Thursday, August 26, 2010

Superbug -New Delhi Metallo Beta lactamase -1 (NDM 1)

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                                                 Superbug NDM 1
Origin

The first recognized victim of Superbug NDM 1 in 2008, Swedish person, was also a medical tourist to India. This claim led to the conclusion of deriving the nomenclature of New Delhi Metallo-beta-lactamase 1 (NDM 1) from India's capital New Delhi. As the United Kingdom health researchers claimed, 9 out of these 19 patients were had undergone medical treatment or dialysis in India or Pakistan at some point of time.

What is NDM-1?

Superbugs are normal bacteria that have mutated so that regular antibiotics used to treat them are no longer effective. New Delhi metallo-beta-lactamase 1 (NDM-1) superbug is nothing but a resistant strain of Enterobacteriaceae which includes bacteria like E.coli, Klebsiella, Morganella morganii etc. The resistant strain of Enterobacteriaceae New Delhi Metallo 1 superbug is potentially dangerous. Health hazard of NDM 1 superbug is severe due to the fact that it is resistant against all commonly used antibiotics and the reason of resistance of NDM 1 superbug is the presence of a gene (protein) New Delhi metallo-beta-lactamase 1 (NDM-1) which hydrolyzes carbapenem and inactivate them.

Reasons for emergence of NDM-1
Indiscriminate use of antibiotics is the major reason behind this, The indiscriminate use of Carbapenem in major ICU and critical care unit cases, burns and other severe infection lead to carbapenem resistance.

Symptoms
Bacteremia, Hemoptysis,Pneumonia,Skin Infections,cough, urinary tract infection, fever,E.Coli and Klebsiella bacterial infection. Patient may undergo in endotoxic shock in severe infection.

Detection

The detection of New Delhi metallo-beta-lactamase 1 (NDM-1) is usually done by Modified Hodge test. polymerase chain reaction (PCR) is required to detect New Delhi metallo-beta-lactamase-1 incase the minimum inhibition concentration (MIC) of NDM 1 is below the breakpoint.

Treatment

As it is resistant to almost all drugs yet few antiobics like combination of antibiotics ,Colistin and Tigecycline has been used to treat.

Prevention

Avoiding indiscriminate and irrational use of antibiotics and also stop prescription free sale of antibiotics.

careful selection of antibiotics in each clinical condition drastically reduces the chance of emergence of antibiotic resistance.

promoting hand wash,Proper sanitation and stringent infection control, superbug infection is maximum spread via patients on ventilation, thus proper sanitation of ICU, proper disposal of hospital wastes can be helpful in controlling infection.

Isolating patients found to be have the superbug Metallo-1, and maintaining hygiene in hospitals will stop spreading.


NDM spreads by air(through patients cough or sneeze), contact (like handshaking), Poor sanitation etc..