Researchers said on Wednesday they had found a
new gene called New Delhi metallo-beta-lactamase, or NDM-1, in patients
in South Asia and in Britain.
U.S.
health officials said on Wednesday there had been three cases so far in
the United States -- all from patients who received recent medical care
in India, a country where people often travel in search of affordable
healthcare.
NDM-1 makes bacteria
highly resistant to almost all antibiotics, including the most powerful
class called carbapenems. Experts say there are no new drugs on the
horizon to tackle it.
"It's a
specific mechanism. A gene that confers a type of resistance (to
antibiotics)," Dr. Alexander Kallen of the U.S. Centers for Disease
Control and Prevention in Atlanta said in a telephone interview.
With
more people traveling to find less costly medical treatments,
particularly for procedures such as cosmetic surgery, Timothy Walsh, who
led the study, said he feared the new superbug could soon spread across
the globe.
"At a global level, this is a real concern," Walsh, from Britain's Cardiff University, said in telephone interview.
"Because
of medical tourism and international travel in general, resistance to
these types of bacteria has the potential to spread around the world
very, very quickly. And there is nothing in the (drug development)
pipeline to tackle it."
Almost as
soon as the first antibiotic penicillin was introduced in the 1940s,
bacteria began to develop resistance to its effects, prompting
researchers to develop many new generations of antibiotics.
But
their overuse and misuse have helped fuel the rise of drug-resistant
"superbug" infections like methicillin-resistant Staphyloccus aureus, or
MRSA.
MEDICAL TOURISM
In
a study published in The Lancet Infectious Diseases journal on
Wednesday, Walsh's team found NDM-1 was becoming more common in
Bangladesh, India, and Pakistan and was also imported back to Britain in
patients returning after treatment.
"India
also provides cosmetic surgery for other Europeans and Americans, and
it is likely NDM-1 will spread worldwide," the scientists wrote in the
study.
Walsh and his international
team collected bacteria samples from hospital patients in two places in
India, Chennai and Haryana, and from patients referred to Britain's
national reference laboratory from 2007 to 2009.
They
found 44 NDM-1-positive bacteria in Chennai, 26 in Haryana, 37 in
Britain, and 73 in other sites in Bangladesh, India and Pakistan.
Several of the British NDM-1 positive patients had traveled recently to
India or Pakistan for hospital treatment, including cosmetic surgery,
they said.
NDM-1-producing
bacteria are resistant to many antibiotics including carbapenems, the
scientists said, a class of the drugs reserved for emergency use and to
treat infections caused by other multi-resistant bugs like MRSA and
C-Difficile.
Kallen of the CDC said
the United States considered the infection a "very high priority," but
said carbapenem resistance was not new in the United States. "The thing
that is new is this particular mechanism," he said.
Experts
cited two drugs that can stand up to carbapenem-resistant infections --
colistin, an older antibiotic that has some toxic side effects, and
Pfizer's Tygacil.
For many years,
antibiotic research has been a "Cinderella" sector of the
pharmaceuticals industry, reflecting a mismatch between the scientific
difficulty of finding treatments and the modest sales such products are
likely to generate, since new drugs are typically saved only for the
sickest patients.
But the
increasing threat from superbugs is encouraging a rethink at the few
large drugmakers still hunting for new antibiotics, including Pfizer,
Merck, AstraZeneca, GlaxoSmithKline and Novartis.
Anders
Ekblom, global head of medicines development at AstraZeneca, whose
Merrem antibiotic was the leading carbapenem, said he saw "great value"
in investing in new antibiotics.
"We've
long recognized the growing need for new antibiotics, he said.
"Bacteria are continually developing resistance to our arsenal of
antibiotics and NDM-1 is just the latest example."http://www.reuters.com/article/idUSTRE67A0YU20100811?feedType=nl&feedName=ushealth1100