Mumbai doctors had warned of superbug in March

Indian doctors had warned earlier in the year about the multi-drug resistant superbug — months before the Lancet study that the government is condemning for scaremongering.

A team of researchers from Hinduja Hospital — including Payal Deshpande, Camilla Rodrigues, Anjali Shetty, Farhad Kapadia, Ashit Hedge, Rajeev Soman — in March warned that foreigners coming to India for cheap treatment could pick up the bacterium and spread it worldwide.

They came to the conclusion after noticing 22 instances of New Delhi metallo-lactamase-1 (NDM-1) in 24 patients between August and November last year. “This high number in a relatively short span is a worrisome trend that compromises the treatment options with carbapenems,” they wrote in the Journal of the Association of Physicians of India (JAPI) in March (carbapenems are a type of antibiotic used as a last resort against many multi-drug resistant infections).

Meanwhile, microbiologists and infection experts from across the country agreed that while the scientific theory behind superbugs and drug resistance is correct, it is unfair to taint New Delhi or India in this context. Union minister of state for health Dinesh Trivedi’s demand for an apology from the Lancet is legitimate, they added.

“Bugs are getting smarter and drug resistance is happening globally and not just in India or New Delhi,” said Dr Abhay Chaudhary, director, Haffkine Institute, and president, Indian Association of Medical Microbiologists. “Wherever there is a new discovery, scientists name it after that place. It was incidental that the discovery was done in New Delhi. It’s not correct to say that these bugs are spreading because of surgery in New Delhi or India.”    

Secondly, it is not the Lancet report but its interpretation that is misleading.

“The microbe does not have race, religion or country. Just to put it in South-East Asia, is wrong. It is a global problem,” said Dr Shashank Joshi, editor, Journal of the Association of Physicians of India (JAPI). “MRSA was not named after Kettering, UK.”
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for several difficult-to-treat infections in humans, and was discovered in the UK.

“I sense a sinister motive in naming the bug New Delhi metallo-beta- lactamase 1 (NDM-1) on the eve of the Commonwealth Games,” he added.

A study conducted by Dr Jean-Louis Vincent of Erasme University Hospital in Brussels (Belgium) and colleagues, published in the December 2009 edition of the Journal of the American Medical Association, said that heavy use of antibiotics in ICUs can make such units into epicentres for bacteria to mutate into drug-resistant forms and spread.

Scientists also believe that China’s reckless use of antibiotics in the health system and agricultural production was creating an explosion of drug-resistant superbugs that risk global health.

“This particular bacteria is present in the environment and present in many people around the globe, many of whom haven’t travelled to India or have no connection with the country. So, how can you link it with a particular country?” asked VM Katoch, director-general, Indian Council of Medical Research.

“There is a need for more detailed research on this issue. Having personally operated on more than 200 patients from various countries abroad, I can safely vouch for the fact that not a single complication has ever occurred,” said Dr Sanjay Borude, bariatric surgeon, Breach Candy hospital.