NDM-1 SUPERBUG DISCOVERY

Presented by,

Soma Vinisha

Pharm D I yr (PB).

What is Superbug?

Superbug is a gene (DNA code)

called New Delhi metallo-beta

lactamase-1(NDM -1) carried by

some bacteria.

If a bacteria strain

carries this NDM-1 gene it is

resistant to nearly all antibiotics,

including carbapenem antibiotics.

This is a drug resistance super bug that infects patients and causes multiple organ failure leading to death.

This is a type of resistance that has been spreading different bacteria.

Gram negative bacterial infections are resistant to even most powerful reserved antibiotics called carbapenems.

This gene makes the bacteria produce an enzyme called a carbapenemase making carbapenem antibiotics ineffective (as well as virtually all other antibiotics)

Why is it dangerous?

This NDM-1 does not lie on genome of bacteria but they are present on small, circular pieces of DNA called plasmids which can be transferred between bacteria even though they are unrelated.

For example this gene could move from E.Coli bacterium that causes UTI to other types of bacteria that cause pneumonia or cholera and thus leads to multiple organ failure and finally death.

Plasmids undergo cell duplication and are difficult to eradicate hence resistant to any dose of antibiotics.

Discovery This gene was discovered by Young and team and was named after the Indian capital New Delhi that led to controversy as this has created a misconception and a feeling that the point of origin of the bacteria is in India. In 2008 a Swedish patient was reportedly infected after undergoing a surgery, later cases were identified in UK in 2009.

Scientists reported in The Lancet Infectious Diseases Journal that

“India also provides cosmetic surgery for Europeans and Americans, and it is likely the bacteria will spread worldwide," on which the Indian Council of Medical Research has alleged a bias in the report and said it is an attempt to hurt medical tourism in the country that is taking away huge custom from hospitals in the West. It also flayed the report saying the superbug is a plasmate which is present in the environment of every country.This plasmate has many genes that increase its ability to be resistant to many antibiotics

PREVENTION:

The preventive steps include stopping indiscriminate and irrational use of antibiotics.

To stop prescription free sale of antibiotics which is mostly seen in Indian subcontinents. A careful selection of antibiotics in each clinical condition drastically reduces the chance of emergence of antibiotic resistance.

Other most important mode of prevention of New Delhi Metallo 1 (NDM 1) superbug infection is promoting hygienic hand wash.

Proper sanitation and stringent infection control may give us a great success in controlling infection.

Reporting any incidence of Superbug NDM-1 and isolating that patient at the earliest, is essential and helps prevent the further spread of such organisms.

TREATMENT:Treatment is guided by the antibiotic resistance pattern. Many NDM-1 strains are resistant to all antibiotics except for colistin but it is an older antibiotic that has not been used much in recent decades, as it is somewhat more toxic than other antibiotics. A few NDM-1 strains have been sensitive to tigecycline (Tygacil), but this agent should be used cautiously in serious infections because it does not achieve high levels in the bloodstream.

A few strains have also been sensitive to aztreonam, although the U.S. strains were not. Researchers have identified a new antibiotic compound that may inhibit NDM-1 containing bacterial topoisomerase function so the bacterial replication is inhibited or stopped. Unfortunately, the compound has not gone through any clinical trials and is not commercially available.

Scientists are working quickly to develop anew class of antibiotic drugs. Picture: Sebastian Kaulitzki

References

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70143-2/abstract?version=printerFriendlyhttp://ezinearticles.com/?Aug-21-Superbug-NDM-1---Its-Prevention-and-Cure&id=4901913http://www.kypost.com/dpp/news/health/Superbug-Gene-wews-4561679171284734951226http://www.health-qna.com/what-are-the-symptoms-of-the-ndm-1-superbughttp://www.indiastudychannel.com/resources/124270-Causes-symptoms-treatment-prevention-New.aspxhttp://www.medicinenet.com/ndm-1/page3.htmhttp://www.medicalnewstoday.com/articles/197616.phphttp://www.mahalo.com/ndm-1-symptoms