Su­per­bug at Mum­bai’s doorstep

Pune hos­pi­tal records 20 NDM-1 cases in last two months, but med­i­cal pro­fes­sion­als in the city say there is no cause to worry, yet

DNA (Daily News & Analysis) Mumbai Edition - - FRONT PAGE - Somita Pal

Clin­i­cal mi­cro­bi­ol­o­gists at Pune’s Sas­soon hos­pi­tal and Na­tional Cen­tre of Cell Science (NCCS) have found as many as 20 peo­ple in­fected with the NDM-1 (New Delhi me­tallo-beta-lac­ta­mase-1) gene since the last two months. Given the highly con­ta­gious na­ture of the pathogen, those in­fected need to be iso­lated in spe­cial cells to pre­vent its spread.

The sci­en­tists col­lected sam­ples of blood, urine and puss from 3,172 pa­tients at the hos­pi­tal and found that 885 had gram neg­a­tive bacilli (bac­te­ria which cause a ma­jor­ity of in­fec­tions). Of these 885, as many as 181 were re­sis­tant to the car­bapenem fam­ily of drugs, while 20 were de­tected with the NDM-1 gene.

“Dr Renu Bharad­waj of NCCS had se­lected some sam­ples. In 20 of them, the se­quence showed ho­mol­ogy to NDM-1,” said Dr Yo­gesh Shouche, se­nior sci­en­tist at NCCS.

State health authoritie­s are now gear­ing up to set a pro­to­col un­der which all pub­lic hos­pi­tals in the city will need to send blood and urine sam­ples of pa­tients not re­spond­ing to treat­ment for NDM-1 test­ing.

“This will help us find NDM-1 cases, if any, in the city,” said Dr Pravin Shin­gare, joint di­rec­tor, Direc­torate of Med­i­cal Ed­u­ca­tion and Re­search (DMER). Ac­cord­ing to authoritie­s, this is a pre­cau­tion­ary mea­sure and Mum­bai doesn’t need to panic as the per­cent­age of drug-re­sis­tant In Pune, clin­i­cal mi­cro­bi­ol­o­gists at the gov­ern­ment-run BJMC and Sas­soon Gen­eral Hos­pi­tal and the Na­tional Cen­tre of Cell Science (NCCS) col­lected sam­ples of blood, urine and pus from 3,172 over the last two months cases is not on the rise.

The su­per­bug, the nam­ing of which cre­ated much con­tro­versy in re­cent months with the In­dian authoritie­s tak­ing ex­cep­tion to ‘New Delhi’, is known to make bacte- ria re­sis­tant to even the most high-end an­tibi­otics, mak­ing it dif­fi­cult to treat in­fec­tions. Pa­tients who get in­fected do not have a good chance of sur­vival, say ex­perts.

The mi­cro­bi­ol­ogy de­part- ment of Nair hos­pi­tal at Mum­bai Cen­tral con­ducted a study on me­tallo-beta-lac­ta­mases (MBLs) in­ci­dence in their pa­tients last year. Around 18% were found to be MBL pro­duc­ers. “NDM-1 is a more re­sist- ant type than MBL. We can’t say any­thing about the pres­ence of NDM-1 in the city. We plan to con­duct a study in a month, which will help us iden­tify the ge­o­graph­i­cal lo­ca­tion of NDM-1 cases, if any,” said Dr Jayan­thi Shas­tri, pro­fes­sor, mi­cro­bi­ol­ogy depart­ment, Nair hos­pi­tal.

Mean­while, re­searchers in a Mum­bai hos­pi­tal had re­ported pres­ence of a mul­tidrug-re­sis­tant su­per­bug in an ar­ti­cle pub­lished in an In­dian med­i­cal jour­nal, months be­fore UK jour­nal Lancet’s study.

Dr Camilla Ro­drigues, mi­cro­bi­ol­ogy head, PD Hin­duja hos­pi­tal, said, “At our hos­pi­tal, we screen for NDM-1. If we find a pos­i­tive case, we iso­late the pa­tient and fol­low the in­fec­tion con­trol rules strin­gently.”

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