Superbug: Brit docs seek reality check (Times of India 13 April 2011)

Want Study To Establish Prevalence In Delhi

New Delhi: British scientists, who found the deadly gene NDM1, now want to join hands with India’s Indian Council of Medical Research (ICMR) to check exactly how many people in Delhi actually carry the E coli bacteria with the gene, inside their gut.

Speaking exclusively to TOI from UK, Dr Mark Toleman from Cardiff University, who recently found gene NDM1 in Delhi’s water supply, said it is now important for the ICMR to know what is the exact “carriage rate” of NDM1 in Delhi or how many people actually carry the E coli bacteria in their gut with the NDM1 gene.

“It can be simply found out from faecal samples or anal swabs.

From there, we can also analyse whether the carriage is higher in hospital patients or in the community. We want to collaborate with ICMR in this study,” Dr Toleman told TOI.

He added “All human beings carry E coli bacteria in their gut flora which is the main cause of urinary tract infections and diarrhoeal diseases. However, not everybody has E coli with NDM1 gene.

These people, when hit by common infections that can be treated with a two-day regimen of antibiotic will find it difficult to recover because of the antibiotic resistant bacteria.”
Since the time the existence of NDM1 was announced last August, 17 countries have reported infections of it.

“The community carriage study, looking for presence of the NDM-1 gene in faecal samples or anal swabs in different regions of New Delhi will highlight risk factors, particularly water supplies or food and also put down a base-line to assess if intervention measures are working or not,” he said.

According to Dr Toleman, “A rough guess is that at least 5 per cent of Delhi’s population would be carrying E coli and the NDM1 gene.

Several people in the 17 countries who have been affected by NDM1 have visited Bangladesh, Pakistan or India. Several had not entered hospitals but just travelled around.”

However, a collaboration between ICMR and Cardiff is unlikely.

ICMR still maintains that “NDM1 is no public health concern” and questions the intention of the scientists who carried out the study.

Meanwhile, India’s plans to conduct prescription audit to check for antibiotic overuse and National Centre for Disease Control’s (NCDC) decision to lead a study to gauge the “prevalence of Carbapenem resistance in Delhi’s ICUs and environment,” was called a “major step in the right direction” for which Dr Toleman said, “I applaud the Indian government.”