MRSA Action UK: NDM-1 - The emerging knockout superbug bigger than MRSA
Thursday, 12 August 2010 12:00 AM
With the recent announcement of 50 cases of a potential new development of a gene, that makes even the most powerful antibiotics useless, this gives MRSA Action UK grave cause for concern.
The NDM-1 gene (New Delhi Metallo-beta-lactamase) is not a new bacteria, it is more over a gene that lives in a DNA strand called a plasmid, which is known to be easily transferable between one bacteria and another.
History has shown us that bacteria use gene codes such as plasmids and transposons to transfer DNA coding including resistant genes, not only from bacteria from the same microbiological family, but more importantly they can also transfer this resistance to bacteria from different non-related microbiological families.
While we have only seen 50 cases of the NDM-1 resistant gene in the UK, our concern centres around the possibility that this new NDM-1 gene can transfer itself in to a strain of bacteria that is very good at cross transmission between people and patients. Another concern stems from the sobering report from Professor Timothy Walsh who is Professor of Immunity, Infection and Biochemistry at Wales Cardiff University.
The report showed between 1 to 4% of gram-negative bacteria carried the NDM-1 gene. However, the fact that 37 isolates came from 29 patients 17 of whom had recently travelled to India and Pakistan leaves 12 people who had not travelled there meaning it is probable they contracted the NDM-1 gene elsewhere. Could we be seeing the origins of a new mighty super bug impervious to any antibiotics we have currently available? Some within the Health Protection Agency share our concerns it would seem, from the reports circulating.
Another serious concern that our Charity has, is that while most highly resistant forms of NDM-1 have manifested themselves in the hospital environment, bacteria carrying the NDM-1 gene are spreading throughout those communities worst affected in India. This concern is that it is just a matter of time unless action is taken before this new NDM-1 affects the communities in the UK. MRSA began in UK hospitals in the South East and has now spread globally into communities and there is no reason to suspect that this new development of NDM-1 will act any differently.
Only in June of this year at a GovToday conference did our Charity raise our concerns of infections such as MRSA and C-diff being on the rise in the community in this country. We also wrote to the Health Minister Simon Burns MP with our concerns which we believe are being dismissed, which is alarming as there is no room for complacency when considering the risks.
Our belief is that if the NDM-1 gene can transfer itself through the plasmids, (and there is no potential reason why it cannot) and it does transfer to MRSA, C-diff, E-coli and Kelbsiella Pneumonia it would have very serious ramifications on health in this country, and the past successes of infection control could be consigned to the history books.
The New Coalition Government needs to follow our advice and extend further the monitoring and recording of all bacteria and to extend the screening for these potentially lethal pathogens both in our hospitals and in the community especially the care homes, GP practices and such.
Hegel's principle shows we learn nothing from history and we have to remember that MRSA started in much the same manner over 40 years ago and spread across the globe spreading into every corner of society.
Burying our heads in the sand in much the same way as before will only create massive problems for future generations and this could leave the bacteria winning this war. We are in a race against a formidable enemy, they are adapting, and changing to the environment we create for them, we have to change that environment so that we retain control.
This will not happen until Governments (including our own) face up to the task that is being set by these bacteria, they need to work in collaboration with the pharmaceutical industry to find new and better ways to combat the threat from these bacteria.
Bacteria are becoming fitter and stronger, while our Governments are losing the resolve to take the tough decisions necessary to win this battle.
With the expected cuts in public spending we believe this is not the time to cut infection control budgets especially in the Health Protection Agency. There is more spending on research on HIV and AIDs than there is on healthcare and community acquired infections, and with the emerging threats from organisms like the NDM-1 gene the potential for harm is a far greater threat.
Derek Butler
Chair
MRSA Action UK
Tel No 07762 741114
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