Recently, there was a furore over a
report by the British journal, The Lancet, which claimed that there was
a presence of a superbug in New Delhi's water bodies. BioSpectrum tries
to find out whether it is just a hoax created to attack the Indian
medical tourism, or do we really need to take the situation seriously
On
April
06,
2011, British
medical
journal, The Lancet published an
online article titled ‘Dissemination of New Delhi Metallo Beta
Lactamase -1” (NDM-1) Positive Bacteria in the New Delhi environment
and its implications for human health: an environmental point
prevalence.' The article was based on the results of reported
testing of the biological samples in the form of swabs of Indian
seepage water and tap water in the UK.
The report led to a huge controversy surrounding the presence of the
antibiotic resistant superbug. The Indian government was quick to
debunk the report. It maintained that the capital's drinking water is
safe and questioned the credibility of the study.
According to the official statement by the Ministry of Health and
Family Welfare, Government of India, the study is unsupported by any
clinical and epidemiological evidence and also does not highlight
the unstable character of the isolates. “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 and post surgical antibiotic treatment indicates
that NDM-1 is not a significant problem in the country,” stated the
statement issued by the Ministry.
However, following the outcry from the public and civil society, the
government decided to set up a committee to carry out research into the
basics of NDM-1.The WHO will be assisting the Indian government in
the research that is expected to reveal if the superbug is a
health threat or not. The director general (DG) of Indian Council for
Medical research (ICMR), Dr V M Katoch, however, says that he is not
aware about the formation of any special committee on the issue.
Speaking to BioSpectrum, he adds, “I am not aware about the formation
of any specific committee for probing the NDM-1 superbug. The talks
about the antibiotic policy are because of unchecked use of antibiotics
and the focus here is not only NDM-1 but the overall microbial
resistance issue. At ICMR, we are clear that it does not have any
huge social implications and that this is just a hype created to
tarnish the image of the country,” says Dr Katoch.
There seems to be an overall consensus among the experts about the
universal presence of superbugs. The experts say that it is present in
the soil, water and even in the gut. The important questions being
raised are, if the rise of this superbug is linked to the use of
antibiotics called carbapenems, then how can it be possible that the
infection is water borne and how can the people of India tackle this
kind of antibiotic issue? Expressing surprise over the fears being
created in the minds of the people, Dr Katoch, said that the superbug
exists everywhere in the world and it is unfair to call India as the
hotbed of superbugs.
Dr V S Chauhan, director, International Centre for Genetic Engineering
& Biotechnology (ICGEB), New Delhi, chose to slightly differ on the
issue. He said, “We need to take this seriously and carefully
investigate its implications on public health. It is very important to
ensure that it doesn't get into the drinking water system.” Meanwhile,
the press release by the Health Ministry also pointed out to the study
carried out by Sir Ganga Ram Hospital, New Delhi, in the affected area.
It shows that E. coli, which is isolated from the gut of a large
randomly selected sample of a pregnant women did not show any
carbapenem resistant E. coli in the stool samples, thus indicating no
presence of NDM-1.
Most of the members of the scientific community agree that the research
findings have gone too far in blaming Indian hospitals and prevalent
hygienic conditions. One expert went to the extent of calling it an
attack on the medical tourism in India.
Rahul Koul in New Delhi