Health experts across the country say report on antibiotic-resistant 'new Delhi superbug' in Lancet biased; similar bugs in 28 countries but only India tagged unsafe for medical tourism

Superbug report is humbug

Health experts across the country say report on antibiotic-resistant 'New Delhi superbug' in Lancet biased; similar bugs in 28 countries but only India tagged unsafe for medical tourism

Even as officials from the Ministry of Health and Family Welfare are busy fighting the claim made by an article in the Lancet Infectious Diseases about the emergence of an antibiotic-resistant superbug in Indian hospitals, medical researchers and senior doctors are not far behind.

At Sassoon, hospital deputy dean and seniormost microbiologist Dr Renu Bhardwaj is also preparing a defence for the Indian healthcare industry.

Though the international journal claims a metallo-beta-lactamese bacterium that has originated from Indian hospitals makes patients unresponsive to most antibiotics and is so dangerous that patients should not travel to India for treatment, Bhardwaj and her team have put together a list of 28 countries where similar bacteria have been discovered in the past few years.u00a0 She says these countries should be equally dangerous to go to if the same yardstick is applied.

Double standards
While the bug that the journal claims originated in India has been named New Delhi metallo-beta-lactamase-1 (NDM-1), in none of the other 28 cases has the bug been named after the country where it was traced first.

"Published data in the most renowned journals show that such metallo-beta-lactamase bacteria have been found in at least 28 countries, including Australia, Spain, South Korea, Japan, China, Greece and Brazil," said Bhardwaj. "But we haven't heard of a Sydney superbug or a Tokyo superbug. Why, then, the New Delhi superbug? The bias is clear."

She added that that Australia had isolated organism K pneumoniae and E coli- IMP-4 enzyme. These organisms were isolated in 2002 and reported in the journal in 2004. In 2004, China reported organism C youngae, while in 2005 Spain, reported K pneumonia.

Dr Naresh Shetty, medical director of Bangalore's MS Ramaiah Hospital, hinted at a deliberate use of a place name in naming the bug to show the medical sector in the country in a bad light.

"The superbug should've been named after the person who discovered it. What I want to know is why there is no New York or Los Angeles superbug?" said Shetty. "There is an element of discrimination here. A broader terminology should be decided upon."

Dr B K Goyal, honorary dean and chief of cardiology at Bombay Hospital, asked how the West could be sure it was in New Delhi that the bug originated.

"This superbug thing is nonsense," said Goyal. "It is impossible to isolate a bug and hold a city or a country responsible for the same. In today's day and age of travel, the world is one global village, so how are the researchers convinced that the bug originated in New Delhi? There are resistant bugs in every country."

Bias against India
Though the nomenclature of the bug is under debate, a hotter argument is over the advisory to medical tourists to avoid India for treatment. Doctors argue that chances of catching a similar infection exist all over the world as similar superbugs have been identified elsewhere too.

"Even after these countries reported similar bacteria, no advisory was given to medical tourists of not travelling to these countries, then why now? And are the researchers of the study guaranteeing that if person doesn't come to India he will not get a similar infection in another country, because half the world has reported instances of a similar bug," said Dr Anju Kgal, co-ordinator, Hospital Infection Society, Pune forum.

Dr H Sudarshan Ballal, Medical Director of Manipal Hospital agreed.

"Certainly there is an angle of bias to it. Advising against travel to India is too much of discrimination. People in western countries have been affected by the superbug in large numbers but no one issued travel advisories then," said Ballal.

Thegovernment is also protesting against the bias. "This is irrational. We are also protesting against it. There is no link in the genetic mapping too. The bugs are independent and are present in the environment," said Dr V M Katoch, secretary of the Department of Health Research and director general of Indian Council of Medical Research.

(With inputs from Alisha Coelho in Mumbai, Astha Saxena in Delhi and Bindiya Carmeline Thomas in Bangalore)

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