India at the forefront of post anti biotic era
Antibiotics have made possible the enormous advancement in human life span. In India reckless, unwarranted and unregulated antibiotic use, combined with an almost complete lack of public sanitation, has led to a situation where a whole multitude of drug resistant bacteria have emerged the latest and most deadliest being the NDM-1 carrying bacteria that is resistant even to last line antibiotics, the carbapenems. Furthermore global travle has spread these resistant bacteria far and wide.

It is reported that in India 60,000 children including neonates die each year due to infections with antibiotic resistant bacteria.

The emergence of NDM-1 carrying bacteria in hospitals in India, Pakistan and UK was first reported in The lancet in 2010.

The indian government trashed this report as malicious and designed to hurt India's booming medical toursim industry.

Researchers at cardiff then with the help of british news channel , channel 4, collected drain/waste water from New Delhi and analysed them for bacteria containing the NDM-1 plasmid and found that the NDM-1 plasmid was not just confined to hospitals but was circulating in New Delhi's water supply system.

There was umbrage in the medical fraternity (ICMR) in india at the underhanded way of sample collection to which the authors replied that waste water is not part of the DGFT notification 27/2007 and did not require a permit for export. Since the discovery of NDM-1 plasmids Indian medical officials have consistently downplayed its importance or significance even as no significant data has appeared to second these veiws. Infact even the few in house studies point to the prevalence and virulence of the NDM-1 plasmid.

Ominously it appears that use of antibiotics by indians is now at a record high while internationally india's reputation as a low cost destination for medical tourism continues to get tarnished.

There can be no modern medicine without antibiotics given that almost all surgeries big or small depend on antibiotics for post operative infective control. The lack of regulation over antibiotic use, the lack of knowledge amonst physicians prescribing them, the excessive self medication and the lack of public sanitation (650 million lack access to flush toilets) have helped bring us to the doorsteps of the post antibiotic era with all of its risky implications for human healthcare

Attached Files
.pdf   Emergence of a new antibiotic resistance mechanism in India.pdf (Size: 253.65 KB / Downloads: 3)
.pdf   Antimicrobial infection.pdf (Size: 746.32 KB / Downloads: 1)
.pdf   Dissemination of NDM-1 positive.pdf (Size: 409.21 KB / Downloads: 2)
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The Wall Street Journal reports that India has "lost the war" against MDR superbugs in general and the NDM-1 carrying carbapenemase resistant bacteria in specific. The causes are the usual suspects

Quote:India has lost the war against the toughest forms of antibiotic resistance, largely because of poor sanitation, unregulated use of antibiotics and an absence of drug resistance monitoring, according to the man who discovered a type of drug resistance in bacteria in New Delhi.

Furthermore the author claims that efforts to gauge the extent of the problem met with complete non cooperation from the Indian medical community.

Quote:“We were banned from India and India had a massive clamp down on sending [biological] strains out,” Mr. Walsh said. “Indians were banned from working with me, or anybody in Europe the whole thing was a systematic campaign to control research into antibiotic resistance in India.”

It also appears that Pakistan is doing much more than India to alleviate the situation :

Quote:The scientist is now working on samples from Pakistan in order to study the impact of NDM-1 on bacteria. “In Pakistan the people want to work with us, and unlike India are completely transparent and open about their health problems,” he said.

He added that the countries had vastly different economic capabilities for tackling the problem of resistance. “Whilst Pakistan can’t do anything about it economically, India can… But it chooses to do nothing,” he said.
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