The new super germ NDM-1

Resistant bacteria that no longer respond to antibiotics: The NDM-1 germ has also been detected in four patients in Germany.

(08/17/2010) Resistant bacteria are not really news. For a long time now, doctors have been concerned about the fact that entire strains of bacteria are developing resistance to antibiotics. But a new germ called NDM-1 is currently unsettling scientists and patients alike. The "super germ" introduced from Pakistan and India has already been diagnosed in Germany. The NDM-1 germ also does not seem to react to so-called reserve antibiotics of the carbapenems. This makes treatment of patients almost hopeless.

Medicine has known resistant bacteria for around 20 years.
Bacteria that become resistant to antibiotics are not really news. It has been observed for around 20 years that more and more germs are becoming resistant to antibiotics. Since then, clinics have had to deal with so-called methicillin-resistant Staphylococcus aureus (MRSA). Because resistant bacteria are very easy to grow. If, for example, patients do not take the required amount of the prescribed antibiotic medication until the end, resistance can develop from this. Inflationary use of the drugs also promotes antibiotic resistance.

Multi-resistant "super germ" NDM-1 also detected in Germany.
Now the multi-resistant "super germ" NDM-1 (New Delhi-Metallo-Beta-Lactamase) has also been detected in Germany for the first time. According to official information from the Robert Koch Institute, four people have already contracted the NDM-1 germ. Treatment with the reserve antibiotics of carbapenems also has no effect. It is an enzyme with which the bacteria can survive an attack by carbapenems. Accordingly, it is not a new microbe, but a gene that scientists have currently detected mainly in two germs - "Escherichia coli" and "Klebsiella pneumoniae". These two microbes settle in the human intestine or in the intestinal flora. In certain circumstances, these pathogens can trigger illnesses. The germ "Escherichia coli" mainly causes (cystitis) and "Klebsiella pneumoniae" can lead to pneumonia. This enzyme has already been found in many enterobacteria in India and Pakistan. It is easily transferred between bacteria in plasmids.

The special thing about the germ is that it exchanges parts of the genetic material with other bacterial strains and thus resistance to an antibiotic can migrate relatively easily to other bacteria. There is a risk that more and more bacteria will become resistant to medication. The problem should therefore not be taken lightly, as some scientists and medical doctors warn.

Where does the NDM-1 germ come from and how did it come about?
But where does the NDM-1 pathogen come from? For the first time, Swedish doctors discovered the pathogen in a patient in Sweden. The person concerned had just returned from a trip from India. In the meantime, it has emerged that NDM-1 is mainly distributed in India and Pakistan. In India, NDM-1 has been found in many enterobacteria. As more and more people travel to these countries, it can be assumed that the spread will also increase rapidly in Germany in the future.

Another peculiarity exists in Pakistan and India. The resistant bacteria are not only spread within clinics, but often also outside of hospitals from person to person. This is an important indicator that the bacteria are spreading more and more rapidly. Monitoring or containment is hardly possible anymore.

But how did it come to this? In Germany, antibiotics are too often prescribed too quickly before the body can activate its self-healing powers. Naturopathic experts, but also scientists, have long criticized the downright inflationary use of antibiotics. According to a study from 2008, too many antibiotics are prescribed in Germany and reserve antibiotics are used too often. But the situation in India and other countries is much more dramatic: In India, patients do not even need a prescription from a doctor to purchase antibiotics. As a result, people in India take the medication too often and too early. In addition, the drug is often not taken as directed and is therefore discontinued too early. This allows the bacteria to develop further and possibly develop resistance.

Spread of the pathogen all over the world.
In the past week we have already reported some cases of illness that have occurred in the UK. Most of the patients were previously in Asia, and many of the patients were in hospitals in the countries. In addition to Europe, other NDM-1 cases are also reported from countries such as Canada, the USA and Australia. A patient in Belgium died in July of this year as a result of a resistant germ infection. According to the Robert Koch Institute (RKI), four cases have officially become known in Germany.

Improper use of antibiotics often causes resistance of the germs.
The proliferation and spread of resistant bacteria shows how carelessly many people use medication. Many believe that one only has to swallow enough medication and everything will be fine. Alternative treatments are still rejected by many physicians and patients, although nature offers numerous treatment options. Many prefer to use antibiotics and give the body no chance of a self-healing effect of the immune system. Antibiotics are essential for many diseases. With just as many diseases, the use of antibiotics is completely exaggerated. The more antibiotics are swallowed, the more resistance is promoted.

No new antibiotic in sight.
A new antibiotic drug against the NDM-1 germ is not in sight. Because hardly anything has changed in this area in the last 10 years. The main reason for this is that the pharmaceutical companies have hardly invested in the research of new antibiotics because they simply cannot make enough money. While patients permanently take medication for Alzheimer's, high blood pressure, diabetes or other diseases, antibiotics are only taken for a while. This results in a lower profit for the pharmaceutical manufacturers. Wolfgang Wohlleben from the University of Tübingen also says this: "All large pharmaceutical companies have withdrawn from research."

According to the expert Wohlleben, research is therefore only carried out in scientific working groups and small pharmaceutical companies. Some of them have already developed new antibiotic agents, but it usually takes up to ten years before the agent appears on the pharmaceutical market. Wohlleben did not want to determine whether and how long it would actually take. Other researchers assume that it will take at least 10 to 20 years before an effective drug against the NDM-1 pathogen comes onto the market. (sb)

Also read:
Resistant bacteria spread
Resistant bacteria in German hospitals
Assessment portal for hospitals launched

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Video: नई दलल सपरबग NDM 1 क आतक Spread of Drug Resistant Superbug in Hospitals, Current Affairs 2018

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