NDM-1 Symptoms

NDM-1 is the gene responsible for the newest superbug. NDM-1 genes can live inside different bacteria and is resistant to currently available antibiotics.http://omniphysicians.com/2010/08/10/ndm-1-a-new-global-threat/ NDM-1 stands for New Delhi metallo-beta-lactamase-1.http://news.yahoo.com/s/afp/20100811/wl_uk_afp/healthdiseasebacteriaantibioticstravelindiapakistan NDM-1 symptoms are reported to be associated with the bacteria it attaches to. The currently known bacterias hosting this gene are E.Coli and Klebsiella pneumoniae. The majority of the patients treated to date who are positive for NDM-1 were those with urinary tract infections, bacteremia, or pneumonia.http://www.medpagetoday.com/InfectiousDisease/PublicHealth/21636

Although only 50 cases have been noted in the United Kingdom, it is feared the spread will be global as the superbug has been associated with travel to India and Pakistan. Many travel to these counties for tourism as well as for low cost cosmetic procedures.http://omniphysicians.com/2010/08/10/ndm-1-a-new-global-threat/ In the U.S. none of the three known cases of NDM-1 bacteria were associated with the medical cosmetic travel seen in the UK.http://www.webmd.com/news/20100810/extremely-drug-resistant-infections-spreading-fast?page=2

There is a fear that the NDM-1 could jump to even more bacteria that are already resistant to even more antibiotics, making the NDM-1 affected bacteria impossible to kill by known methods. Drug resistance is transferred from one bacteria to another by plasmids, genetic material that move from one organism to another and reproduces, passing along the resistance. The NDM-1 is resistant to the number one antibiotic used for hard to treat infections and emergencies, the Carbapenems. The key aspects of containment by the Health Protection Agency include isolation of the sources and increased screening.http://www.hpa.org.uk/hpr/archives/2009/news2609.htm

A new study of NDM-1 by Dr David Livermore, director of antibiotic resistance monitoring at HPA, notes that the NDM-1 gene is wide spread in India.http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2010PressReleases/100811resistance/ The researchers noted that the popular press in the UK has made calls to the population to have corrective surgery done in India to decrease costs; however, doing this may be both life threatening as well as increasing costs in the long run. As a result of this study Dr. Livermore sees the NDM-1 gene as a potential worldwide health threat.http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2810%2970143-2/abstract He also recommends a coordinated international surveillance.http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2810%2970143-2/abstract

The Department of Health in the UK, on the advice of the Health Protection Agency, has issued a National Resistance Alert 3 notice. They recommend that microbiologists be suspicious of isolates with resistance or reduced susceptibility to carbapenems and suspect isolates should be sent to ARMRL for further investigation.http://www.hpa.org.uk/hpr/archives/2009/news0409.htm#enterora

British researchers face recently stated that a newly-identified gene mutation may be responsible for a new class of drug-resistant superbugs. According to ABC News, researchers say a group of plastic surgery patients who traveled from India or Pakistan back to Great Britain returned carrying bacteria which has an antibiotic-resistant "superbug gene" known as NDM-1. NDM-1 stands for New Delhi metallo-beta-lactamase. AFP quotes researchers as saying that a "new class of superbugs…could spread worldwide." The New York Times quotes experts calling the gene mutation "worrying" and "ominous."

One strain of bacteria linked to NDM-1 in the UK has been Klebsiella, a bacteria in the gut which contains the superbug NDM-1.http://www.harrowtimes.co.uk/news/8325541.Superbug_patient_treated_at_Harrow_hospital/Klebsiella pneumoniae symptoms include sudden onset, of high fever and hemoptysis (currant jelly sputum). Klebsiella pneumoniae is a common gram-negative bacteria seen worldwide. It is also known for causing urinary tract infections, nosocomial pneumonia, and intraabdominal infections.http://www.cdc.gov/ncidod/eid/vol8no2/01-0025.htm

NDM-1 which is found in the E. Coli bacteria may be the cause of the cases whch show symptoms of urinary tract infections. E. Coli is the leading cause of urinary tract infections outside of hospitals. Antibiotic-resistant E. Coli may also be responsible for cases of fatal pneumonia and other infections. http://www.cbc.ca/world/story/2010/08/11/uk-lancet-new-superbug.html#ixzz0wLzJOyYP

Doctors advise the best means of NDM-1 prevention is to provide adequate cleaning and sanitizing of all areas is the best means of preventing further spread of the superbug.http://www.youtube.com/watch?v=K1axIgJ1VC0 Those displaying NDM-1 symptoms should insure the areas they are in are sanitized to prevent spread to those around them. Hospitals and doctors are under advise to stay on top of the cleanliness issue.

After the St Mark's Hospital in Harrow, London announced that they had treated a NDM-1 positive patient , they stated they contained the infection by isolating the patient and then allowing only a single staff member per shift to treat the patient.http://www.dailymail.co.uk/health/article-1302432/Drug-resistant-NDM-1-superbug-London-Nottingham-hospitals.html?ITO=1490 The staff member had to wear a long sleeved disposable gown and gloves and when the patient was released the room was fumigated. No other cases were reported at that hospital.

Bacteremia means bacteria in the blood and may be associated with blood infections. Generally there are no symptoms until the amounts accumulate to the point of an infection in tissue or organs. Bacteremia is most dangerous to those with low immune systems.http://www.merck.com/mmhe/sec17/ch191/ch191b.html Bacteremia can lead to sepsis.http://www.medicinenet.com/sepsis/article.htm