With the New Delhi Metallobeta lactamase (NDM-1) gene, also known as the “superbug” gene, being capable of changing the genetic code of pathogens causing cholera and gastroenteritis, doctors will now have to look much more beyond uncontrollable loose motions and vomiting while treating their patients.
Doctors warn that cholera and gastroenteritis patients may suffer from infection of the blood, bone, kidney, lung and heart if the pathogens they carry have mutated, harbouring the NDM-1 gene. These infections are likely to turn more serious than the common symptoms of vomiting and diarrhoea.
“Forget about the common symptoms like loose motions and vomiting. Doctors will have to look beyond these symptoms for treating cholera and gastroenteritis patients. Since the NDM-1 (New Delhi Metallobeta lactamase) has been found in bacteria like Vibrio cholerae and Escherasia coli, these pathogens will become more powerful and can infect body organs like the kidney, lung and heart, besides bones and blood. Doctors will now have to treat these problems too,” said infectious diseases expert Suneetha Narreddy.
The report that the NDM-1 gene has been found across more than a dozen bacteria will not augur well for people infected by them. These pathogens will emerge more powerful and potent and will not respond to many antibiotics, including the most powerful ones called carbapenems.
“At present there are only two antibiotics that will fight the NDM-1 influenced superbugs. They respond to colistin/polymixin and tigecyclin. If the pathogens become resistant to these antibiotics too, we will have to search for newer medicines,” she warned.
Dr Aftab Ahmad, a senior physician, said it would be difficult in a clinical setting to find out whether the pathogen carries the NDM-1 gene. “First we have to rule out through culture tests whether the bacteria is resistant to common antibiotics. If it is resistant, then we will have to go in for more tests to determine whether the patient is affected by NDM-1 gene. But during the process, precious time is lost and the infection spreads to other areas,” he said.
Ironically, most hospitals in the country are ill-equipped to identify the presence or absence of the NDM-1 gene. Only a few high-end research laboratories have the facility. Water samples are collected by the municipal and public health authorities, who simply test them for the presence of certain bacteria, but do not test if the bacteria are also carrying the NDM-1 gene. This makes identification of the gene even more difficult.
“If the NDM-gene is really found in common bacteria, then one has to take extra precautionary measures like using good water filters, boiling water and sufficient dose of chlorination. The best way to fight superbugs is prevention,” he added.