TUESDAY Sept. 14 (HealthDay News) -- A new antibiotic-resistant
germ that apparently has it origins in India has sickened a handful
of people in North America, with three of the cases reported in the
United States, health officials said Tuesday.
But the bacterium -- designated New Delhi metallo-beta-lactamase
NDM-1 -- is a close genetic cousin of another bacterium that's been
present in the United States for many years. Both germs produce an
enzyme that makes them resistant to a group of antibiotics called
carbapenems, which include drugs such as penicillin and
"NDM-1 is a newly recognized mechanism of resistance that allows certain bacteria to become resistant to certain antibiotics," said Dr. Alexander J. Kallen, a medical epidemiologist and outbreak response coordinator with the U.S. Centers for Disease Control and Prevention's Division of Healthcare Quality Promotion.
"Unfortunately, carbapenem resistance is not uncommon even in the United States," Kallen added. "We have our own homegrown version of NDM-1 that has been recognized for quite a few years."
In the United States, carbapenem-resistant bacteria --
designated carbapenem-resistant carbapenemase (KPC) -- are usually
transmitted in health-care facilities such as hospitals and nursing
homes, and are typically spread from patient to patient from
contaminated surfaces and hands, he said.
While none of the patients in the United States died from their
infections with the NDM-1 germ from India, people should be very
concerned about this new breed of germs that are showing resistance
to carbapenem antibiotics, Kallen said.
"What is new in NDM-1 is a new mechanism that produces a strain [of bacterium] that looks the same as KPC," Kallen said.
NDM-1 appears to have started in India and is now found in
countries such as Canada, Pakistan and some nations in Europe. Some
people have died from their infections, but Kallen couldn't say how
In the United States, three cases have been reported. They were
in Massachusetts, Illinois and California, Kallen said. None of the
U.S. patients died from their infections, he said.
While NDM-1 is new, carbapenem resistance has been increasing,
How dangerous NDM-1 will become isn't known, Kallen said. But
some studies have found the death rate from KPC [the North American
bacterium] to be as high as 40 percent, he said.
Most of the transmission of the NDM-1 (Indian) and the KPC
(North American) bacteria happen as infected people travel around
the world, Kallen added. "These people carry with them all their
antibiotic-resistant bacteria and that mechanism [travel] has been
recognized lots of times, including with NDM-1 and KPC," he
Kallen said routine testing can reveal bacteria resistance. "As
far as treating the patient or infection control, it doesn't matter
what the mechanism is -- they're all bad and they all need to be
controlled in the same way," he said.
Hospitals that identify cases of NDM-1 or KPC infection should
isolate the patient before treatment. Hospitals should also check
to see if other patients have had contact with infected
One of the most common ways that bacteria become resistant to
antibiotics is through the overuse of the drugs, Kallen noted.
Infectious diseases expert Dr. Marc Siegel, an associate
professor of medicine at New York University in New York City, said
that "the number of [NDM-1] cases is small, but what is concerning
about this is this is a new bacteria that is emerging because of a
genetic change that is causing a garden-variety bacteria to become
resistant to most antibiotics."
Antibiotic-resistant bacteria are emerging because of lack of
cleanliness and sterility in hospitals, too many antibiotics being
prescribed, and drug companies not developing new antibiotics
because they aren't profitable, Siegel said.
Dr. Pascal James Imperato, dean and distinguished service
professor at the School of Public Health at SUNY Downstate Medical
Center in New York City, explained: "Bacteria with this resistance
capability are most likely to pose a problem first in hospitals.
Some antibiotics are still effective against NDM-1. The first three
cases in the U.S. were successfully treated. It is difficult to
predict the future role of NDM-1 bacteria since they were only
first detected in December, 2009."
For more information on antibiotic resistance, visit the
U.S. Centers for Disease Control and
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