, result in life-threatening pneumonia and urinary tract infections. There is no emerging class of drugs that can be used to treat such infections.

Why is it spreading?

The spread of the gene is being assisted by international travel and by so called health tourism, as more people travel to get cheaper medical treatments, including cosmetic surgery.

How can spread be prevented?

A more controlled use of antibiotics coupled with basic hygiene control measures such as hand washing and sterilisation remain the most effective way of preventing its spread.

Eoin Burke-Kennedy

Eoin Burke-Kennedy

Eoin Burke-Kennedy is Economics Correspondent of The Irish Times