BOSTON | An infectious-disease nightmare is unfolding: A new gene that can turn many types of bacteria into superbugs resistant to nearly all antibiotics has sickened people in three states and is popping up all over the world, health officials reported Monday.
The U.S. cases and two others in Canada all involve people who recently received medical care in India, where the problem is widespread. A British medical journal revealed the risk last month in an article describing dozens of cases in Britain in people who had gone to India for medical procedures.
How many deaths the gene may have caused is unknown; there is no central tracking of such cases. So far, the gene has been found mostly in bacteria that cause gut or urinary infections.
Scientists have long feared this — a very adaptable gene that hitches onto many types of common germs and confers broad drug resistance.
“It’s a great concern” because drug resistance has been rising and few new antibiotics are in development, said Dr. M. Lindsay Grayson, director of infectious diseases at the University of Melbourne in Australia. “It’s just a matter of time” until the gene spreads more widely person to person, he said.
Dr. Grayson heads an American Society for Microbiology conference in Boston, which was buzzing with reports of the gene, called NDM-1 and named for New Delhi.
The U.S. cases occurred this year in people from California, Massachusetts and Illinois, said Brandi Limbago, a lab chief at the Centers for Disease Control and Prevention. Three types of bacteria were involved, and three different mechanisms let the gene become part of them.
“We want physicians to look for it,” especially in patients who have traveled recently to India or Pakistan, she said.
What can people do?
Don’t add to the drug-resistance problem, specialists say. Don’t pressure your doctors for antibiotics if they say they aren’t needed; use the ones you are given properly; and try to avoid infections by washing your hands.
The gene can spread hand to mouth, which makes good hygiene very important.
It’s also why health officials are so concerned about where the threat is coming from, said Dr. Patrice Nordmann, a microbiology professor at South-Paris Medical School. India is an overpopulated country that overuses antibiotics and has widespread diarrheal disease and many people without clean water.
“The ingredients are there” for widespread transmission, he said. “It’s going to spread by plane all over the world.”
The U.S. patients were not related. The California woman needed hospital care after being in a car accident in India. The Illinois man had pre-existing medical problems and a urinary catheter and is thought to have contracted an infection with the gene while traveling in India. The case from Massachusetts involved a woman from India who had surgery and chemotherapy for cancer there and then traveled to the U.S.
Lab tests showed their germs were not killed by the types of drugs normally used to treat drug-resistant infections, including “the last-resort class of antibiotics that physicians go to,” Miss Limbago said.
She said she did not know how the three patients were treated, but all survived.
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