Fight against antibiotic resistance brings India to focus

Chand Wattal, who strongly objected to New Delhi assigned as name to a gene that confers resistance to bacteria, discusses the latest findings

By Vibha Varshney
Last Updated: Wednesday 30 January 2019

The genes that help bacteria make the enzyme New Delhi metallo-beta-lactamase 1 (NDM-1), has now beenreportedly found in microbes in Arctic’s Svalbard region. This gene confers resistance to the bacteria against antibiotics.

The gene was first isolated in 2008 from a Swedish patient who had travelled to India, and was in news mainly because it gave  “New Delhi” a bad name since such antibiotic resistance conferring genes have been isolated from across the world earlier.

In 2010, Chand Wattal, chairman of the department of clinical microbiology and immunology at Sir Ganga Ram Hospital, had strongly objected to this name. Wattal talks to Down to Earth about the implications of the latest findings.

Q) What is the significance of finding this gene in the Arctic?

For one, the find suggests that evolution of organisms in nature is a continuous process and antibiotics are naturally present in nature. It’s produced by various fungi so organisms continue to face challenges in nature and acquire newer mechanisms of resistance. This also suggests that the movement of organisms to the farthest corners of land has become easier due to considerable mobility of humans who can carry the bugs with them and shed them as asymptomatic carriers. Further, the finding shows that migratory birds, that touch habitations across the world as per their cycle are not immune to the ecological disaster created by humans by way of drug resistance. The study also indicates that there are multiple mechanisms of resistance in a single bacteria. Such bugs with multiple mechanisms are multi-drug-resistant (MDR) and difficult to treat.

Q) Since 2008, when the gene was named, where else has it been reported from?

It was, in the first place, unfair to name it after our city and within months since the new mechanism of antibiotic resistance was detected in Indian isolate, other countries started finding it. It was a matter of chance that it was detected in an Indian state isolate first. However, we have to agree that the use and abuse of antibiotics is greater in Asia pacific region, and hence, chances of it appearing in this region were higher. The population burden also is unmatched compared to the West. The gene has now been reported from Pakistan, United Kingdom, United States, Canada and Japan.

Q) What can be done now to control the spread of this gene?

We need to follow infection control practices in letter and spirit. Every healthcare facility needs to have an antimicrobial stewardship programme in place with an antibiotic release team. We need to implement the existing law which bans over the counter and without prescription sale of antibiotics. Use of antibiotics for non-human purposes should especially be considered a crime.

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