While India continues to fume over the study that named the new antibiotic resistant bacteria after the country’s capital — New Delhi Metallo-beta lactamase-1 (NDM-1) — and disputes the fact that the country is the origin of this superbug, the World Health Organisation (WHO) seems to have virtually endorsed the study published in The Lancet Infectious Diseases.
In a statement issued on Saturday, the WHO said that the article published on August 11, 2010 identified a new gene that enables some types of bacteria to be highly resistant to almost all antibiotics. “The article has drawn attention to the issue of antimicrobial resistance (AMR), and, in particular, has raised awareness of infections caused by multi-drug resistant bacteria,” the WHO said.
Without talking about India or on the naming of the bacteria, the WHO said that while multi-drug resistant bacteria are not new and will continue to appear, this development requires monitoring and further study to understand the extent and modes of transmission, and to define the most effective measures for control.
It has advised countries to be prepared to implement hospital infection control measures to limit the spread of multi-drug resistant strains and to reinforce national policy on prudent use of antibiotics, reducing the generation of antibiotic resistant bacteria.
Agreeing with the WHO’s take on the Lancet report on the superbug, Dr Abhay Chaudhary, president of the Indian Association of Medical Microbiology said, “There is definitely a need to observe restraint on the use of newer antibiotics, and also a need to improve infection control practices in hospitals.”
According to GB Davar, director and consultant surgeon, Hinduja Hospital, every hospital should have a hospital infection unit along an antibiotic policy, which suggests that antibiotics should not be used randomly.
“Major hospitals are now coming up with antibiotic policies, deriving a dual benefit from it. Not only do they give good correct medicines which work well on patients, but also avoid the risk of higher antibiotics, which are more expensive and come with the threat of developing drug resistance,” explained Davar.
The Indian government, commenting on the statement by WHO, said that it was a general one and cannot be seen as an endorsement of the study. “AMR is a matter of concern for India also. WHO has taken note of the study, but has said nothing about India. It is a general statement on prudent use of anti-biotics to which even we agree,” said Dr VM Katoch, the director general of Indian Council of Medical Research (ICMR). He added that India is not against the findings of the study per say but against the singling out India for the problem. “When the paper had no scientific evidence against India, then why link it to this country?” Katoch said.
Based on the Lancet study, which had linked the spread of Superbug from India and other south Asian countries through medical tourism — especially from patients who underwent plastic surgery — WHO has strongly recommended that governments focus control and prevention efforts in rational antibiotic use, including education of healthcare workers and the public in the appropriate use of antibiotics; introducing or enforcing legislation related to stopping the selling of antibiotics without prescription; and strict adherence to infection prevention and control measures, including the use of hand-washing measures, particularly in healthcare facilities.
(With inputs from Deepa Suryanarayan)
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