Millennium Post

Superbugs immune to antibiotics

For nearly a century, bacteria-fighting drugs called antibiotics have been saving millions of lives across the world. But, in recent decades, several tried-and-tested medicines have reached their expiry date and  no longer work as they are rendered ineffective by certain types of bacteria. These strains of bacteria that are resistant to antibiotics are called superbugs.

Researchers have blamed it on a new gene called New Delhi Metallo-beta-lactamase-1, or NDM-1, which produces an enzyme that makes bacteria highly resistant to almost all antibiotics. These include the most powerful type of drugs called carbapenems, which are usually reserved for emergency  and to treat infections caused by other multi-resistant bugs.

NDM-1 was identified by a team of doctors led by Timothy Walsh in 2010 in British patients who had travelled to India or Pakistan (on medical tour) for affordable medical care, particularly for procedures such as cosmetic surgery. When these people were later treated in UK hospitals, NDM-1 passed to other patients, the doctors had concluded.Walsh’s study, published in the British medical journal Lancet, had found that NDM-1 was becoming more common in Bangladesh, India, and Pakistan and was also imported in Britain through patients returning after treatment.The study on superbug caused intense controversy because of its repercussion on India’s popular medical tourism industry. The Government immediately refuted the findings.

Since then, cases have reported in several countries including the United States, Canada, Belgium, the Netherlands, Austria, France, Germany, Kenya, Australia, Hong Kong and Japan.

Following the spread of superbugs, doctors and scientists raised an alarm leading to a world-wide scare. Doctors are worried that superbugs are increasingly challenging antibiotics. If there are no antibiotics to treat them, then routine procedures could become life-threatening.

But, antibiotic resistance is a multifaceted global issue. Last year, the WHO had in a report warned that antibiotic resistance–when bacteria change so antibiotics no longer work in people who need them to – is now a major global threat to public health. Resistance is occurring across many different infectious agents, the report noted. It focused on antibiotic resistance in seven different bacteria responsible for common and serious diseases such as bloodstream infections (sepsis),
diarrhoea, pneumonia, urinary tract infections and gonorrhoea.

Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-expanding range of infections caused by bacteria, parasites, viruses and fungi. A post-antibiotic era, in which common infections and minor injuries can kill, is instead a very real possibility for the 21st century.

Regrettably, the use of existing antibiotics is helping to create new drug-resistant superbugs. Antibiotic dSrugs save lives, but their excessive use, often for non-life threatening conditions like treating flu will make the drugs stop working for everyone. The reason: the bacteria they target grow more and more resistant, according to RamananLaxminarayan, Vice President, Research and Policy, Public Health Foundation of India (PHFI).

Various other reasons have also been attributed to the proliferation of superbugs. These include self-medication, indiscriminate use of antibiotics and poor sanitation and hygiene, especially in hospitals. The most susceptible are neonatal intensive care wards where newborns are at greater risk because their immune systems are fragile. In India, more than 3,00,000 newborns die on the very first day of birth; thus, accounting for nearly one-third of all babies dying globally.Doctors have found that they carry antibiotic-resistant infections.

Antibiotics are freely available over the counter across the country. Patients, to avoid paying consultation fee to doctors, seek chemists’ opinion, purchase drugs and swallow them at will, ignorant of the chemical composition of the antibiotic. Self-diagnosis and consuming a wrong drug, without the physician’s prescription,may prove counter-productive.

According to a WHO survey on antibiotic use in Delhi, 53 per cent of Delhiites self-prescribe antibiotics, 1 in 4 stop taking them once they feel better, instead of finishing the course and 25 per cent treat regular fever with antibiotics. And, almost 18 per cent doctors prescribe antibiotics for non-specific fever, cough and even diarrhoea.

The findings and warnings ought to be taken seriously by India, home to tuberculosis, malaria and several other diseases. As population surges, so do colossal dispersal of wastes by irresponsible dwellers across the country. Wastes lie untreated and invite bacteria which spread diseases. The clean India campaign is yet to take off following the show off.

The growing threat of antibiotic resistance is of serious concern. Building toilets and sweeping streets with broomsticks alone will not banish the superbugs. Instead, India will have to wield a magic broom to diappear garbage heap from streets, and most importantly hospitals and everywhere.

Our policy makers and the public have woken up to the problem but it may take years to witness clean surroundings. Equally importantly, both patients and doctors alike need to think of antibiotics – and their ongoing effectiveness – as a finite resource, and to think twice before we tap into it.

The author is an independent journalist
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